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April 21, 2010

Breastfeed for the Health of the Nation?

Not nursing has major societal and health consequences — but even so, mothers deserve our support and understanding, not our judgment.

A new study published in Pediatrics journal concluded that breastfeeding has major life- and money-saving benefits. The study found that “if 90 percent of U.S. families could comply with the medical recommendations to breastfeed exclusively for 6 months, the United States could save $13 billion [per] year and prevent an excess 911 deaths annually, 95 percent of which would be of infants.”

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The $13 billion figure came from examining occurrences and associated costs of 10 common illnesses that occur less often in breastfed children, as well as calculating the lost potential wages of infants who die. The preventable deaths are due to Sudden Infant Death Syndrome (SIDS) and several infectious diseases that breastfeeding has been shown to reduce.

Breastfeeding came easy for me and my babies. They latched on, my milk came in, they gained weight. It is not so for many women. Their babies are tired, their breasts hurt, the nurses are overworked, the grandmas won’t stop asking if a bottle might be easier, the calendar careens toward the end of maternity leave, and they crave nothing more than the uninterrupted sleep they might get if their husbands could give bottles of formula.

While 43 percent of American mothers do some breastfeeding, only 12 percent breastfeed exclusively for the first six months as recommended. Advocates argue that breastfeeding’s life-saving qualities should convince mothers to do it, and everyone else to support them, without all the drama about choices and guilt. The blogger Feminist Breeder, for example, had this to say: “You know what else saves lives? Car seats. So, why aren’t people spitting mad at the [National Highway Traffic Safety Administration] for saying that? Why aren’t they leaving thousands of comments on car seat articles saying, 'But I just couldn’t afford a car seat, why are you trying to make me feel guilty?!' Well, maybe it’s because our society will admit that car seats save lives, and we’re willing to give them out free at fire stations and hospitals if we have to because it is that important.”

I agree with the Feminist Breeder, medical experts (including the Pediatrics study authors and physicians who commented on it), and others who argue that mothers struggling with breastfeeding should focus on the support they need and don’t get, not feel guilty. Breastfeeding can be beautifully simple, but it is not always easy, in part because of cultural and employer expectations. We expect new mothers to bounce back and return to the daily grind ASAP, whether that means returning to work or to the carpooling, chores, and errands that fill most stay-at-home mothers' days.

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This latest study makes clear that nursing is much more than a personal lifestyle choice the rest of us have no obligation to support. New mothers need hospital policies that give priority to breastfeeding; low-cost or insurance-covered lactation assistance; paid maternity leave; flexible workplace policies; and husbands, relatives, friends and neighbors who help care for other children and manage the household during an infant’s first months.

We should support breastfeeding not only because it is good for babies, but also because it honors women’s bodies as God’s gifts, capable of giving babies exactly what they need. But we should also acknowledge that breastfeeding does not always feel like a gift to mothers wrecked by fatigue and overwhelmed by the challenges of breastfeeding while raising other children, managing households, and working. While informed, healthy choices honor our God-given bodies, even healthy bodies are limited (guaranteed to fail, actually) and are only one part of the human story. Our salvation comes from God, not from exclusive breastfeeding, organic diets, natural childbirth, baby-wearing, or any of the myriad other ways that women are encouraged (or commanded) to achieve optimal health for their children.

Because breastfeeding involves unpredictable, limited human bodies, it is not directly comparable to life-saving technologies. Using an infant car seat, for example, does not require a mother to wake up every 90 minutes throughout the night, grit her teeth as her baby latches onto sore nipples, and lock herself in a bathroom stall at work to attach a mechanical contraption to sensitive body parts (although the recent health-care overhaul, which requires large employers to provide a private, non-bathroom space for women to pump breast milk, should make this task less unpleasant for some).

Even if a woman’s breasts are producing milk and her baby is drinking it, she can bump up against physical and psychological limits that make long-term, exclusive breastfeeding more burden than gift. I have a friend who breastfed her baby for several months but found it, overall, to be exhausting and difficult, even though her body did its thing and the baby thrived. She eventually stopped nursing, with trepidation and guilt, but immediately felt happier and better able to enjoy her child. Breast milk is good for babies, but so is a peaceful, happy mom.

