#239 | The Cost of Breastfeeding Versus Formula Feeding with Dr. Rhonda Trust, PhD

A 2023 article from Yale News flashed across news outlets in the United States headlined:

"Yale researchers find that breastfeeding can cost over $11,000 a year. " The article goes on to say, "While the 2022 baby formula shortage in the United States sparked calls for an increase in support for breastfeeding nationwide, a group of researchers at the Yale School of Public Health and Yale School of Medicine sought to demonstrate how breastfeeding can impose significant financial burdens on families as well."

While there is no doubt breastfeeding is a major commitment and consumes a tremendous amount of time, there is also a significant cost of NOT breastfeeding, which failed to be discussed in the article.

In today's episode, we invited university professor and lactation expert, Dr. Rhonda Trust, PhD, to discuss the true costs of formula feeding versus breastfeeding. She explains that the Yale article misled the public and failed to name the protective health benefits for both mom and baby over a lifetime when breastfeeding is optimally supported, such as lower infant mortality and decreased risk of breast and ovarian cancer for mothers. Drawing from her prior experience as the Policy and Advocacy Chair for the Connecticut Breastfeeding Coalition, Rhonda also shares economic data from numerous research studies, demonstrating the direct cost savings are upwards of 14 billion dollars annually when 90% of babies are exclusively breastfed. 

Breastmilk is a free food source for every baby and saves infants' lives. While breastfeeding may not always be the right choice for every mother, breastmilk is the best choice for every baby. It is the job of public health officials and medical schools to share accurate and complete information regarding breastfeeding. In this episode, we discuss critical research that was either purposefully or unintentionally omitted from this article.

Yale News Article
No Such Thing as a Free Lunch: The Direct Marginal Costs of Breastfeeding
Suboptimal Breastfeeding in the United States: Maternal and Pediatric Health Outcomes and Cost
Rhonda Trust on Instagram
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Transcript

Dr. Rhonda Trust, PhD 
This said, which felt like dagger stabbing me as I read it, because I know the implications is has on the average reader found that breastfeeding a child can cost more than 11,000 a year, a significantly greater cost, then that of baby formula.

Trisha Ludwig 
But you cannot deny that breast milk is the best choice for every baby. It isn't always the best choice for every mom.

Cynthia Overgard 
Breastfeeding isn't supposed to be for the rich. And that's how they're making it sound. This is just another thing that catches the headlines. The next dinner conversation someone can hear oh, did you hear breastfeeding is actually more expensive than formula. Bear begins new rhetoric, because there are a lot of powerful bodies at play behind all of these publications. And they're not in the public's best interest. And when you hear about shaming, don't get manipulated by that either.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Dr. Rhonda Trust, PhD 
Hi, I'm Dr. Rhonda trust. I am a university professor I have a PhD, a doctorate in health communication from the University of Connecticut. For years during my doctoral work, I research breath, breastfeeding, and many aspects of breastfeeding looking at from a social scientific perspective why people decide to breastfeed behaviors around breastfeeding, public health, societal norms, workplace norms, social norms, and so on. I currently teach a research at the University of Miami, I'm full time at Palm Beach State. And part time also at FAU, which are in Boca. I'm also actively pursuing another degree in nutrition and dietetics. Because I'm very interested in food, human food. It's why breast milk is first human food and the importance that it does for obviously baby mother and society.

