Helping Themselves: Breastfeeding Advice Nestle-Style

This is a guest post by Erin, a breastfeeding counselor who teaches women how to succeed at breastfeeding. This post is a reflection of her opinion on Nestle's breastfeeding advice. Read what follows and decide for yourself what the company's true intentions are.

Why would the world's largest infant formula company want to help mothers breastfeed? Huge spoiler ahead. Ready? They don't. Yes, Nestle runs a glossy US website called the Start Healthy Stay Healthy Resource Center which claims that it gives expert advice about infant nutrition. Yes, the website's informational section on breastfeeding is actually larger than the corresponding section on formula feeding. And yes, of course, some of the advice is accurate. It has to be. If they gave nothing but blatantly bogus information that would look pretty bad and a certain level of credibility is essential. Instead, the advice is misleading and manipulative in subtle ways. The "why" part should go without saying; if they can turn a mother who plans to breastfeed (as the majority do these days) into a mother who feeds her baby Good Start, they have just earned thousands of dollars. Switzerland is not in fact neutral.

Confident commitment before initiation is important to breastfeeding success. If a mother's desire to nurse her baby, her trust in the process, or her confidence in her own abilities can be eroded then that is a win for Big Formula. Take a look at the pages that follow and you will see that those are precisely the types of subliminal messages (breastfeeding is difficult, painful, icky, and unnecessary) in Nestle's breastfeeding information. I have provided screen captures after the links for readers outside the US who may not be able to access the website. (Clicking the photos again will make them large enough to read, by the way.)

• Breastfeeding accessories (screen capture) This page is bound to get traffic since shopping for a new baby is perennially popular. According to Nestle, a nursing bra is "designed to let you inconspicuously open a cup to expose a breast for your baby." That's right-- if you want to breastfeed you're going to have to expose yourself to your child (who incidentally wants "easy access") while trying to hide the fact. Pervert! Anyway so, oh yeah, you wanted something to put on your gift registry? How about some special (read: weird) nursing clothes. More "oversize shirts with buttons down the front" are going to sound awesome to women who have been stuck in maternity clothes for months.

• Nutritious choices for breastfeeding moms (screen capture) Wait, what, you thought you were going to be able to eat? Make sure that pasta is "lightly sauced" and have some more vegetables with your vegetables. This reinforces the myth that a mother has to be really careful about what she eats while breastfeeding, which in turn makes nursing seem like an ideal that is probably unattainable for the average mother. Sure it's a great idea for everyone to eat healthier, including nursing mothers, but this page is conspicuously lacking one important fact: what a mother eats usually has zero effect on the quality of her milk.

• Feeding on the road: safe and simple (screen capture) This page is supposed to describe how to feed your baby on the go. Hmmm...something is missing...can't quite put my finger on it. Hey, wait, aren't we still in the breastfeeding section?

• Breastfeeding problems and solutions (screen capture, screen capture) There is no mention of colostrum in the section titled "Understanding your lactating breasts." From reading that someone might think that it could be up to 6 days before there is anything for the baby to eat. And how about the description of the milk coming in? Pain in the mother's breasts and the baby having a hard time latching are emphasized. Then in case you missed the part about the pain they've got "chapped or tender nipples" next in bold. The information given on how to deal with that is flat-out wrong; "lanolin-free moisturizing balms" are not recommended and hydrogel patches are controversial. Next up is "inflamed milk ducts." Huh? I think they mean "blocked ducts" there. If they were a bigger, richer, more powerful company maybe they could Google the proper term. Or, maybe "inflamed" sounds more painful. To "feed a baby right," Nestle then tells you, it necessary to make sure your nipple is "covered almost completely by the baby's mouth, with her tongue on the underside of your nipple." Poorly written, details and phrasing chosen for creep-factor, and last but not least totally wrong. If your baby doesn't have the entire nipple far back in her mouth, as well as a good portion of areola, you are going to have some serious pain as well as a baby who cannot get milk from your breasts. In closing, they advise that you should "pay attention to your milk supply" and that fatigue can reduce it. That's okay though because no new mom is fatigued, right?

• Solve breastfeeding dilemmas (screen capture, screen capture) You supposedly learned how to solve breastfeeding problems so now you can move on to the dilemmas. Nipple confusion, they say, happens because the bottle is "easier" for the baby and apparently can be avoided by not giving bottles "during the first week." Then a few sentences later it says to wait three weeks. Oh hell, it sounds like one week is probaby good enough, right? The sooner the better since this breastfeeding stuff is so garbled and confusing. For latch on problems, make sure your baby is taking in "approximately one inch from the tip of your nipple." Which is unlikely to be a deep enough latch and certainly won't solve any existing problem.