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Comments

This was an excellent article...until the last paragraph, "Breast milk is good for babies, but so is a peaceful, happy mom." As if they are mutually exclusive! You built up breastfeeding, but then essentially stated, but you can always quit! It's like you're endorsing quitting as a means to regaining happiness. Please don't undermine the life saving benefit of breastfeeding, by promoting the all too common in our society, "it's exhausting and difficult." Women need support, not discouragement. There is a wonderful article on beliefnet called "the milk of human kindness," that I highly reccomend:
http://www.beliefnet.com/Love-Family/Holidays/Mothers-Day/Milk-Of-Kindness.aspx

Hi Amy: I hemmed and hawed about that last paragraph for the reason you stated, but I left it in because I was making the point that even with plenty of support, if a woman is really just undone by the pressures, it's better for her to breastfeed for as long as she can, perhaps mixing breastfeeding with formula, than to either not do it at all or keep at exclusive breastfeeding even when it's making her crazy. For my friend, breastfeeding and a "peaceful, happy mom" were definitely mutually exclusive (which is not to say it always is, and it certainly was not for me). When we become parents, of course we are obligated to do the exhausting, difficult stuff. But no one can do the absolute best thing 100% of the time. At least I can't, and I don't want to heap guilt on other moms if they make some compromises and keep the big picture in mind (that we have a duty to help our kids be as healthy as possible, but that's not our only duty). But I admit I'm still working out what it means to do our best for our kids while recognizing our limits, our imperfections and our utter inability to protect them from all that threatens them. And thanks for the link to that article--I will check it out!

Ellen

I think this article is a beautiful example of how someone can be pro-breastfeeding for all the right reasons, while supporting the differences and obstacles inherent in motherhood.

As a mom who was up against major roadblocks when I tried to breastfeed (and I wanted to breastfeed - oh, how I wanted to), I really appreciate this piece. I think it shows true compassion.

I doubt that there has ever been a study done on the connection between breastfeeding and depression because it is too much of a hot potato. I wish there was one done, but science, which is supposed to be open to all opinions, obviously is not. It's like the poor scientists who said there is actually global cooling while Gore was busy giving his highly biased film presentations on so-called global warming.

However, I believe, though it is just anecdotal evidence, that breastfeeding is directly linked to depression in many women. It happened, not only to me, but to many, many, of my friends. But of course, we'll never know, because the study won't be done, and it would be ripped to shreds regardless of how well the study was carried out. For me, as soon as I gave up breastfeeding, I immediately lost postpartum depression and on top of it, felt one million times better. My daughter is now in her upper 20s, and has always been as healthy as can be. I'm just saying it is not for everyone, and don't feel badly if you need to give it up, giving it up was best for the baby and for me.

Great article. Just a couple of random thoughts in response.

Among other things, we must be mindful that one source of hindrance to more widespread sustained breastfeeding is the entrenched interest of giant food companies that manufacture formula. To them, maternal and infant health is no match for profits.

Maternity leave in Canada is 52 weeks, with income replacement (55% of salary) through the federal government's unemployment insurance system. You job is protected while on mat leave. Many employers, especially those in the public sector, provide a "top up" benefit so you continue to be paid over 90% of your salary while on maternity. And mat leave can be "split" with the father (max 35 weeks for him) as long as both add up to no more than 52 weeks.

http://www.servicecanada.gc.ca/eng/sc/ei/benefits/maternityparental.shtml

I'm really getting tired of the US being compared to Canada all the time. If you like Canada so much, go there and live. It's a socialist country. The US has been a democratic republic. Canadians have lost their right to own handguns, they have lost freedom of speech, you would be arrested for quoting the Bible on homosexuality, as even pastors have been arrested for this in Canada. Their taxes are much higher than the US. People don't fly to Canada for healthcare treatment, their own leaders fly to the US for treatment.

Stop comparing the two. We're dangerously close to socialism as it now, with obama buying banks, insurance companies, car companies, and now his health care plan, which many of us are praying is overturned. Just go to Canada or any of the other socialist/communist countries-there are plenty of them, and stop holding them up as something we should do. My father and grandfathers fought for our FREEDOMS, which you give up when you become socialist/communist. The US has always been a highly respected country until this current administration. Canada doesn't have the respect of the world, as the US does.

