Breastfeeding doublespeak in Japan

Hi everyone-- sorry for the lack of posts recently! I have a good excuse: I just gave birth to a lovely baby girl!!

I could write a great deal about the birthing experience (I was induced over 4.5 days, no joke) at a university hospital specializing in high-risk pregnancy (Type 1 diabetes in my case), but I first want to focus on one topic as a kind of public service announcement to other foreigners giving birth in Japan: Beware the invasion of the formula empire into Japanese hospitals and pediatric standards!!

Allow me to share my experience. First, let me provide one caveat: the hospital was great with the induction. They did everything possible to avoid a C-section, for which I am extremely grateful. Now, allow me to complain about formula.

Okay, first off, the hospital claims that they advocate exclusive breastfeeding, per WHO standards. I attended their seminar on breastfeeding. They duly promoted "Breast is best" because it prevents allergies and lifestyle diseases, encourages "skinship" between mother and child, releases good hormones for the mom, and so on and so forth.

A number of overly conservative standards, though, particularly in high-risk hospitals, results in the promotion of formula supplementation. For example:

* A baby with borderline high bilirubin levels (an indicator of jaundice), as experienced by my daughter, is first treated with formula supplements rather than light treatment. Formula supplements, the reasoning goes, increase the baby's bowel movements when the mother's milk hasn't come in yet. To see a counter to this treatment, read La Leche's statement on jaundice.
* A baby who loses more than 8% of her body weight while in the hospital is required to take formula (this despite the fact that up to 10% and even more is regularly considered safe in the U.S., especially when the mother has been given copious IV fluids during childbirth).
* A baby born with low blood sugar is treated with formula. (This often happens in diabetic pregnancies. Fortunately, my daughter cleared the blood sugar requirement.)
Moreover, babies are not allowed to leave the hospital until they register a weight gain, this despite the fact that many babies continue losing until 5-7 days after birth, and standard hospital stays are only 4-6 days.

I desperately wanted to leave the hospital, and I also wanted my daughter to clear the jaundice standard (a failure on the bilirubin count level would result in 24 hours separated from me in the NICU), so I agreed to play the midwives' game (I even told them I considered it a game) to give her formula while in the hospital so I could get out of the formula oppressive environment as soon as possible. Indeed, I asked one midwife, "So what percentage of your patients makes it out of the hospital exclusively breastfeeding?" To which she replied, "We don't release that statistic, but you're correct it's low. We deal with high-risk pregnancies after all."

I played the game, and we got out of the hospital barely clearing the bilirubin test just four days after birth. We had to follow up on the jaundice levels and weight gain issues at a local pediatrician's office in the following week, though, so I continued to supplement formula a very little, even after my milk came in, for about five more days. This pediatrician seemed horrified that I had given my daughter formula. "Don't you know the WHO standards? Stop that poison immediately!" he said. I thought I had found a kindred spirit! I was relieved! "Please don't make me give her formula," I said. He encouraged me to try exclusive breastfeeding.

However, his tone recently changed. I have continued to go to him after cutting out formula, and he told me that her weight gain over a week--170g--was too low. He didn't say we need to give formula yet, but he did say 様子をみましょう ("let's see what happens"). By Japanese standards, a baby should gain 30g a day.

So I did my own internet research and discovered that Mayo clinic recommends weekly weight gain of 140 to 200g a week, much less than the standard issued by the Japanese government, who are relying on statistics calculated based on the fact that most Japanese babies drink formula!! As this website shows (in Japanese), formula fed babies achieve different weight gain than breastfed babies. Next time I go to the doctor, I will have to print out Mayo Clinic's guidelines and show this misguided pediatrician the way Americans think about weight gain and breastfeeding.

Sorry for the rant, but as a new mother, I find it painful to have to argue against the formula establishment's invasion of the private sphere. Other foreign women I know who have given birth in Japan, incidentally, said they were required to attend sales presentations by Japanese formula companies. It is totally sickening.
Phew. Will post happy things later. Consider this a PSA!