Cynthia Overgard 
So Rhonda, you and I have a long history together, along affectionate, wonderful history. Right? I first met you, I guess it was 16 years ago when you were newly pregnant with your first and you showed up to my HypnoBirthing class when I was a fairly new instructor. And you asked me if it's true that women really have orgasmic births, and you're grinning from ear to ear standing next to your husband looking forward to your orgasmic birth. And I always tell women that they bring a piece of themselves into their births. And I always think about you because you started off with that mindset. And you in your own words have let you laughed all through your births, and your first one eating watermelon and laughing. So I think that's a beautiful part of you that I want everyone to know about you. Thank you. And then for many years, you worked for me at my business teaching my quarterly breastfeeding workshop and you're just such an incredible abundance of research and knowledge. And I've learned so much from sitting time and time again, at that workshop learning from you. So I'm so excited we have you on the show, we really don't need a breastfeeding person on the show because Trisha is the most experienced breastfeeding consultant that I've ever known. And you're this PhD researcher. So it's just so exciting to get both of you together. So you and I have always been in touch, but I shouldn't do both an article about a week ago, that just got me all worked up as usual. And the title of it was Yale gal, researchers find that breastfeeding can cost over $11,000 a year. So I just I needed to send that to the right people. And that was both of you. So, Trish, any comments?

Trisha Ludwig 
Yeah, yes. Let's not forget that the conclusion of the article was that breastfeeding costs far more than formula feeding. This is what we're going to discuss today, because there's a lot of misinformation. Now run a you have the actual article, we just read the Yale daily news summary of the article. So you're gonna help us break down what the what the research really says. And we're gonna discuss the finer points. The actual cost of breastfeeding versus formula feeding a baby.

Dr. Rhonda Trust, PhD 
Absolutely. So when I first read the article, and again, this article that was in Yale Daily News is designed for the public. It's not designed least the way it's written for an academic researcher. It's not designed for some And who's going to look at the statistical significance of the results. And it's not designed for someone who knows the literature out there, which contradicts these findings. So basically, what I did is I, the staff reporter who wrote the article was discussing a current article that was done. And I found that article directly using the databases I have access to at the university. And the article was from the Journal of Periodontology from March of 2023, titled no such thing as a free lunch, the direct marginal costs of breastfeeding. So when the the lay article that article written for the public was constructed, pieces of this academic published article were pulled out. That talks about the study led by Dr. Mahoney, who's a second year medical student and a PhD candidate, actually so. And Sara Taylor, who's a professor of pediatrics. So they found in their study that breastfeeding a child can cost more than $11,000 a year. Now, having breastfed three, I'm sure there's a lot of listeners out there who breastfed I don't recall spending $11,000 a year, and I was working after each birth, I had to go back to the workplace, I didn't have leave or anything like that. So I breastfed each child for years pumping and breastfeeding and so forth. So this said, which felt like dagger stabbing me as I read it, because I know the implications is has on the average reader a year found that breastfeeding a child can cost more than 11,000 a year, a significantly greater cost than that of baby formula.

Trisha Ludwig 
They quoted baby formula to cost somewhere between 12 120 $500 A year and the cost of breastfeeding to be $11,000 a year. And the only thing that I saw them consider in the cost of breastfeeding was the cost of vitamin D supplementation which is

free if you go outside and and pump parts the to actual costs dollars out of your pocket vitamin D, and pump parts which are generally covered by insurance insurance. Insurance covers them the main costs then they factored in the hours it takes to breastfeed at $7.25 An hour and came up with opportunity last at a total of about double their total costs for breastfeeding was $11,000. If you subtract a $200 pump, and you know $100 on vitamin D,

Cynthia Overgard 
they also assumed three to four hours a day of breastfeeding, which I just think it's interesting that they also assumed three to four hours a day of breastfeeding. Now, of course, in the beginning in the early weeks, it's like you're constantly constantly figuring out breastfeeding, but this is an annualized cost. And if you're breastfeeding for a whole year, we all know that breastfeeding becomes like something that absolutely isn't three to four hours a day. But it was very manipulative, which is I think Trisha is point to factor in like the opportunity cost at minimum wage. As if Oh, if you only weren't breastfeeding a child, you would be out working making money.

Trisha Ludwig 
There was no consideration of the dollar spent going to drive to get formula every single week. All the bottles you have to buy to get formula every week. They did cost they factored in the cost of the actual purchase of the Canna formula.