• When your baby loses interest in breastfeeding (screen capture) Even if your baby is only 3 months old, a nursing strike might mean that "she's ready to give up nursing." No, wrong answer, but it plays right into the hope that just a little bit of breastfeeding is enough (surely if baby herself is ready to stop there is no harm) and transforms normal occurences like temporary disinterest into pseudo-self weaning.

• Why breastfeeding is best (screen capture) By this time maybe the resolve to breastfeed is beginning to waver. Why would anyone undertake such a confusing, embarassing, inconvenient sacrifice? Surely reading about why breastfeeding is "best" will affirm that choice. Well, it says here that breastmilk "contains the perfect balance of nutrients including DHA & ARA." It is also "naturally gentle on baby's developing digestive system." Furthermore it "contains antibodies to help protect your baby from illness." That sounds kind of good. But the language sort of rings a bell. Let's check the description of Nestle Good Start Protect Plus. (screen capture, screen capture) This stuff has "complete nutrition," "DHA & ARA for baby's brain and eye development," is "easy to digest" and it "supports baby's healthy immune system." Wow that's almost exactly the same! (Except, of course, it isn't. Not even close.)

Have you come to your senses yet, new mothers? If so, then it's time to either start supplementing your breastmilk (screen shot) or you might want to just go ahead and transition to formula (screen shot). Nestle treats these two situations as different events even though they usually aren't. There is no mention of milk supply dropping when supplements are introduced. Any doubts you might have about whether or not this is the right thing to do should be soothed by the assurance that formula could be a "nourishing, nurturing choice for your baby" as well as the helpful transitioning chart, where formula feedings are represented by cute little red hearts that multiply and breastfeedings are the faded blue dots getting nudged off the edge.

You may have noticed that in multiple places these marketing materials (we can stop playing along by calling them breastfeeding information) carry disclaimers. This is one crops up frequently: "Breastmilk is the ideal food for babies. Talk with your doctor about your feeding choices." For an explanation of why "ideal" is a description of human milk that is ineffective in terms of breastfeeding promotion, check out this classic piece by Diane Weissinger called Watch Your Language. As for the second part about looking to your doctor for guidance, although many health organizations worldwide have very strongly worded recommendations to breastfeed, unfortunately doctors in America don't necessarily recommend it to their patients. In fact, according to the American Academy of Pediatrics, "Obstacles to initiation and continuation of breastfeeding include...lack of encouragement and guidance from health care professionals." The disclaimer is probably there at least in part for legal purposes; the company needs to avoid looking as if it is giving out medical advice. But really why wouldn't Nestle spam this disclaimer all over the place anyway? It makes them look more honest and credible while risking little or nothing. Maybe even gaining.

There is, however, a disclaimer on the site that they probably benefit less from. Not coincidentally it is a little more difficult to find. After trumpeting all over the website that breastmilk has DHA and ARA but so does formula, they quietly admit in the fine print at the bottom of this page that "studies to date have not established brain and eye development like breastmilk based on the levels of DHA and ARA added to infant formula." Surprisingly, US FDA regulations do not require novel ingredients like these new oils (which are chemically extracted from algae, by the way) to prove their usefulness before being added to an infant formula. If formula companies wanted to, they could throw some blue food coloring into their recipe. Why not. It's a food product that has "GRAS" (generally recognized as safe) status according to the government. That might be a good idea actually; since human milk often has a slightly blue hue, this new and improved formula could then be marketed as "closer than ever to breastmilk." If you think that's way over the top, read this document from the California WIC Association about the lengths that formula manufacturers will go to increase their profits, and also this report from the Cornucopia Institute, a food safety watchdog group.

So, should Nestle revise the faux "breastfeeding advice" given on their website? Should they post links to La Leche League International instead? Or should they remove all mention of breastfeeding and just stick to formula? No. None of those options would be the ethically and morally correct course of action for the company to take. They should delete the entire website. All advertising or promotion of infant formula to the general public is forbidden by the International Code for the Marketing of Breastmilk Substitutes (Article 5.1) and furthermore marketing personnel are not permitted to seek contact of any kind with pregnant women or mothers of young children (Article 5.5.) Within the gigantic and blatant violation that is the "Start Healthy Stay Healthy Resource Center" are many more transgressions, such as idealizing artificial feeding (Article 4.2.) Essentially the company breaks every rule that it possibly can ands get away with it because in the United States there are no legal repercussions for doing it.

