Monday, July 30, 2012

Nanny State In Action: Bloomberg's Boobish Plan

New York City Mayor Mike Bloomberg continues proposing health-related plan after health related plan, regardless of their constitutionality (the sugared beverage plan) or smoking bans in public spaces (and restaurants, etc.). His latest idea is to ban giving new mothers formula as part of a plan to increase the number of mothers breast feeding.
Mayor Bloomberg is pushing hospitals to hide their baby formula behind locked doors so more new mothers will breast-feed.

Starting Sept. 3, the city will keep tabs on the number of bottles that participating hospitals stock and use — the most restrictive pro-breast-milk program in the nation.
Under the city Health Department’s voluntary Latch On NYC initiative, 27 of the city’s 40 hospitals have also agreed to give up swag bags sporting formula-company logos, toss out formula-branded tchotchkes like lanyards and mugs, and document a medical reason for every bottle that a newborn receives.

While breast-feeding activists applaud the move, bottle-feeding moms are bristling at the latest lactation lecture.

“If they put pressure on me, I would get annoyed,” said Lynn Sidnam, a Staten Island mother of two formula-fed girls, ages 4 months and 9 years. “It’s for me to choose.”
Under Latch On NYC, new mothers who want formula won’t be denied it, but hospitals will keep infant formula in out-of-the-way secure storerooms or in locked boxes like those used to dispense and track medications.

With each bottle a mother requests and receives, she’ll also get a talking-to. Staffers will explain why she should offer the breast instead.

“It’s the patient’s choice,” said Allison Walsh, of Beth Israel Medical Center. “But it’s our job to educate them on the best option.”
Doctors have long known of the benefits of breast feeding but it is ultimately up to the parents to decide. Many have already talked the matter over with their physicians, and are able to make an informed decision. Lactation specialists at hospitals are more than welcome to share their information on how to prepare expectant and new mothers on how to maximize their experience and how to best nurture their newborns.

But to knowingly make it more difficult for new mothers to obtain formula? That's just nuts. Not every new mother can and would have the opportunity to breast feed once they're out of the hospital. Some could have medical conditions that make it impossible. Others could have job situations that make breast feeding (or pumping) impractical or impossible. They've already given it thought and the notion that the Bloomberg, by and through his Health Department, can limit access to formula is most certainly an infringement on the patient's right to choose a course of treatment and what's best for them and their children.

In fact, his proposal could actually worsen the health of the mother - it could lead to further post-partum depression since mothers who have made the choice not to breast feed will be continually lectured each time they seek to bottle feed. It will spur a feeling of inadequacy:
For many women, breastfeeding is HARD, that's why there are lactation consultants who charge like $175/private visit or $35 for a 15-minute phone call after you leave the hospital. And when the breastfeeding isn't going well, it really makes the mom depressed. For some moms and babies, it's easy, for others, it's harder.
It is bureaucracy at its worst, and even worse, it is a waste of limited health care resources.

Time wasted each time on giving instructions about breast feeding over bottle feedings is time that could go to improving care in other more important facets. It would mean less time devoted to infection control and making sure health care instructions are followed upon discharge - those two issues are a massive problem for hospitals since it leads to unnecessary complications and quantifiable health care costs.

Bloomberg's nanny state ways continue to irritate and show no bounds. Many New Yorkers will likely be relieved when Bloomberg's term comes to a close.

If Bloomberg were truly seeking to improve health care and the lives of New Yorkers, he would be directing the Department to seek tighter regulation on infection control and discharge instructions at City-controlled/operated hospitals. Consumer Reports recently ranked hospitals based on quality of care issues, and many of the hospitals fared poorly (both city-run and privately operated facilities including nationally known ones such as NYU Medical Center for instance), precisely because of infection control and instruction issues that lead to readmissions. Making sure that hospitals improve in these areas would have a huge impact on public health.

The focus must be there; Bloomberg is addressing a non-issue and a non-starter.


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