Cynthia Overgard 
Well, can I jump in on that? There? I know Toronto is chomping at the bit to get to the real cost here. Yes, but let me just say, you know, and they they've encoded the formula cost as being as little as 760 a year in the year 2020. They said, and you know, they're looking at the worst possible garbage out there that probably has likely has high fructose corn syrup as its first ingredient. The clients I know who use formula, by choice or by necessity, because of course there's that population we need to support. They're doing the research and the hard work to find good quality formula, which is a fortune. And I have feelings around this because they wrote this article, supposedly in defense of the poor family, the families suffering from poverty, and Rhonda, what do you want to say about so

Dr. Rhonda Trust, PhD 
they mentioned in the public article that that also increased the cost that I wanted to point out in addition to the vitamin D and so forth, but the nutritional intake, remember, they assume that women are going to spend hundreds of dollars more a week in food? That's right. That was even though our ancestors much more were our ancestors who did not eat three square or meals a day, somehow managed to keep the species alive without having three meals a day snacks, and the vitamin D in which they emphasize which is recommended for breastfeeding mothers. So that was something else I wanted to add from that article that from the lay article, the public article, then from the actual academic article published in the journal, an accurate accounting and appreciation of these costs is critical in developing effective breastfeeding promotion and policy. Okay, breastfeeding is not however without costs, women who choose to breastfeed beer, bear financial, societal and psychological costs, which may be profound, profound. So the the language is quite dramatic.

Trisha Ludwig 
Can I just say they may not be so profound if we provide a little bit more readily available support for their support,

Dr. Rhonda Trust, PhD 
of course, but this article did come out of this article came out because of COVID. And the shortage on formula and the shortage of formula, suddenly quoting the article that was written in not the academic one, but the Yale Times article. Quoting from page three, suddenly breastfeeding was thrust into the limelight. And families struggling to feed their babies and wake of the shortage were told, just breastfeed it's free. But as any half baked economist knows, nothing is free. And rhetoric, to the contrary may engender shame and non breastfeeding mothers.

Cynthia Overgard 
Oh, my God.

Dr. Rhonda Trust, PhD 
So this is the rhetoric that we see. This is what we're seeing in the the article that was again, yelled Daily News. The academic article definitely started out in the introductions about the benefits of breastfeeding. What who, what the World Health Organization recommends, but then the pair the sentence from the last paragraph. You know, breastfeeding is, however, not without costs, cost of alternative formula feeding and so forth. So what I like to just mention is a famous study that's been done and repeated about every five to 10 years, comes out of researchers and physicians at Harvard University, Melissa Bartik, who I personally met years ago, when I was involved in the Connecticut and the Massachusetts breastfeeding coalition. I was years ago, that policy and advocacy chair for the state of Connecticut. And when I did a postdoc at Boston University, I went and met Dr. Bartek, who's famous in regard to doing these costs analysis with Harvard economists. And every time they do this every five to 10 years, they find the results that are mind blowing. The article is called sub optimal breastfeeding in the US, maternal and pediatric health outcomes and costs. And this was published in 2017. Again, they repeat the study every five to 10 years. And they basically find that if 90% of infants were breastfed, according to medical recommendations, which is exclusively for the first six months $14.2 billion annually would be saved. And that includes health care costs.

Cynthia Overgard 
We're talking sick children who otherwise they're assuming would not become sick. Am I correct? And understanding you

Dr. Rhonda Trust, PhD 
are correct? Well, the those dollars are broken down into different settings. So those are like medical costs of children going in getting sick and going to the hospital and medical costs of parents missing work. The cost of missing work because your child has their seventh ear infection. You know, because we know that there's a correlation between media otitis and and formula feeding and so forth. GI infections are increased among babies who aren't breastfed, so ER visits, purchases of special formulas, purchases of PD, you know, co pays Pedialyte, hospitalization rates, respiratory tract infections. So they've done this study every every year, they find that for every 597 Women who breastfeed one maternal or child death is prevented. So they're looking at this and this article is fantastic. Every again every time that these researchers, the team of researchers repeat this study and do the economic cost analysis cost benefit. It's just mind blowing.

