Baby formula 'should be prescribed'

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... a Melbourne doctor of midwifery has inflamed the emotional debate by calling for infant formula to be made available only by prescription.

Dr Jennifer James wants infant formula banned from supermarket shelves.

She says the move is not designed to make mothers feel guilty, but rather to help them by ensuring that they see health professionals when problems arise.

The World Health Organisation's message that breastfeeding is better for newborns has been made loud and clear.

But breastfeeding is not always easy or possible.

... Dr James says the majority of women want to breastfeed but she says many give up very early when they encounter problems like pain, lack of milk or when their baby fails to properly attach.

She says her plan to make formula available only by prescription will help mothers by forcing them to see a health professional when difficulties arise.

Seeing a health professional will not solve the issue. For example, the woman would most likely consult her GP in the first instance and most GPs do no have good knowledge of breastfeeding and support of breastfeeding. I can imagine scripts for formula being handed out willy nilly, simply because the GP does not have the knoeledge and skill to handle breastfeeding issues. Next is the issue of access: who should the woman turn to if she has issues overnight when there are no GPs open? The best person to consult would be a midwife or a lactation consultant, however without prescribing rights, formula could not be prescribed.

"It's about looking at ways of ensuring that women get the support and the education they need when they need it," she said.

Education is best done before the baby arrives. Most hospitals have breastfeeding classes for pregnant women; women can learn from other breastfeeding mothers via the Australian Breastfeeding Association and there are many books and articles on breastfeeding.

"Having to get some sort of prescription ... then the woman is sitting with a health professional who can go through her breastfeeding problems and set up a plan of action to help her achieve her goal of successfully breastfeeding her baby."

Ms James says it is important that women do their best to ensure they breastfeed their children.

"Artificial formulas have to meet food safety standards, but they are at best basic nutrition. They don't provide anywhere near what a mother's own breast milk can provide," she said.

"So they're a substandard product. We know that children that aren't breastfed exclusively for at least six months run, have higher incidences of chronic disease in the long term."

... While Dr James says her idea is designed to help women, the proposal has been fiercely attacked.

The editor of Practical Parenting Magazine, Mara Lee, says the proposal is outrageous and deplorable.

"What this move will do is further promote the notion that formula is poison and is not safe for infants and mothers shouldn't have access to it," she said.

I wouldn't go quite this far: it's no different to having other specialised foods available on prescription.

"What that does to mothers who are already struggling with guilt, with fatigue, with mastitis, with babies who simply aren't being sustained by breastfeeding is it's making them feel that they have no choice and locking them into a cycle of despair.

"That to me is pretty deplorable. I already see enough mums who are really struggling to make feeding work and I don't think we should be trying to make it harder."

The Australian Medical Association has also attacked Dr James's idea.

It says there are a significant number of mothers who simply cannot breastfeed and limiting their access to formula could increase their sense of failure and be psychologically damaging.

Melissa Maimann, Essential Birth Consulting 0400 418 448