The milk of human kindness: Social welfare and breastfeeding policy in the United States

Breastfeeding is valuable and worth protecting, promoting, and supporting. Yet, social welfare in the United States does not take it into consideration.;Mother's milk nourishes perfectly; it is a miraculous substance. Formula is a poor substitute which causes short and long-term disability and infections, chronic diseases, plus other health effects for both mother and infant, including death. There are also troubling psychosocial consequences of formula use, including lower intelligence, poorer maternal-infant attachment, and possibly increased child abuse.;The excess costs associated with formula-feeding average ;Although rates of exclusive formula-feeding are falling, they are still at 30% overall. Aggressive marketing tactics by formula companies are likely to blame for even higher prevalence among low-income, less educated, and minority families.;State and federal bodies and laws protect breastfeeding. For example, breastfeeding is allowed on any Federal property a mother may be. Some states have laws which include a right to breastfeed anywhere, the right to take breaks at work to breastfeed or pump, and the right to breastfeed immediately at birth. More are needed.;Many policy areas could use improvement, such as in maternity hospitals, where formula marketing still takes place, and low maternal-newborn contact is still the norm. Medical and government policy should support family cosleeping and put an end to circumcision, both of which would increase breastfeeding success.;The American Academy of Pediatrics and other professional groups, some corporations, and ethicists have breastfeeding-supportive policies. But the National Association of Social Workers, and the National Association of Perinatal Social Workers, do not.;Child welfare and family support policies need to change to support breastfeeding. An analysis using CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) to determine whether the Temporary Assistance for Needy Families program (TANF) caused a rise in formula-feeding was inconclusive, but other evidence suggests that it did. Exemption from TANF work requirements should be granted for breastfeeding. This policy would reward healthy breastfeeding behavior in the mothers who most need our support and encouragement.