Trisha Ludwig 
It's Can you repeat that line about the use of for everyone 597 Children breastfed maternal,

Dr. Rhonda Trust, PhD 
for every 597 Women who optimally breastfeed according to standard, the WHO recommendations one maternal or child death is prevented.

Trisha Ludwig 
Interesting, the maternal is included in there

Cynthia Overgard 
because women are less likely to develop cancer in their lives if they break around

Dr. Rhonda Trust, PhD 
and that's what they include here in this analysis as well. They found from 2013. Their analysis of maternal costs that sub optimal breastfeeding was associated with $734 million in direct medical costs 126 million in indirect costs, and 17 point 4 billion in societal costs. And over 4000 premature deaths. I came from a research one university UConn. So we did very advanced quantitative research analysis as graduate students. And this study uses a very sophisticated model. It's called the MonteCarlo simulation model to get this data, so they look at, you know, all bunch of numbers and statistics and facts and work with economists. And then they use a very advanced statistical model. And they've been repeating these studies and getting the same like wow results for decades. So some key messages from this study that suboptimal breastfeeding obviously has a substantial impact on both maternal and pediatric health outcomes, and costs 80% of the excess death rates and medical costs attributed to sub optimal breastfeeding, actually, maternal, which is a very interesting, and this is an economic study that really puts the other I don't want to say puts the other study to shame, but really does. I mean, it really

Trisha Ludwig 
didn't include a critical piece of information.

Cynthia Overgard 
I want to point out something that the other thing wasn't a study, we have to just look at what really happened. You have this, this woman wrote an article, she did what any one could do as a high school project. She just estimated estimated, estimated, let's assume women breastfeed three to four hours a day, let's assume the minimum wage, let's assume she's buying breast pumps, let's assume she's eating more food. That's not research.

Dr. Rhonda Trust, PhD 
She correct. The journalist wrote the article based on a scholarly article that was published in the Journal of perinatal ontology, which looks, you know, which was titled no such thing as a free rock lunch, the direct marginal cost of breastfeeding

Trisha Ludwig 
on that scholarly article, and in that scholarly article, there was no discussion of everything that you just discussed in karate. So very important studies.

Cynthia Overgard 
Did she write that no such thing as everyone just saw someone else did did that. Right.

Dr. Rhonda Trust, PhD 
So the author's right, this is a scholarly article.

Cynthia Overgard 
But what was the research in that article? The no such thing as a free lunch? What was the research? There wasn't research in it? It was just an economic analysis. Right? Right. That wasn't research. So we can't do this. Rhonda, what I hear you saying because you're talking at such a big global economic societal level, is foot like IF formula is if some woman is struggling in poverty, and making that decision between formula and breastfeeding. I do want to point out for her for that individual woman's, what we believe is the safest, healthiest and lowest cost to her. So let's talk about that one woman. Perfect. I guess I just want to be clear the costs that you're talking about, If a family is persuaded into using formula, and they say, look, it's only $1,000 a year. Yeah, breastfeeding, there's no doubt breastfeeding is a major commitment. There's this is not necessarily the easiest path women go to you to know more than anyone, what women go through sometimes to establish that relationship. But But why do they do it? Let's talk about why that is worthwhile. I think what I heard you saying is that there is an actual cost to not breastfeeding. And that cost is a child who research consistently shows is going to be sicker is going to be home from school more,

