Thursday, June 15, 2006

Global warming and breastfeeding

In Al Gore's book from the 1980s, he highlights breastfeeding as one way to serve the earth's ecology.

We found this intriguing when first read years ago, so we wrote up the concept in an article for a conference on Breastfeeding as a Women's Issue held at Georgetown University in the early 1990s.

Here's the jist of it:

Breastfeeding causes no plastic or pharmaceutical waste production.

Breastfeeding causes no dairy pollution, including methane and waste run off.

Breastfeeding demands no fossil fuel for its preparation.

Breastfeeding helps space births, especially if the Lactational Amenorrhea Method is used, which lets the mom know when other birth control is needed to ensure adequate spacing.

Also, while not in the article,

Lack of breastfeeding causes excess illness, demanding excess use of antibiotics, not always used properly, contributing to development of resistant strains.

AND

Lack of breastfeeding also causes excess mortality globally, and, yes, here in the United States. Somehow, excess mortality does not seem like a good thing, ecologically, or any other way.

Finally, to end on a lighter note, non-breastfed babies produce smellier, more copious stools.

So, for the environment of the earth (and for the environment of those who live with the baby) breastfeeding is the way to go.

Now, if only our social systems would support it...

Flurry about breast bullies: Who are the real bullies?

Where is this anger coming from? Let's trace it to the source...

Several persons and media are describing feeling bullied by breastfeeding support work and ad campaigns.

From my perspective, the anger at feeling "bullied" is fully justified. But why not trace it to the proper source?

Folks support breastfeeding because, indeed, it is the physiological norm, and the undisputed way to reduce short and long term child illness as well as to reduce risks of some cancer and chronic diseases for moms. Lack of breastfeeding is associated with immune system deficiencies and risk of contamination that cannot be corrected by any formula anywhere.

But why are so many folks feeling bullied? May I opine that we are indeed being bullied, and we should look to the source of the problem, not to those who are trying educate. The bullying is not coming from the dissemination of correct information, or from the (albeit watered-down) ad campaign. We are all feeling bullied because our nation and society, and our social norms, are among the slowest in the world to truly support women, mothers, and optimal mother and child health.

In northern Europe, women experience humane delivery care, and then they (and their partners) have leave that is paid for up to a year, and trained lactation consultants are readily accessed. In other settings, extended families step in to support the new mom, freeing her of other work so that she may be exclusively there for her infant for at least 42 days. In these societies, breastfeeding is the norm. And it is reflected in child survival and maternal health statistics.

What happens in our society? After an invasive hospital delivery, we are bundled off home in 24-48 hours, where the world of family and friends expect to stop by and see the baby, and you are expected to be the congenial host. And of course, you are expected back at work in a few days. And there are no creches or day care that will allow you to be near your baby. Your are forced to suffer, consciously or unconsciously, the separation anxiety that is normal for a new mother, when separated from the sight, smells and sounds of her newborn.

So, yes, we are being bullied. But not by those who support women to succeed with breastfeeding. We are being bullied by those who deny us the right to practice what is best for ourselves and our children.

Yes, women in the US deserve a good deal of slack, because we are expected to be all things to all people, but we are not supported by policy, law, workplace, or society to be true to our educated decisions.

Keep up the good fight, my friends! But, please, let's be clear on who is the "enemy".

Guilt about breastfeeding: Who should be experiencing it?

Recent articles (Breast-feed or Else, NYTimes 13 June 2006) and news coverage (NBC 14 June 2006) have been emphasizing the guilt “imposed” on women who choose not to breastfeed. Where is this coming from, and why, when guilt is slathered on if obese persons don’t exercise and diet, or if women smoke or drink during pregnancy, is the issue considered so negative only in the breastfeeding arena?

While the Center is preparing an academic article on this subject, please allow me to share some preliminary thoughts.

Lack of breastfeeding, especially early and exclusive breastfeeding, in the US is associated with excess disease and mortality. Indeed, there should be feelings of guilt that we are allowing excess disease and death in the United States, when we know how to avoid it. So wherefore do we always hear the cry against “guilt”? No doubt, this is a huge issue, but it is also misused to a great extent in discussions about breastfeeding support.

Guilt occurs when you do something you know you should not, or when you do not do something that you know you should. Guilt is a major motivator to do the right thing.

Concerning breastfeeding, however, it is not mother who should be experiencing the guilt, but rather the guilt should be experienced by a mix of health care systems, third party payers, workplace and society that makes it nearly impossible for a mother to succeed in breastfeeding: we have virtually no guarantee of paid maternity leave for most workers, professional lactation consultant services are rarely covered by health insurance, and we are bombarded with slick ads for the ease, perfection, and father-friendliness of commercial formulas.

As to fear of making women feel guilty by telling them that breastfeeding is normal and protects them and their babies against disease – what is the alternative? Should we deny new mothers correct health information and guidance?

My congratulations to every mother in the United States who succeeds with doing the best thing for her child by early and exclusive breastfeeding! She is beating the odds. And my support, respect, and encouragement for women who attempt to breastfeed, but who are beaten down by the constraints and obstacles that our society sets out for her. She should not feel guilty, but rather should feel proud of her efforts.

Fostering the idea that supporting breastfeeding is bad because it makes women feel guilty is blaming the victim, and then denying her solace. Instead, our society, our legislators, our workplace standard-makers, and our health system should be the bearers of the guilt in this case. Rather than a guilty mother, we should have a supported mother, and if not supported, than these other entities should be the guilty ones.

The answer is to truly support and enable every woman to succeed with the feeding approach that is best for her and for her child. With social, workplace and health-worker skilled support, for most, this will be to exclusively breastfeed. Unfortunately, in the United States today, societal realities still make it necessary to take on the short and long term health risks and therefore, to not breastfeed, or only partially breastfeed. In every case, complete and accurate information and support is every mother’s right, so that she may reach her decision free of guilt and free of commercial bias, and enabled by her workplace and society.

Action is needed at every level of our society, if we truly wish to enable each woman to make an informed choice and then to succeed with that choice. The following areas of action were just reconfirmed by the 59th World Health Assembly (WHA59.21, Agenda item 11.8 27, May 2006, “Infant and young child nutrition 2006”) at the World Health Organization, based on the 1990 and 2005 international Innocenti Declarations. The major actions called for worldwide equally apply to the United States, and include a call, with urgency, for:

  1. Renewed support for Baby-friendly Hospital Initiative, which requires all health workers in contact with mothers and babies to have at least basic training in breastfeeding support,
  2. Renewed support for the International Code of Marketing of Breast-milk Substitutes, which call for ethics in commercial marketing of infant formulas.
  3. Attention to maternity protection by the workplace, including paid leave and related support.
  4. Consideration of additional policy, law and regulations that would enable women to succeed in optimal feeding.

These documents also raise the issue of fostering societal and community support through social marketing, such as the US Campaign, and including breastfeeding skills and knowledge in the education of all health workers.

These actions are do-able, and would be a logical response on the part of our society to relieve itself of the guilt it should experiencing for creating obstacles to the best health choices for women and their infants.