Breastfeeding

            My experience in the early childhood field is deeply rooted in my experience as a birth and postpartum doula, as well as my years of experience leading new mom support groups. I have witnessed over a thousand mothers’ early journeys into motherhood, and have seen the emotional and physical benefits of breastfeeding first hand in both mothers and babies. So, when we were asked to pick a public health issue that affects child development to discuss in our blogs, breastfeeding was an easy choice. I have seen countless moms and babies in love with each other, gazing into each other’s eyes, connected in every way by their breastfeeding connection. I have seen mother driven nearly to madness as they try to increase their milk supply, work through nipple pain caused by a bad latch, or struggle through recurrent thrush or clogged ducts and mastitis.  I have seen breast milk squirted on clogged tear ducts, scratches from thin baby fingernails, and sore nipples, and seen the almost magical healing affect that it has. Too many of the tough stories I see and hear are rooted in poor postpartum support, misinformation, or lack of education in general… All too much of that poor information is still coming from hospitals and pediatricians, and all too often this misinformation leads to moms giving up on breastfeeding. To add insult to injury, the sense of guilt and defeat that these women carry for giving up is overwhelming.

            In my work as a doula, both pre and post partum, one of my main go-to books is Dr Jack Newman’s Guide to Breastfeeding. Dr. Newman wasn’t always a breastfeeding activist. In fact, he bumped into the field almost by accident. In  1981, after finishing his residency as a pediatrician, Dr. Newman went to Africa and witnessed how devastating bottle feeding was in a culture that was suffering with issues of starvation, contaminated water, poverty, low immunization rates, and a tuberculosis epidemic, amongst other things (Newman, 2003).  Dr. Newman didn’t really understand the intricacies and challenges that breastfeeding could present at that time, but he did realize that breast milk didn’t require mixing contaminated water into it like formula did, that breast milk was made to be exactly what babies need, and that it was free . He also saw the babies were being admitted into the hospital daily for starvation because their mothers weren’t breastfeeding them, but were, instead, struggling to afford to give them formula. So, Dr. Newman became a breastfeeding advocate for the first time (Newman, 2003).

             Upon his return to Canada, Dr. Newman then went on to start several breastfeeding clinics in hospitals in his area and began to realize that breastfeeding is a major public health issue (Newman, 2003). He began to notice that the information being given to new moms in many hospitals was (and is in my experience) quite poor and often illogical. As he put it, “Once I started examining it, I realized the whole system works against mothers and babies breastfeeding. We have stacks of research to show that breastfeeding is important for the health and optimal development of babies, and yet it is too often seen as expendable and unimportant” (Newman, 2003, p.5).  My experience definitely aligns with Dr. Newman’s experience. Few people realize that breastfeeding is not always easy and when women encounter difficulties and have no support, far too many professionals, friends, and family encourage them to quite. I can’t count the number of times that I have heard someone say, “Well, I was raised on formula and I’m fine!” as an excuse for not supporting women and babies who are learning to breastfeed. Formula has its place, but it should be considered a last resort, in my opinion (Newman, 2003).

            Dr. Newman also points out that a pack of cigarettes comes with a label that says the ingredients are known to cause cancer, but when people speak about giving babies formula versus breast milk, they say that breast milk offers benefits for mom and baby that formula does not provide. Dr. Newman says then goes on to say, “If women who were breastfed as infants show (as they did in a recent study) a decrease of 25 percent in breast cancer rates when compared to women fed formula as infants, this can- more accurately- be restated this way: Women who were fed formula as infants had a 33.3 percent increase in breast cancer rates” (Newman, 2003, p.9).  Why is it that this public health issue is always presented in a way that downplays its significance? In fact, the benefits that breastfeeding provides (and formula doesn’t) are vast. Children who were breastfed as babies score higher, on average, on tests of intelligence and development. Babies are less likely to develop diabetes is they are not introduced to cow’s milk until after one year of age. Some researchers have found links between formula and SIDS. Breastfeeding has been shown to decrease chances of developing allergies, asthma, and ear infections. Immunity is also boosted by breastfeeding, and increases the efficacy of vaccines (Newman, 2003). I, myself, breastfed my youngest daughter until she was nearly three years old. During that time, she had very mild eczema that we never thought much of. After I weaned her, she developed severe eczema, respiratory problems, and a huge gamut of food allergies became apparent. While breastfeeding didn’t keep those problems from happening all together, the immune boosting qualities of the breast milk, were what kept her from developing those ailments for her first three years. I am so grateful that I was able to nurse her as long as I did and that she didn’t have to spend those formative years itching horribly and in and out of the hospital.

