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Cover Story
Examining Breastfeeding
Despite increased acceptance, breastfeeding remains a controversial subject. A special Mother's Day report
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May 05, 2010 | 01:47 PM They're marketing tools, advertising gimmicks and one of Heidi Klum's best features. We restrain them, expose them, even enhance them but often forget what they're made for. Seems only right that this Mother's Day we should celebrate breasts, not as Victoria's Secret-type objects of desire but as they were meant to be: life-sustaining sources of nourishment.
Why is it that we're OK with Pamela Anderson, former Baywatch babe, routinely strutting her surgically enhanced stuff but are squeamish if Mom provides baby a snack in a public place? (In some states it goes beyond squeamishness and is actually considered indecent exposure.) And why does social commentator Bill Maher get lots of laughs when he says, "Breastfeeding a baby is an intimate act, and I don't want to watch strangers performing intimate acts. At least not for free."
Breastfeeding has somehow gotten tied up in America's schizophrenic view of sex. In popular culture, overt sexuality (and breasts) sell. But take it (or them) off the pages of a magazine and put them at the next table in a restaurant and the puritanical streak still running through our psyche is triggered.
This hasn't always been the case. Since breastfeeding is both the natural means of feeding a baby and a defining characteristic of being a mammal, it's obviously been the norm rather than the exception throughout history. Mothers nursed—often publicly—in ancient Egypt, Greece, Rome, Japan and India. Check the ceiling of the Sistine Chapel; you'll even see evidence of it there.
Fast forward to the early 20th century, post-WWII especially. Formula companies like Nestle were mostly to blame for breastfeeding taking a back seat to the bottle. They promoted and marketed the living daylights out of their products, espousing the "superiority of formula" over breast milk. And women believed it, sometimes with disastrous results. In Third World nations, women mixed the powder with contaminated water or diluted it to save money. Millions of babies suffered severe malnourishment and even death. These days, formula companies—or "masters of misinformation" as Nancy Irvine, lactation consultant and local childbirth educator calls them—are being held more or less accountable through laws like the International Code of Marketing Breast Milk Substitutes. But now they use more subtle techniques to woo women over to the "wonders" of formula—like providing free formula and other "goodies" to new mothers as they leave the hospital.
The road to successful breastfeeding is littered with old wives tales, superstitions and even out-and-out lies. According to Kim Clelland, MPH and registered dietician with the Women, Infants and Children program at the Malama I Ke Ola Health Center, new (and often young) mothers worry that it's going to hurt and that they won't be able to produce enough milk, neither of which is true in most cases. And the belief that formula is somehow more convenient than breast milk should be considered a non-starter. Isn't it obvious that breastfeeding mothers have their feeding equipment with them at all times? Study after study shows that no formula can duplicate the properties of breast milk no matter how many supplements, vitamins or minerals are added. In fact, the list of benefits reads like a primer of health and wellness. Breastfeeding protects babies against stomach upsets, ear infections, respiratory illnesses, allergies, asthma, meningitis, childhood lymphoma, Crohn's disease and ulcerative entercolitis. It reduces the risk of childhood diabetes and SIDS (Sudden Infant Death Syndrome), helps increase bone density and reduces the risk of heart disease later in life. And, if that's not enough, breastfed babies have higher IQs. Benefits to the mother include: easier post-pregnancy weight loss, shrinkage of the uterus to normal size, increased bone strength and a lowered risk of certain cancers. Plus, there's the obvious and essential bonding experience with your child.
So why doesn't everybody breastfeed? Here in the islands, many women do… at least for a while. In fact, the rates of breastfeeding are higher than the national average, according to CDC statistics—88 percent in Hawaii compared to the national average of 73 percent. But those numbers drop significantly at six months, in Hawaii to 56 percent and nationally to 43 percent. They drop again at a year, in Hawaii to 35 percent and nationally to 21 percent. According to both Irvine and Clelland, the problem is often easy access to formula. Says Irvine, "We have higher failure rates because of mothers receiving samples from formula companies." Clelland, whose office is actually mandated to have formula available for free, says that "for those sitting on the fence [about breastfeeding] the formula looks very attractive… because for young girls, if they can't get past the first week they will stop."
