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Wednesday, June 6, 2012

The Politics of Breastfeeding

I have to admit that I'm shocked that I have to chime in on breastfeeding as an issue today, but with the recent Time magazine article on Attachment Parenting, the New York formula ban in hospitals, and the recent photo of women in uniform nursing their babies, I feel that it's time for me to speak up.

I am a mother of two, an attachment parent, and a women who regularly attends La Leche League meetings.  We now know from recent research that women who were breastfed as babies or who watched their mothers breastfeed are more likely to breastfeed their own babies.  I know I was at a distinct advantage because I had been breastfed, had a family supportive of my breastfeeding efforts, am a college graduate, a non-smoker and I have no real modesty to speak of.

I can still tell you that breastfeeding was not easy in the beginning.  It's not always comfortable, learning to use a breast pump isn't natural, overhauling your wardrobe to make your breasts accessible 24/7 isn't something you necessarily think to do and the first time anyone breastfeeds in public it can feel awkward and strange.  By the way, this is the opinion of someone who will readily state that I had an easy time breastfeeding.

I'd like to state for the record that it is almost never the fault of the mother for not breastfeeding or not breastfeeding as long as she would like.  Despite a lot of legislature protecting women's rights to breastfeed in public, cultural biases and standards loom large in the face of a mother trying to do what is best for her baby.

Your right to breastfeed in any private or public place is protected in 45 states.  Breastfeeding is exempted from public indecency laws in 28 states (we need to work on increasing that number,) and 24 states have laws regarding breastfeeding and the workplace (again, that is a number we need to work on.)  Only 12 states and Puerto Rico will exempt women from jury duty if she is breastfeeding, and a pitiful 5 states and Puerto Rico have a breastfeeding awareness and education campaign.

It seems really simple on paper.  Breastmilk is best for your baby.  It has compounds in it that we cannot even begin to replicate in a lab, much less in commercially prepared formula.  It supplements the baby's immune system.  It's better for the baby's brain.  It's nutritionally balanced, helps prevent diarrhea and ear infections, is better for babies with reflux, lowers incidence of obesity and diabetes later in life.  It is considered a clear fluid and is therefore the only way to provide a vomiting baby with complete nutrition.  At every turn, research is finding more interesting and amazing components in human milk. It's liquid gold.  Best of all, it's free.  Who wouldn't want to give this to their baby?

Well, fighting our puritan-based society's ridiculous sexualization of our breasts is battle #1.  This problem alone is probably to blame for most women quitting or not even initiating breastfeeding.  It makes everything about breastfeeding awkward and uncomfortable.  Teens (read: the undereducated) are among the least likely to breastfeed and many of them cite how "weird" and "gross" allowing their babies to suck on a nipple is.  I would argue that it's a much less physical than the act that put the baby inside them in the first place, but that's beside the point.  They think like this because they're immature, and it is that immaturity in our society as a whole that has lead us to have any problem whatsoever with breastfeeding, no matter how much breast, nipple or areola is exposed.

I've been told it "just makes good sense" and it's "only polite" to cover up while nursing my baby in public.  Both those people got a big middle finger in the face in the form of my prompt, uncovered nursing right in front of them while I insisted on carrying on a conversation with them.  I simply refuse to use a "nursing cover," because I find them preposterous.  I won't eat with a blanket over my head, so I won't ask my baby to.  I also think it takes away the bonding aspect of nursing.  Yet women seek these covers and pay good money for them in the name of modesty and "respect."  Public breastfeeding is crucial in promoting breastfeeding because it desensitizes the public to it.  If we see it everywhere, it becomes normal and natural.  Furthermore, women who were reluctant to feed their babies in public become encouraged to do it when they see other women doing it and everyone around them perceiving it (correctly!) as "no big deal."

Modesty is the useless virtue.  It benefits no one, hinders and harms many, and has allowed this puritan "bodily shame" to continue unchecked for generations.  It's time to stop claiming that modesty has any benefits.

That brings us to the controversy over breastfeeding images in the media and politics.  This is not a sensationalist image:

This one is:

See the difference?  A mother breastfeeding her babies, staring into their faces and smiling is not a bid for attention despite the fact that she's wearing her Air Force uniform.  A sexy, young mother staring boldly into the camera while nursing her standing preschooler is definitely trying to stir up controversy and attention, and it doesn't matter that you can't actually see her boob.

I listened to the two women in the Air Force uniform on their interview for NPR, as well as a woman publicly criticizing them for doing this photo shoot.  First of all, the viral photo I posted above was one of only two shots of the women in uniform from an entire photo shoot in the park that day.  It was never intended to be exclusively about women in uniform breastfeeding.  The women also did not anticipate the uproar these photos caused.

They were informed that it was inappropriate to use their uniforms to "promote a product" such as breastfeeding.  What?  I think the military might have had a case for this argument if she had been using a Boppy nursing pillow with the logo showing, but they were just feeding their babies.  In fact, by this logic, no woman should ever be allowed to be seen bottle feeding in uniform.  That's direct promotion of the formula and bottle companies!  Except no one has ever made this argument.  Bottle feeding would be fine, but breastfeeding, an act of bonding that provides unarguably superior nutrition is under fire?  Inconceivable!

Another argument that was put forward was that this was an inappropriate action because the woman nursing twins was not being discreet enough.  Furthermore, it's been said that these women need to understand that, as military mothers, some things must be sacrificed for the sake of appearances, and breastfeeding is one of those things.

What?!  Are we so all-consumed with our Victorian need for propriety that a baby's need for proper nutrition is secondary?  The idea that someone could have the gall to make such a statement in all seriousness this day in age just floors me.  It is a baby having a meal.  Anywhere a baby needs to eat is a place where a baby should be allowed to nurse.  Period.  There are no caveats to that.