If any of this makes you angry, and you live in the US, take action. One quick and easy thing you can do is to file a complaint with the FTC online. Companies aren't supposed to advertise in a way that is false and deceptive. If anyone comes away from that website thinking that any formula is similar to breastmilk then they have been misled. Each time the advertisement is seen it's a separate violation, so go ahead and bookmark that page. The next thing you can do is to contact Congress. Tell your state Representatives and Senators that you want the Code put into law, in its entirety, so that companies are forced to start honoring it. You may also want to consider joining the Nestle boycott. Speaking to the company in the language they understand, in other words money, is probably the best hope outside legislation for creating change. Finally, perhaps the most important thing we can do is to spread the truth about infant feeding and to reach out and help other mothers whenever possible. Propaganda like we've just seen can only be taken seriously enough to do harm in a world where a motley mixture of myth, advertising copy and wishful thinking is routinely allowed to pass as fact.

Note from Annie (PhD in Parenting): If you are in Canada, you may wish to read up on Misleading Representations and Deceptive Marketing Practices and consider filing a complaint with the Competition Bureau.

Erin (@Artemnesia) is a breastfeeding counselor from central Massachusetts.  When she isn't busy kissing boo-boos and nursing in public, she may be found playing no-limit Texas hold'em online. She isn't a blogger yet, but is thinking of it...would you all give her some encouragement?

Comments

[phdinparenting]

@coffeewithjulie: I agree that the "Breast is Best" message is very strong. I think the problem is that it is understood, yet not fully supported. Women are told to breastfeed, yet there are so many http://www.phdinparenting.com/2009/09/10/societal-barriers-to-breastfeeding/" rel="nofollow">societal barriers to breastfeeding. Many women who want to breastfeed end up turning to formula and then feeling like a failure. We need to break down those barriers so that women who want to breastfeed are able to do so successfully and do not receive messages from formula companies, health professionals, family members, friends, the media, their employer and colleagues, and the public at large that undermine their ability to breastfeed.

[phdinparenting]

@LeahGG: I agree. It isn't right to blame mothers. We should be attacking the things that prevent women from being able to breastfeed. Not attacking the women who cannot breastfeed.

[Kathy]

Well, it's Nestle, after all. Unethical practices around formula are kind of their stock in trade, no?

I would add, as another Australian, that the breast is best message is reinforced loud & clear throughout our health system, and hospitals generally offer good and accurate support to getting bf established. So much so that unfortunately I must agree with Julie and Leah above that mothers who are not bf get ostracised and stigmatised by nursing staff, which I think is also wong.

I had my husband bring in a tin of formula and some bottles for my poor roommate when I gave birth to my youngest -she'd had an emergency c-section, had intended to bf but it wasn't working AT ALL and she was expressing zero - nothing whatsoever - and her baby was screeeeeaming day and night. Nurses just pointblank refused to get her any bottles, and her own partner was away, no family support. She was in sobs, begging them to help her feed her bub and they wouldn't. It made me VERY cross. I even expressed a syringeful for her baby for one feed to get some colostrum into her (I had plenty, supply was never my problem) but obviously that wasn't a sustainable solution.

I have fed all three of my daughters and the public hospital I gave birth in (via caesarian, all three times) really helped me get started feeding and helped me over the humps of poor latch (firstborn) and deep breast thrush (secondborn). My firstborn breastfed until 16 months of age and self-weaned during my pregnancy; my secondborn weaned at 23 months, and number 3 girl is still feeding several times daily at 9 months. Only one of my children has ever had any formula, and that was the firstborn, who had 1 bottle a day 3 days a week from 9 to 15 months when I returned to work part-time. In hindsight, I wish I had not even done that; I was only away 7-8 hours on those three days, and I could have pumped a cup of my milk for her and she would've been fine with food and water otherwise. But hey!

I guess what I find puzzling in Australia is, given the ostensibly good support for bf, our bf rates are pretty low past 3 months. The norm seems to be for most women to have a go, but for people to wean to formula very quickly for a whole bunch of reasons. Maybe the social / marketing messages have a part to play here - I'm not sure.

[Nestle Answers: Can a formula]

[...] to Nestle’s Web help that was documented in my recent guest post by @Artemnesia called Helping Themselves: Breastfeeding Advice Nestle Style, which documented specifically a number of ways that Nestle tries to undermine a mother’s [...]