In response to Leslie's post, I don't quite understand your comment about science "obviously" not being "open to all opinions". In fact reliable scientific research is open to all opinions, which is why scientific research is always being done (based on some person's new idea), & the guidelines/recommendations that are based on such research are constantly evolving based on what that science reveals - from nutrition, to vehicle safety measures , to breastfeeding, etc. However, that is a whole other discussion that I will not tackle at this time.

In response to your inquiry about how breastfeeding relates to depression, here is the state of current research on the subject, & why the connection hasn't been well-researched: http://bfmed.wordpress.com/2010/04/18/does-breastfeeding-prevent-postpartum-depression/.

Anyone that works with women in the perinatal period would love to have a better understanding of post partum depression - how to prevent it, how to predict it, & how to treat it - because we all want the best for the women that we work with & their families. Do you know that studies aren't being done, or that they won't ever be done? Why do you think this? It is my understanding that studies are being done currently. Hopefully we will continue to learn more about it, whether the research comes out in support of breastfeeding or not. I am glad that you were able to resolve the depression you experienced, but I don't think the issue is as black & white as you might think.

Your statement is totally trite and untrue about scientists being open to "all opinions". It is laughable. Do you pretend to be unaware that one of the countries leading young astronomers who was coming up for tenure at his university, and had written by far tha most articles printed in scientific journals, lost his position because he dared to mention "intelligent design" on his own, completely private website? He never mentioned his website in the classroom, it was completely privtate. No others came close to his prominence in the field, and he was dismissed immediately when they found out that he had the audacity to mention the possibility of inteliigent design on his own, private website.

http://chronicle.com/article/Advocate-of-Intelligent-Design/38966/

Also, the scientific advisor, for the governor of Oregon (I believe that is the state), was threatened to be fired, or was fired because he disagreed with the theory of global warming.

No, you have to be very politically correct in the scientific world. It's a complete lie that they are open to all theories. The universities are completely closed minded to the idea of intelligent design, and if Al Gore is busy giving half-truths about global warming, scientists, if they want to keep their jobs, need to keep their mouths shut. Notice that Gore never mentions the hundreds of undersea, active volcanoes spewing their gases into the atmosphere. No, everything is due to man's lawnmowers and bbqs. And have a scientist try to get an article printed against evolution? Lots of luck.

As a mother who didn't produce enough milk, I am so bloody tired of defending myself and being made to feel guilty. Yes believe it or not I really was one of those 10% of women who simply didn't produce enough. 16 months later I am still defending myself and it makes me mad. We all know its better but life isn't perfect so instead of doing study after study to make mothers feel even worse about themselves, move on. Make formula better, pass news laws, etc etc and try studying something different.

Great article on breast feeding. You spoke about tired moms and even though that is true I believe some moms think they have to nurse all through the night until they decide to quit. Breast fed babies can be physcally and nutritionally ready to sleep through the night by about 9 to 11 weeks. The milk supply will adjust and both mom and baby are much happier and rested. I did this with my children and have instructed many moms on how this can be accomplished. It is all about knowing the sleep needs of the average infant, TEACHING them how and when to sleep, and feeding them at least one extra feeding daily to supply them with the needed amount of breast milk. It is not a "feed on demand" schedule. I worked over 20 years with newborns and infants and was successful 100% of the time if I had parent cooperation. Each child's personality and needs vary but with proper coaching and instruction parents can learn how to help their child accomplish one of the most important aspects of healthy growth coupled with breast feeding and that is acquiring adequate sleep. I would be happy to discuss this further if anyone is interested. It is best accomplished when starting with new infants but some infants can be transitioned into the night sleeping pattern even as late at 3 months old. About 90% of a newborn and toddler's behavior is conditioned by what the parent teaches.

Here's another reason a mom may not breastfeed: she's on medication that isn't safe for the baby. That was my case, and yes, it was absolutely necessary for me to be on that medication. I would not have been a peaceful, happy or even mentally stable mom had I not had that medication.

Had I breastfed, my child might've had the perfect food but she would've had a wrecked, unstable, unnurturing mother. In the end, I think she benefited from being bottlefed because I was more stable.

Virtually everyone in my church group breastfed and I felt defensive each time the topic was brought up, even though no one tried to make me feel guilty. I guess I didn't want people to think I was a "bad mommy" for not nursing.

I appreciated your compassionate blog post. I wish I could have nursed, but all things considered, bottle feeding was the safest, healthiest option for both my daughters and for me.

