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In the February issue of Obstetrics & Gynecology, researchers present data that suggest infant formula information brochures, formula samples and business reply cards for free formula could discourage women from breast-feeding.

The author, Dr. Cynthia Howard, and colleagues from the University of Rochester School of Medicine in New York and the St. Louis School of Public Health in Missouri recommend that advertisements for infant formulas should therefore be eliminated from doctors’ offices, prenatal clinics and hospitals in an effort to increase the percentage of mothers who breast-feed.

Currently only about 59 percent of women in the United States breast-feed their babies as soon as they are born. By age 6 months, only 22 percent of babies are being breast-fed. These figures fall far short of the “ideal” set by the American Academy of Pediatrics and U.S. national health goals set for the year 2000. The national health goals included the hope that 75 percent of new mothers would breast-feed and 56 percent would breast-feed for six months.

But is limiting infant formula ads the best way to help women make an informed choice about how to feed their newborn? In reflecting on this question, two observations are particularly relevant:

First, breast-feeding is considered the preferred mode of feeding for all infants, except in rare instances where either the mother or the infant has a medical problem that makes breast-feeding inadvisable. Breast-fed babies have fewer infectious illnesses, such as respiratory inflections and infectious diarrhea, than do bottle-fed babies. This has been demonstrated both in developing societies and in technologically advanced countries, such as the United States and Canada. A breast-fed baby’s protection against infectious diseases starts during his or her first days of life. There is also some evidence that breast-fed babies may have an easier time adjusting to new foods later in infancy.

Second, deciding to breast-feed or bottle-feed is a personal matter for each new mother and her family. While breast-feeding has an edge over bottle-feeding in terms of medical advantages, those advantages are not so overwhelming that women who choose not to breast-feed should feel guilty. No studies have pointed to long-term health risks or disadvantages for bottle-fed babies.

Indeed, it is a good idea for prospective parents to learn about both feeding methods, so they can make an informed choice. Feeding is just one of the many aspects of an infant’s early life experience. To attribute too much importance to any one aspect of a baby’s life is not only scientifically unwarranted, but it may also create anxieties in some parents that, in turn, prove detrimental to their interaction with their infants.

The reality is that many new mothers, perhaps for reasons related to their work schedule, choose not to breast-feed. And for them, there are excellent alternatives in the form of commercial infant formula — generally nonfat cow’s milk that is substantially modified both to meet an infant’s unique nutritional needs and to make the milk more digestible. There are also special formulas based on soy protein or protein hydrolysates for infants who cannot tolerate cow’s milk-based formula.

The key factor in a new mother’s decision to breast-feed or bottle-feed her baby is information. Her decision should be an informed one, which means she should understand the benefits of breast-feeding — and be aware of the alternatives should, for whatever reason, she choose not to breast-feed. The proposal to restrict prospective and new mothers’ exposure to ads or information about infant formula seems to have as its premise that breast-feeding is the only “right” decision and that infant formula ads are “bad” because they lure women away from that decision.

The reality is that no one option is right for all women. Infant formula education, as well as facts about breast-feeding, is what will allow the new mother to make a truly informed decision.

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