Trisha Ludwig 
it's not really appropriate to look at the cost of breastfeeding on an annual basis, you have to look at the cost of feeding your baby over a lifetime. Because breastfeeding is is extremely, you have to heavily invest in the beginning. It's extremely time consuming in the beginning. And it becomes extremely not kind of consuming as time goes on. And by the time you're breastfeeding as well established. breastfeeding your baby at the breast is the easiest way to feed your baby by far. Now if it's not going well, then that's a different story. But that's a result again of lots of things that we do in society that make it that way. We're not even given a fair shot at making it easy, but when it's going well it is by far the easiest way to feed your baby. And over many, many years of your life. It's feeding a second baby feeding a third baby feeding a fourth baby it's almost always easier and not as time intensive. In the beginning. It's still a lot but you I just think you can't think about breastfeeding versus formula feeding on it's not fair. To compare them on an annual basis, it's apples to oranges, even on a financial basis, this pair, yes, you have to think about it over a lifetime, because that's why I wanted you to repeat that line about the maternal and infant life saved because most people don't even know the benefits to women of breastfeeding in their lifetime, and the decreased risks that they have to harvest important things that kill women in life, breast cancer, ovarian cancer, heart disease, osteoporosis, all of those things are significantly reduced in women who breastfeed more, more years more months.

Dr. Rhonda Trust, PhD 
And I want to make a note to follow up what in their methods section of the article by Bartek. Who wrote, you know, the sub optimal costs of not breastfeeding in the country, they really, like did what you're talking about, they modeled the health outcomes of a cohort of woman born in a single year, followed over their lifetime from 15 to 70, in their children's health outcomes, from birth to age 20. So they did look over this life, this time, in order to capture women whose P childbearing age would be captured by the 2012. Breastfeeding data. Based on a review of the lit we selected disease for our model that have the most robust evidence demonstrating an association with breastfeeding. And that apply to the US population. So in their analyses, they looked at the woman over time, what the data, the diseases, the illnesses that would impact them and babies, the most from not breastfeeding.

Trisha Ludwig 
We haven't even discussed the cost of contraception by exclusively breastfeeding, you have you know, lactational, a man or a amenorrhea is is a real protective way of child spacing. And when you're not breastfeeding, you don't have that. And you may have more children in a lifetime, which certainly adds a lot of cost to your life. And if you're if you if you are preventing children actively, then you have a cost of doctor's visits and contraception. That's another another little just another little thing that people don't talk about,

Cynthia Overgard 
well, yeah, they got creative enough to say, well, let's assume she's buying more groceries and eating more and driving up her cost of food.

Trisha Ludwig 
So it didn't talk about her oral contraceptive pills every month. Exactly.

Dr. Rhonda Trust, PhD 
You know, that's a really good point. It just goes to show and this is what you know, the formula industry, pharma, pharmaceutical industry, Formula industry, has been doing for over 100 years, the way they're marketing, you know, it's all about the marketing and the marketing. And this article is considered marketing. You know, that's why I was trying to find out if there was a pharmaceutical company or formula company behind the article, and I wasn't able to find that direct affiliation, I found an affiliation from an organization that supported that the actual, original article, but that's, you know, you're always wondering what the motive is behind this? Did the authors have a negative experience with breastfeeding and decide, okay, instead of shaming woman, I'm going to do some research or do some review of literature and come up with something that's not going to make people feel bad, and we don't have intentions to make people feel bad. We just want to make people informed understand

Cynthia Overgard 
it, I'm getting really concerned about how much the public is getting manipulated by this threat of being perceived as shaming anyone. I don't I, first of all, I hear it constantly, constantly, that we have to stop shaming shaming, we're trying to provide evidence not that we are we're not accused of that at all. I'm saying, as a society, we are told to feel guilty and bad about literally everything. And I don't see the shaming happening, but in the name of not shaming anyone. We are now putting really bad information out there. I remember when we launched this podcast, there was an article in The New York Times where a woman she she threw this out there to see if it would stick and it didn't stick. But I remember she was opposed to the term natural birth and said, Let's stop using the term natural birth because it can make women feel bad. So this is what I'm talking about. This is what exactly the kind of nonsense I'm talking about. First of all, treating everyone like they're absolutely non resilient is like, you know, the whole thing of like, everyone on the team gets a trophy. The whole mentality is like, let's try to protect everyone's feelings every minute of the day is absolutely against mental health and wellness. But anyway, she was like, let's not say natural birth or physiologic birth, because people can feel bad. You know, if they hear that if they or their partner didn't give birth that way. Well, what do we call it them? Right? So her proposal at the end of her article was let's just say a good birth, or not a good birth, and I was like, no No, no, no, no, we're launching a podcast. I'm not saying I'm not playing this game.

