A nudge for breastfeeding

I listened to a podcast this morning of a recent NPR story on New York City’s attempts to get more new mothers to breast feed instead of relying on formula.  The basics:

Starting next month, dozens of hospitals will participate in “Latch on NYC,” an initiative aimed at encouraging new moms to breast-feed instead of using baby formula.

Health care professionals say breast-feeding is better for both mother and baby.

But critics — many of them mothers — say the city is inserting itself where it doesn’t belong…

Hospital officials are quick to point out that Trinidad could get baby formula if she wants it or if there’s a medical reason to use it. But it’s clear that they want to steer new moms away from the bottle.

North Central Bronx is one of 27 hospitals in New York that are participating in the “Latch on NYC” initiative. They’ve agreed to stop giving away free formula in gift bags from manufacturers and to make nurses sign out bottles of formula as they would any other medication. Policies like these are already in place at many hospitals. Still, the initiative touched a nerve with critics — including many mothers.

“You’re asking women to do something hard and basically making them feel bad if they fail,” says Ada Calhoun, author of Instinctive Parenting, and founding editor of the parenting website, Babble.com.

This strikes me as a classic example of a nudge.  Government pushes you in the direction of a particular behavior that is presumably for the good of society (e.g., saving for your retirement, registering to vote, being an organ donor), but you totally have a choice.  It’s just that the “default” value is pro-social.  Richard Thaler and Cass Sunstein outline this approach in their excellent book, Nudge.   It’s a great idea.  Let government encourage behavior that will be better for society (and the benefits of breastfeeding in terms of healthier babies are clear), but still allow people their freedom to do otherwise.

The cost, in this particular case, is presumably increased stigma and guilt for the women in these hospitals who choose not to breast feed at all.  I appreciate that, but I think that cost is surely outweighed by getting more women to breastfeed who otherwise might not.  Given that my first two kids were both on hypo-allergenic formula by a month due to the inability to tolerate something in Kim’s milk, I get that breastfeeding is not going to work for everbody, but that doesn’t change the fact that we should want our hospitals encouraging breastfeeding, rather than giving away tons of free formula.  Just a little nudge.