[geek anachronism]

There's a lot of social pressure too - in my mother's group (all first babies and between 3.5 to 5 months) I am the only one exclusively breastfeeding. Two formula fed from the start, the other five 'transitioned' because of everything from growth spurt issues to nipple trauma to pressure from other people. So you can imagine how wonderful it is for me, being the youngest, the only one exclusively breastfeeding, the only one co-sleeping and the only one who isn't talking about upgrading my house/car/pram. The last meeting turned into a formula ad at one point - it's so much easier apparently. And the little ones only throw up four times an hour and are a little constipated when you get the right brand.

I'm lucky - I'm highly educated, pretty damn ornery and not much for socialising. I also have a lot of support for breastfeeding from my family. If I didn't and my only touchstones for children my age were the women in my mother's group? I'd have thought the four month growth spurt meant my daughter was starving. I would have assumed that the drop in what I was expressing meant she wasn't getting enough. I would have believed that I need to give her bottles of water now it's getting hot. I would have believed that weaning would mean my breasts would stay perky and big (even though they're already big and saggy). I would have believed that weaning would be better for my health. I would have believed that weaning would mean I could go out. I would have believed that weaning would stop the mastitis. Because these are women like me, right? They know what they're talking about, they lived it, right?

[banthebags.org » Can a f]

[...] and promotes artificial breastmilk substitutes, as Erin explains beautifully in her guest blog, Helping Themselves: Breastfeeding Advice Nestle-Style. SHARETHIS.addEntry({ title:"Can a formula company give good breastfeeding advice?", [...]

[coffeewithjulie]

Kathy - Thanks for sharing your experience in Australia. I have birthed one baby in Canada and one in Australia. Overall, I found that my public health care experience in Australia was excellent -- the use of mid-wives as standard practice, the at-home support, the baby wellness clinics in every neighbourhood, and the availability of specialists as needed.

However, during the post-delivery days in hospital, some improvements seem necessary. Although we wouldn't want the public system to encourage formula use, it seems inhumane -- just plain cruel -- not to help someone like your roommate. I only got through because I had a proactive, assertive husband who insisted that the nursing staff show him how to properly sterilize a bottle, make formula and store it safely. When I was able to get out of bed, he then taught me how to do it. My roommate in
in the Australian hospital was a heavy smoker, and again, although we don't want to have a public hospital encouraging smoking, it seems some kind of reality check is necessary because people do smoke. When she would leave to go and have a cigarette, she needed to go down 3 floors and across the street, so it was not a quick process. Yet, there is no nursery and the nurses will not watch your baby so you can have a smoke So, what did she do? Well, she left an underweight new-born baby on her own periodically throughout the day and night.

On the flip side, I exclusively nursed my daughter after her birth in a Canadian hospital and was sent home with a bag full of "goodies" that included the standard fare of diaper coupons and whatnot but also promotional materials for formula. I don't think public institutions should be giving out these "goody bags" at all -- regardless of contents. I would be annoyed if my child's public school sent home corporate crap too. These are public institutions, they should not be passively assisting in corporate campaigning.

[natalieushka]

Julie, that is so interesting. I had my son at the (public, obviously) hospital here in Victoria, BC, which is an accredited Baby Friendly hospital. There was zero discussion of formula, even when he was not latching properly and a touch dehydrated (the nurse showed me how to manually express and feed it to him with a finger, to get him enough calories so that we could keep working on BFing). It is clear to me from this discussion that the variation in practice among hospitals and care providers is a real point of potential change if we're going to encourage and support breastfeeding.

In my town, there is more embarrassment and shame in buying formula than there is in showing your breasts in public to feed your baby. I have been using a mixture of pumped breastmilk and formula to supplement for a few weeks now and every time I buy formula at the grocery store I feel like I almost have to hide it with my other purchases just in case I run into someone I know. And that is a shame.

[phdinparenting]

@coffeewithjulie: Was your goodie bag from the hospital? Or from an organization operating in the hospital? I got a goodie bag in the hospital too, but I think it was from the Welcome Wagon.

[coffeewithjulie]

phdinparenting - Hmmm ... good question. It was seven years ago and I just can't remember who actually gave us that "goody bag." I don't know why Welcome Wagon folks should be allowed access to women in the hospital though -- they're a business, just like any other. Why should they get priviledged access to hospital patients? (From the Welcome Wagon website: "Serving the advertising needs of reputable businesses that can assist people with the changes they are experiencing.")

[phdinparenting]

@coffeewithjulie: Not sure how they get access. But I know that my goodie bag was from them and that it did contain samples and coupons from formula companies.