The idea that the woman is nursing multiples also doesn't seem to come into the argument for her to cover up, and I think it's because so few people have ever tried to nurse two children at once.  It's hard enough to keep any visible skin covered while feeding one baby (so I don't even bother to try,) why would anyone expect this to be an accomplishable task while nursing two?

As I see it, these two women are promoting the military as a family-friendly environment, and one that supports a woman's right to raise her child the healthiest way possible.  What could possibly be wrong with that?

That brings me to my next point: our miserable breastfeeding rates.  Are they better than they have been since the "formula boom" of the 1950's?  Yes, they absolutely are.  But we're still nowhere near where we should be.  About 75% of all women start out breastfeeding their newborns.  By 4 months it drops to just over 50%, with only about a quarter of women breastfeeding exclusively, as is recommended until at least 6 months of age.  By 6 months about 44% are breastfeeding at all, and a measly 14% are still breastfeeding exclusively.  At a year, only about 24% are still breastfeeding.  The American Academy of Pediatrics recommends at least a year of breastfeeding (6 months exclusively,) and the World Health Organization recommends 2 years.  There is no upper limit to the benefits of breastfeeding, and it should continue as long as the mother and the child are happy with it.  See what I mean when I say we still have a long way to go?

So we should be doing everything possible to boost our breastfeeding rates, right?  I mean, 85% of moms want to breastfeed exclusively for 3 months or more.  So why do just under a third of women meet that goal?

As I said before, there are lots of factors that get in the way of a mothers breastfeeding goals.  Hospital and formula sabotage are high among those.  Mothers who have had a cesarean section (a practice that is grossly abused by hospitals and doctors trying to speed the birth process along) are less likely to breastfeed immediately, and women who are unable to breastfeed within an hour of birth are less likely to breastfeed on a longer timeline.  Babies given bottles of formula and pacifiers were more likely to have problems nursing, as well.  These routine practices need to end to promote breastfeeding as a whole.

On this episode of "The View," the women discuss a proposed ban in New York, wherein formulas companies would be prohibited from giving out free formula to new mothers.  Sounds crazy, right?  I mean, I'm a huge proponent of women's rights to all choices in their lives.  Formula feeding is a valid parenting choice.  Wouldn't any good feminist be against this?

Actually, no.  An educated feminist would be applauding this ban.

Since 85% of women want to breastfeed, and free formula samples sabotage that, they should not be offered.  I am not saying that they should not be available on a request-only basis, but a policy that allows formula companies to freely use hospitals to pass out their products when women are at their most tired, vulnerable and open to any suggestion that will stop a frustrated newborn from crying, is not a feminist policy.  Furthermore, nurses need to be trained to help and encourage mothers to breastfeed, rather than bring in a bottle of formula and tell her it's okay to give "just one bottle."  "Just one bottle" helps sabotage milk production, especially in the beginning.  It helps get the baby used to a rubber nipple, and makes it more painful when they latch onto a human one.  It makes the mother feel like a failure when they see their baby gulping down inferior formula after they've struggled for an hour to get a newborn to latch on properly.

None of this is okay.  It is not okay for formula companies to offer tons of free samples in the beginning, helping to make sure that the mother's milk supply is compromised, the baby is used to the shape and fast flow of a bottle nipple, and making the mother think formula is a decent alternative.  Then they turn around and charge at least $120 a month for a supply after the free samples (and mom's breastmilk) are all dried up.  It's a cruel practice that should not be permitted, especially in a hospital that is supposed to be promoting health, not commercial gain.

One of the biggest problems I have with this clip is Whoopi Goldberg's insistence that not all women can breastfeed.  It's true that women who have had mastectomies, some who have had breast augmentations or reductions, women with extremely rare breast deformities, and some women on daily medication that isn't safe for breastfeeding are unable to.  It is estimated that 2-5% of women fall into this "unable to breastfeed" category.  I do not in any way mean to minimize the struggles of these poor women, but that is a very small percent of the population.  It's certainly far less than is believed to be unable to breastfeed by the media and the public in general!  

Not only that, most of the problems that women believe are issues that would keep them from breastfeeding exclusively can be addressed and remedied.  Low milk supply is more of a myth than a reality, but it's fixable in the rare cases where it is a problem.  Babies are never "allergic to their mother's milk," but they may be allergic to something their mother is eating.  She can simply find out what's causing the allergy through an elimination diet and stop eating the allergy culprit.  Babies with a poor latch can be coached to latch on correctly, and nipple shields can help with this problem as well as inverted nipples.  Lactation consultants, as well as a local La Leche League branch, are more than happy to help women with any of their breastfeeding issues.  

Breastfeeding benefits us all.  It lowers a woman's risk for certain cancers and other health issues, it makes babies healthier, it promotes healthy bonding, and it saves us all money! Yes, it's estimated that the United States could save $13 billion in medical bills if mothers would exclusively breastfeed to 6 months.  It also saves individual families when they breastfeed for a year at least $1400 in the first year of life because formula is no longer necessary.  

As a nation, we need to do everything we can to promote and aid in a mother's breastfeeding efforts.  It is not enough to provide a room where women can pump milk.  Breastfeeding is highest among mothers who can stay home with their children, so 6 months of paid maternity leave is something this country needs to work towards.  Large companies that provide in-house childcare go the extra mile to facilitate breastfeeding, as well as allowing parents the comfort of knowing that their children are just down the hall if they become sick or just need a little extra attention.  More education for doctors regarding breastfeeding is a must, since so few of them truly know how vital it is to health and well-being.  More education and promotion of breastfeeding for the general public might help the poor and minorities, whose breastfeeding rates are even lower than those of educated, white mothers over 30.

Much can be done to help our situation, and good political policy changes are a necessary component.

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