Education is crucial when dealing with any mother but especially for teenage moms. Pat Regan, lactation educator at Kaiser. "When young girls get pregnant people want to keep punishing these girls," says Irvine. "Let's make them good mothers." Irvine says she works with the whole family to make sure everyone's on board. She especially wants to have grandparents in her classes because "grandmothers can be a little resistant at first but come back after and suggest they wish they'd had something like this when they were giving birth. It takes a village. We live that here."
Clelland observes that "girls whose mothers say they can't breastfeed will often do it as a rebellion, proving to their parents that they're not selfish." Surprisingly, she says that often changes the dynamic between mother and daughter—for the better.
Lactation educator Pat Regan says Kaiser "is very pro-breastfeeding and gives out nothing from the formula companies—no diaper bags, no formula samples." But, she adds, "the reality is, they're lucky if they go six weeks. Some of the younger moms don't do it because of the time. It takes dedication."
Maui High School has gone the extra mile to help pregnant and nursing students, forming the Maui High School Pregnant and Parenting Teen Program. The goal, says program coordinator Crystal Kondo, is to make sure these young women graduate. They offer core courses in English, social studies, math and science as well as pre-natal and parenting classes, including breastfeeding. Best of all, they also offer child care.
Then there are the women who know, even before they give birth, that they will breastfeed—those truly and preemptively committed to the cause. But even these new mothers can be challenged, both by issues of nursing in public and by the availability and seductiveness of formula. "Bringing home that formula bag from the hospital that Infamil calls a 'diaper bag' [is] really a Trojan horse, if you ask me," says Akiko Shero, a 31-year-old expectant mother of one. "It had pre-mixed formula with nipples just ready to instantly use with the flick of a wrist. I remember sitting with my little three-week-early baby who was hungry; I was sobbing...and actually questioning my amazing body that has nurtured this baby and fed her for 22 months after we finally got a hang of nursing. I should have known better than [to] take that junk out of the hospital."
Alyssa Haber-de Leon, a 29-year-old mother of two—who has no problem with nursing in public—says, "It makes me really sad that people feel that they can't nurse, or can't do it in public...it is such a natural and normal part of life. Our culture's sexualization of breasts has really screwed over babies nutritionally."
And nutrition is the key. While it happens less here than in developing countries, babies who are not breastfed often die. According to UNICEF, 6 million babies are saved every year through exclusive breastfeeding. Unfortunately, according to World Health Organization (WHO) statistics, less than 35 percent of infants worldwide were exclusively breastfed for even the first four months of life.
So are we doing the best we can to improve the number of women breastfeeding, in the U.S. and Hawaii in particular? The U.S. lags behind a lot of other developed nations in breastfeeding protection, promotion and support. Maternity leave, if it occurs at all, is much shorter than in countries like Canada and much of Western Europe. Thankfully, there is legislation on the books allowing for pumping in the workplace in all 50 states. This means that women who would otherwise have to wean can maintain a breastfeeding relationship even after going back to work (pumps are available for sale, rent or even free through WIC or the Maui High School program).
There are also laws guaranteeing the right to nurse in a public place. This doesn't mean that a nursing mother will not face discrimination while breastfeeding her child. In fact, according to a brochure outlining the laws in Hawaii, "the legislature found that on occasion, mothers have been told to leave public premises or have been discouraged from breastfeeding by being told to breastfeed in a restroom." It happens less and less, but you still hear stories. (Recently, a popular Facebook group sprang up that put it succinctly: "If breastfeeding offends you, put a blanket over your head.")
All this brings us back to the original question: What is more indecent, buxom babe or breastfeeding mom? What's sad is that we still need to ask.
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