Trisha Ludwig 
Isn't that equally shaming if you call somebody's birth a good, that's that's

Cynthia Overgard 
literally true Trisha, that is a judgment that's literally

Trisha Ludwig 
so exact. So you know, you're saying yours is here and mine is here. Exactly. And

Cynthia Overgard 
now we're supposed to say human milk, right? Instead of breast milk when every ounce of breast milk in the world comes out of a breast. I mean, I'm this whole thing of like this article with any article mentioned shaming, and like, there you go. Now we're not now we're not going to be helping people anymore, because now it's about this. I don't know this other

Dr. Rhonda Trust, PhD 
article is exactly what you're doing. Like, what you're saying. It's okay, let's, we're gonna, we're gonna prime everyone the reader. So okay, shaming if you say, oh, you can't You're not breastfeeding shaming. But you're taking away from facts. We are here, every human is here, because someone in our line was breastfed. I mean, that's bottom story. We're here because of breast milk. Humans are here because of breast milk. Formula, artificial feeding is a new and newer invention. In the realm of human existence,

Trisha Ludwig 
there is no denying that breast milk is the superior food for humans. For babies, there's no denying that nobody can or you can't argue that. And so this is the Fed is best conversation now that we've we've just let ourselves right into it. And it isn't fed as isn't fed as best as Fed is necessary, you must feed the baby, there is no choice there, you must feed the baby. But you cannot deny that breast milk is the best choice for every baby, it isn't always the best choice for every mom. Correct? It just isn't there. Sometimes it's not the right choice. And we would love it to be the right choice for every single mom. And it probably could be if she had the right support. But it isn't always the best choice. But it is the best choice for every baby.

Cynthia Overgard 
And it doesn't mean well. It's possible. And we're grateful. Just as we're genuinely grateful for surgical births, it doesn't mean we're gonna say it's all good, it's all the same. It's not all good. It's not all the same, there is more risk for the surgical birth, we need to have this conversation. But that comes without any kind of like just the very notion of judgment, right?

Dr. Rhonda Trust, PhD 
There does need to be more conversation around. Also donor milk. That's a huge thing that is like left out of a lot of conversations here. Because with donor milk, okay. You're feeding the baby through a feeding system. I forgot the abbreviation, SNS or a bottle, whatever. Your baby's getting human milk. And when we know it and ranking, you know, milk from the chest is best or from the breast is best mother's own milk from a bottle, donor milk from a bottle or a feeding system. We're forgetting donor milk. And that's what happened. Obviously, what generations ago if someone in the family couldn't breastfeed you, another family member did another woman did and, and you you probably know more about milk sharing and so forth. But there's so much that is missed there. Okay, baby, you can't breastfeed. Here we go formula. No. Okay, so we know breast milk from mother's breast is best directly from breast second best mother's milk fed via a US feeding system or a bottle. Third best human other human breast milk from a donor donor bank, milk banks, species specific milk is the most important we're the only species that drinks and other species breast milk. And we're expected to thrive, non species specific milk allows us to survive, it doesn't allow us to thrive. That's why we see these insane medical costs associated with babies who are not fed breast milk. They're not fed species specific milk.