[coffeewithjulie]

natalieushka -- I don't know if it was real or imagined, but I admit that I did feel like I was being judged when I fed my baby with formula out in public. I agree that with you that it would have been much easier to nurse in public (although this type of social judgement changes after a baby looks over a certain age).

[coffeewithjulie]

I think it's wrong, and downright unethical that they get access. Imagine a company getting access to your children in school and giving them "goodie bags" of Coke coupons, samples of Cheerios, and free stickers with Lego logos on them. We'd be outraged (well, okay, I would at least). Not necessarily by the product in and of itself, but the priviledged access in a public institution. It's not that I'm against advertising, PR, marketing -- I'm all for it actually -- but not in my hospital room, uninvited.

Hmmm ... my friend just had a baby in an Ottawa-area hospital. I'm going to find out if these goodie bags are still the norm (and what's inside).

[phdinparenting]

@coffeewithjulie: I agree that it is outrageous. I did ask someone recently to tell me if she got a visit from the Welcome Wagon and a goodie bag and she said no. I also didn't get one with my second child (born in 2007), although I did with my first (born in 2004).

[On the new National Breastfeed]

[...] providers and family, outright harm to the breastfeeding relationship and ’simple’ misinformation. Breastfeeding isn’t simple and easy for everyone, but that isn’t a reason to give up. [...]

[coffeewithjulie]

BTW - I did send an email inquiry to Welcome Wagon asking if they visit new mothers in hospitals. Never got a response.

[Helping Themselves: Breastfeed]

[...] Comment! Originally published November 4th 2009 as a guest blog for Phd In Parenting. [...]

[I'm a Full Time Mummy]

Thanks for posting this! I am so glad to find this site. Hope you don't mind if I share this out on my blog so that my bloggy friends can read about this too!

[One Bottle Does Hurt]

[...] do yourself (and your baby) a favor, and DO NOT look for it on a formula website. They are full of traps. Call your local LLL Leader. Visit a lactation consultant. Talk to an experienced (and successful [...]

[More strange bedfellows: WebMD]

[...] I’m sure others can find plenty of other examples, but those are two I pulled from just looking at one article for less than five minutes. I didn’t even bother clicking through to the Gerber stuff, because I know how horrible Nestle’s breastfeeding advice is. [...]

[Breastfeeding guides that make]

[...] RSS feed for updates from my blog.Powered by WP Greet Box WordPress PluginI’ve told you about how bad Nestle’s breastfeeding advice is. I’ve looked into the conflict of interest in Babble offering a breastfeeding guide that is [...]

[Social media skirmishes in &#8]

[...] Nestle invited mommy bloggers (and some dads) to its U.S. headquarters to discuss parenting issues. Breastfeeding advocates went ballistic in social media, trying to convince influential bloggers not to attend and accusing [...]

[Varda]

My personal favorite was the fact that they kept reiterating that you will leak. Your leaky boobies will leak all over your clothes and bedding. So you need to wear nursing pads that come in different absorbancies (like tampons). Because it's a big, yucky mess that you have to wear nursing pads to avoid.

[My Breasts Need a Marketing Bu]

[...] and big box stores), I was horrified. The more I read, the angrier I became, particularly after I read this post about Gerber’s “breastfeeding advice” that really does more to scare women away [...]

[Jenny]

Fabulous Post Erin, Thanks for the Pdf

[Varda]

I am an educated, Internet proficient, well-read and well-connected upper middle class professional and did my own research. However, if I had not be brainwashed by my mother on the benefits of breastfeeding starting from the age of 10, I might have be derailed by the advice that my LACTATION CONSULTANT gave me.

[Are Breastfeeding Boobytraps R]

[...] [4] http://www.phdinparenting.com/2009/11/04/helping-themselves-breastfeeding-advice-nestle-style/ [...]

[Everybody Needs to Read This A]

[...] by Nestle. Here's a great article on how "helpful" Nestle is with breastfeeding advice: Helping Themselves: Breastfeeding Advice Nestle-Style __________________ S, mother to three great kids, Birth and Postpartum Doula Placenta [...]

[One Bottle Does Hurt (Instant]

[...] do yourself (and your baby) a favor, and DO NOT look for it on a formula website. They are full of traps. Call your local LLL Leader. Visit a lactation consultant. Talk to an experienced (and successful [...]

[You are not a failure… —]

[...] people or companies who gave you bad breastfeeding advice failed [...]

[My heart hurts… «]

[...] able to breastfeed doesn't make you a failure, but… …the people or companies who gave you bad breastfeeding advice failed you. …the companies that sent you unsolicited formula samples in the mail failed you. [...]