I am ten months into breastfeeding my son, exclusively until six and a half months. I've done the reading, watched the mommy wars unfold on the mommy message boards and talked with friends about it. As with so many of the decisions I've made in my life (to go with a midwife, to breastfeed exclusively, to cosleep with our son for six months), it's been because of the way my mother raised me. She breastfed us all exclusively for 8 or 9 months, coslept with us for years, had three natural childbirths. She's not a raging hippie but that's just what she did. Same with me, this is just how parenting was going to go for me. I'm far from saying that all you need is a positive outlook. But I think that the first step is not to go to the government or hospitals for support, it is to lead by example. To be someone who is committed to breastfeeding through sore and cracked nipples, who is comfortable nursing in public even if it could be awkward. And then to be loving in the way we speak with each other about these topics, understanding that my experience was great. Yes, I did work to have a natural childbirth (homework, that is) and yes, I did reading and attended breastfeeding groups to work through issues. I wish there was more of that that was easily accessible. If my friends ask me, I will give them my honest experience. That it can be done (barring medical problems, though I would argue that *some* reasons doctors and nurses discourage breastfeeding are wrong) and that I did the work to figure out how. And in the end that is all I have to offer. I have a son, but hopefully I can be an encouragement for his future wife the way my mother was for me. Thanks for the post!

Margaret - Thank you for sharing your experiences. A great example of the importance of having others who support/model the choices you make combined with proactive seeking of info and support. One thing I wanted to mention in the post but didn't to keep it from being too long is the issue of nursing in public. I think the stares/comments/blushes nursing mothers get is one way in which our culture does NOT support breastfeeding. Really, which is more bothersome--a little skin showing while a baby happily eats, or a screaming, hungry baby? I always breastfed my babies wherever we were--church, a family restaurant, etc. I was discreet, but I did not go into the bathroom, nor did I put a blanket over my head or my baby. I think more cultural acceptance that nursing mothers are everywhere and they cannot control when and where their babies are hungry would ease a lot of women's discomfort with nursing.

Ellen

I wish I had this quote the other day for ibdc who tried to continue the myth of the openness of the scientific method. They are either naive or purposefully trying to continue the myth to an unaware public. The late Harvard paleontologist Steven Gould himself said "The stereotype of a fully rational and objective "scientific method" with individual scientists as logical (and interchangeable) robots is self-serving mythology." Scientists, being human, are world-view driven and have various motivations that go beyond science. Deeply held notions are not allowed to be challenged in today's society, it leads to the ridicule and firing of the individual for daring to contradict them.

There are so many factors that play into breastfeeding besides the nutritive. Societal, emotional, psychological, logistical, medical, familial, financial... these are areas that affect a woman's choice and ability to breastfeed, particularly long term. I tire of those that seem to argue that every woman should be able to breastfeed simply because she has breasts without understanding the nuances and reality of life that affect a successful breastfeeding relationship. And I am angered by those who blame and attack mothers who aren't successful because they assume that it is without good reason without even listening to her story. As though they have the right to judge. I would venture to say that MOST women do NOT get the help and support they need to be successful long-term, which is amply demonstrated by the fact that only 12% of women are still exclusively breastfeeding at 6 months.

When I pondered what I would have needed in order to achieve that lofty goal for myself, it became crystal clear that there was no way I would be able to find that level of help and support. After a month of intense pain and cracked, bleeding nipples that simply would not heal... after seeing the lactation consultant many, many times and nothing improving... after sleep deprivation had made me into a total zombie and completely robbed my husband and other child of any relationship with me whatsoever... I gave up breastfeeding and finally, FINALLY was able to bond with my son and stop resenting him. Yes, there are more important things to provide a child than breastmilk, such as a competent, engaged, and loving mother.

The benefits of breastfeeding are endless. It's sad the way society per the media have brainwashed people viewing it the way it is. AMA marketing at its best.

I know this is an old thread and don't know if anyone is checking back in, but I think this story on Motherlode kind of proves my point that breast is best--except when it's not, in which case we need to give each other a break.

http://parenting.blogs.nytimes.com/2010/08/12/a-breast-feeding-guru-who-uses-formula/

when a baby is born, the most essential thing to do by his mother is breastfeeding. it is really a special gift from God to the child. that's why, mothers should be more fit-mentally and physically for breastfeeding.

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