Cynthia Overgard 
I also want to I have two things I want to add to that. I know the fourth feeding option is formula. But I also feel that that should be in a few categories, because some formula is literally toxic. And other formula is very, very good, quite a world of difference in the options for formula. And of course the worst ones in the world are made here in the USA. Okay. And then the other thing I want to say is and I want I hope everyone understands this, that this article is, like you said, it's marketing to the poor family. They're talking about poverty, they're talking about minimum wage, they're talking about average household incomes. And this is why actually this article upsets me so much. I feel like it's exploiting those families they need or they maybe they need actual support.

Dr. Rhonda Trust, PhD 
There are so many disparities means that it's

Cynthia Overgard 
to me it's pushing them down further. It's pushing them down further. Breastfeeding isn't supposed to be for the rich. And that's how they're making it sound

Trisha Ludwig 
even. That's because lactation services are not covered by insurance in most cases. I mean, they're starting to some insurance companies like Aetna does a good job of providing insurance coverage, but most insurance companies will not

Dr. Rhonda Trust, PhD 
pay when I was part of the Connecticut breastfeeding coalition. There are many there are many women who are ibclcs, who worked for WIC Women, Infants and Children. They were registered dieticians for WIC. And they were lactation consultants and the women when they were coming in to get their vouchers for food, were able to get free counseling at that point if they needed it, if they wanted it if they knew about it.

Trisha Ludwig 
But did they have more than 15 minutes? With them?

Dr. Rhonda Trust, PhD 
I have no idea. I'm assuming no. They probably didn't. So it's there's so many levels. We have the micro level we have the macro level, there's so many levels.

Trisha Ludwig 
So it to me It boggles my mind that insurance companies do not pay for lactation services when they know that that is going to reduce their overall health care costs for that child's childhood and their entire life. And so they're just paying paying for it out the other end instead of paying for it in the moment when they can when a mother needs that support. And if a mother gets the right support in the beginning of her breastfeeding journey, her chances of successfully breastfeeding her kid and getting to that place where breastfeeding is by far the easiest way to feed her baby is so much greater,

Dr. Rhonda Trust, PhD 
so much greater. I know. I know. And it's it's quite bizarre. There are some companies for people who are employed at larger companies that will pay for new mothers to access a lactation consultant on the phone.

Trisha Ludwig 
It is improving, I will say and actually that was benefit of COVID that telehealth and lactation services started to be picked up and covered somewhat but it should be stated should be tough. And it should be a top priority for health insurance companies to pay for this

Dr. Rhonda Trust, PhD 
not in our country. It's such a I want to say an argument because it seems like there's always a back and forth back and forth about you know, the Fed is best argument. And the rhetoric we see around that in the promotion we see of formula as being here you go. I mean, when you we talked about this in the breastfeeding workshops I used to teach. Hospitals receive many free items from pharmaceutical companies slash formula companies. So if they're willing to say bye bye to the free diapers, they can not give every new mom a welcome bag with formula. But that's not the case unless it's a Baby Friendly Hospital. Baby Friendly is a certain certification for those listeners who aren't sure that they they have to reach these milestones to become a certified, Baby Friendly Hospital.

Trisha Ludwig 
They're still giving out formula to those babies in the Baby Friendly Hospital because as soon as they think there's slightest problem. Oh, the baby's not latching Well, oh, you need a nipple shield. Oh, your milk, count your votes coming in a little bit late. Here's the formula. It's really

Dr. Rhonda Trust, PhD 
upsetting. pediatricians office, I can't tell you how many times I've had an interaction with the pharmaceutical rep in the pediatrician office, they walk in, they've got you know, the lunch trays for the doctors. And then they have their samples and then the flyers they put right in the front where you check in all their fliers and their coupons. And I take them I throw them in. I mean they they just love me and I would get in heated arguments with these like really young. Some of them were guys these young like 25 year old guys doing their job, they don't know. They just know you know what the paycheck at the end of the day or whatever, like. So,

Trisha Ludwig 
I want to add one more thing to the formula distribution in the hospital because no doubt it is geared toward sabotaging breastfeeding, because the little formula bottles that they give out with those little brown nipples are the worst nipples for breastfeeding. They teach every baby who gets one of those learns terrible latch. And even if the mom was off to a good start once they get those bottles done, if you're not getting the right help, it's done. Yeah. So it's so sabotaging.