            The incredible gift that breastfeeding is really came into focus for Dr. Newman when he worked in Africa in the early 1980’s.  A look at breastfeeding in Africa continues to shine a light on the power of breastfeeding today. According to Unicef, three million children under the age of five die each year. Of those, Unicef estimates that hundreds of thousands of lives could be saved if their mother’s were to exclusively breastfeed (2014).  Some of the highest rates of mortality and malnutrition in the world are present in Central and West Africa. 56% of deaths of children under the age of five are due to malnourishment.  Unicef says, “Protecting, promoting, and supporting breastfeeding could be the single most important child survival intervention in the region. Exclusive breastfeeding alone has the potential to avert 13 per cent of all under-five deaths in the region” (2014). While breastfeeding is a part of the culture in all of the regions of West and Central Africa, Unicef estimates that only 20% of babies exclusively breastfeed for the first six months of life. Indeed, the rates of breastfeeding are amongst the lowest in the world. Unicef’s goal is to make breastfeeding education and direct support available to all breastfeeding women through implementation of community support. “This means promoting the benefits of breastfeeding at the community level to ensure that each and every mother is supported.  This includes the creation of community structures such as mother to mother groups, health system support to breastfeeding mothers, health worker, community health worker and lay counselor training, workplace support and assisting breastfeeding mothers affected by emergencies, HIV and other crises” (Unicef, 2014). (I’ve left the links in above, so that you could check out more individual stories on Unicef’s website).

            The story that Unicef paints about breastfeeding in Central and West Africa really speaks to the reality of how tough breastfeeding can be without support. In my experience, many people mistakenly believe that breastfeeding comes easily and naturally and takes no education. For some, that is true, but for so many it takes vigilance, commitment, and lots of support. Even in San Francisco, one of the most liberal areas of the United States, where many moms feel pressure to breastfeed and are embarrassed to bottle-feed in certain circles, the medical world is filled with mixed messages about breastfeeding.  When I was in the hospital six years ago after the birth of my oldest daughter, for example, some nurses would not let me have a breast pump when I couldn’t be with my daughter in order to stimulate my milk coming in. Nurses on other shifts would ask me if I had been pumping and be horrified that I hadn’t. One Neonatal ICU doctor even chastised my wife, telling her she was being “negligent” by not giving our daughter a glucose drip or formula before she was even twenty-four hours old! Even a cursory understanding of lactation would teach you that that is unnecessary! This is not an unusual story. I hear stories like this nearly every day. This is a huge part of the reason that I do what I do. I work to support, normalize, and connect together new moms, so that they don’t feel isolated, have the information and connection that they need to learn and thrive, and so that what they are going through is very common. Breast milk and the experience of breastfeeding are some of the most magical, powerful gifts that a mother and baby can have, and the benefits are vast. If you have a breastfeeding story that you would like to share here, I would love to hear it! Thanks!

All the best,

Lauren

References

Newman, J. and Pitman, T.. (2003) Dr. jack newman’s guide to breastfeeding: the Canadian expert offers the most uo-to-date advice on every aspect of breastfeeding. Toronto, Ontario: Harper Collins.

           

Unicef. (2014) Promoting and protecting breastfeeding. [Website]. Retrieved from http://www.unicef.org/wcaro/english/4501_5055.html.