Cynthia Overgard 
For me this conversation reminds me of an episode that Trisha and I did in November of 2021, where we had a vaccine scientist come on to basically explain and dispute very manipulative information marketing information. The New York Times had put out there that I came across some I contacted her and said this is baloney. I looked up the research and this they're misleading the public and she was like Oh, Uh huh. And we had her this vaccine scientist, this woman with a double PhD. Come on.

Dr. Rhonda Trust, PhD 
Do you remember her name? Yeah. Caitlin crutch,

Cynthia Overgard 
Dr. Caitlin crutch. She was a scientist specializing in breastfeeding. And she she knew the research the actual research on whether the vaccine ended up in breast milk anyway, she came on our show. And the purpose of that was to let our listeners know that what they read is often marketing. And then the second purpose of that episode was for her to explain to the layperson how to understand research. So if you read that marketing article, how do you go deeper and find the research? And how do you make sense of these terms? That seems so intimidating at first glance, like, confidence interval? Um, so she explained all of that, in that episode, I feel like this episode for me, is, this is why I think this is valuable. And we're putting this out there. Because I want everyone to know we've come across it again. This is this is just another thing that catches the headlines. It can take the next dinner conversation someone can hear oh, did you hear breastfeeding is actually more expensive than formula. There you go. Like there begins new rhetoric. So as I always say, Keep your wits about you. Find the research, find the conflicts in the research that say they often exist, and make your own decisions for yourself. Because there are a lot of powerful bodies at play behind all of these publications. And they're not in the public's best interest. And when you hear about shaming, don't get manipulated by that either. That's just our trend of the day that we're always shaming shaming mean, so that's for me, that's what I hope is the food for thought that we're putting out there. What about each of you? What do you think is the main thing you want everyone to take away?

Trisha Ludwig 
I think that it just is to basically, question when you see science trying to outwit nature, like, go back to the basics, like when you see that we're trying to recreate something that nature has spent billions of years perfecting, we're not going to do it. Like always just question that first. And then dig a little deeper if you start to actually believe it. Because when you dig a little deeper, we find that nature wins again.

Dr. Rhonda Trust, PhD 
That's one of the IoT points. And that's one of the things I was gonna say, on natural versus natural. Your body's producing free food, you can't dispute that. Your body is producing free food to feed your baby. That is the perfect food. It's perfected exactly for your baby. It doesn't cost you anything, you're not exchanging money to feed your baby, the milk that your breasts have produced. So anything, anytime we start doing anything unnatural, there's a cost. There's a cost. So nature is providing free food for your baby. The second takeaway is educating, educating question what you read, like hopefully you're the you're when you read articles like this, you being the public, you are a critical thinker, and you're something that we call Communication Studies media literate. You're you're trying to look for other messages in that media that you're reading. You're becoming more media literate. Understanding there may be another agenda. And educating yourself. Educating yourself okay. Oh, you know, face value. Oh, yell researchers find the cost over 11,000 Oh, wow. Yell researchers over 11,000 and it was that's why it's important to be educated in not everyone has a desire to get educated. You know, pregnant new newly pregnant mom has families. It's important to educate and it's important to empower as well.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

Dr. Rhonda Trust, PhD  
Just showed my friend the video of Sierra's which was six years ago it could might one of my friends two of my friends are pregnant actually cousin and a friend and I'm like, see birth can be fun one of them. Actually, one just switched to a midwife. Thank God because her doctor was like, controlling her. Oh, you're too small for a vaginal birth, you know, the same rhetoric. But I showed them the video of me laughing and smiling and dancing.