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When 'Breast is Best' Is Not Enough

Friday, August 26, 2011

For all the promotion of breastfeeding, U.S. women are not responding well to the "breast is best" message, says Kimberly Seals Allers. It's time to clear the air and talk about all the other factors--beside nutrition--that affect a mother's feeding choice.

Subhead: 
For all the promotion of breastfeeding, U.S. women are not responding well to the "breast is best" message, says Kimberly Seals Allers. It's time to clear the air and talk about all the other factors--beside nutrition--that affect a mother's feeding choice.



(WOMENSENEWS)--It's National Breastfeeding Awareness Month. But rather than celebrating, I'm in questioning mode.

I'm questioning why our natural instincts to nurse have gone askew and why our views about feeding our young are less instinctive and more socially and culturally constructed.

I'm questioning why what should be one of the most natural experiences of motherhood is under cultural fire and even being used as fodder for political grandstanding.

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But mostly, I'm questioning why with all the awareness, information and a preponderance of evidence on the benefits of breastfeeding, breastfeeding education has been essentially ineffectual.

Our unimpressive breastfeeding rates show the full picture. In the United States, only about 13 percent of babies are exclusively breastfed for six months, according to the Centers for Disease Control and Prevention (CDC), based in Atlanta. Meanwhile in South Asia, 44 percent of babies are exclusively breastfed for six months, according to UNICEF.

The solution isn't in more pamphlets or brochures. Or more awareness months, for that matter. The problem is in the invisible external forces not mentioned in those glossy materials that markedly affect a woman's decision to breastfeed and her experience thereafter.

These many forces include: the competitive mommy culture, the media who always love a good fight, aggressive infant formula marketing, the Internet and social media outlets, where the battle between breastfeeders and formula feeders has reached World Wrestling Entertainment proportions, and capitalist interests--because let's face it, breastfeeding is bad for big business.

Perhaps the biggest culprit though is closed-door deals between the pharmaceutical industry and hospitals that wind up with women going home with formula in their goody bags. That sends a deep message that health authorities think formula is really "just as good."

All of these factors create a muddled environment that prevents a woman from clearly choosing based on fact alone.

The biggest losers against this "machine" of forces are newborns, who don't get the best first food possible, and mothers, who lose out on the many health benefits of breastfeeding.

A More Nuanced Message

As a mother who breastfed both of my children for at least 12 months, I know that breastfeeding is marketed as a simple decision. Breast is best, end of story. But breastfeeding is actually more complicated and nuanced than that, and that is where we are losing many women.

The conversation must include existential matters like how connected women are to the experience and how breastfeeding works in the actual context of our lives. We need to address and name the psychological, sociological, economic, political and cultural forces that are undermining our breastfeeding experience.

We must speak to the tremendous pressure mothers are under to optimize every dimension of our child's life. And how that pressure can be polarizing, and then exploited by others, robbing many women of the joy of breastfeeding and deterring others to never even try it.

For decades, moms-to-be and new mothers have fantasized, and at times even romanticized, the act of breastfeeding. From the days when La Leche League International's book "The Womanly Art of Breastfeeding" made us believe that nursing our children was the deepest expression of womanliness to the power of the pump--which allowed us to breastfeed without being tethered to an infant--giving our newborns human milk as their first food has been inextricably linked to our mothering values and our womanhood.

But loving your baby and loving the act of breastfeeding is not the same thing. As mothers, breastfeeding contains all of our awe about motherhood and also some of its ambivalence. So along with the empowerment comes conflict--a deep personal conflict between a mother's desire to give her child what's best and a woman's desire to live a full life.

Shrinking the Outer World

Despite the many benefits of breastfeeding, the fact remains that it also can considerably shrink your outer world, at least for a while. Stories of women being ousted from cafés, and earlier this month from the Houston Zoo, for breastfeeding in public don't help. Neither do stories about women getting fired for pumping breast milk at work. There needs to be an honest space to explore all of that.

Meanwhile, our post-feminist selves (perhaps foolishly) believed that our marriages would be partnerships with a co-equal dynamic. In reality, even in the best of marriages, the domestic burden often shifts, sometimes in slow ways, onto the woman. Breastfeeding plays a central role in that shift. When the woman alone is in charge of feeding (or even pumping so someone else can feed), it's assumed she naturally knows better how to comfort the child, and then she is a better nurse when the child is sick, and so on. Something happens from an initial breastfeeding decision, and it can sometimes lead to frustration, disappointment and even depression for some mothers.

These forces take a toll on women and their families, not to mention on public health. At a time when U.S. infant mortality rates rank higher than less developed nations like Poland, U.S. maternal mortality rates skyrocket annually and childhood obesity runs rampant, a stronger and more broad-based breastfeeding culture could have a significant impact on the health of infants and mothers.

If 90 percent of new mothers exclusively breastfed their babies for the first six months of their lives, it would save 911 babies and $13 billion each year, according to the CDC. If 80 percent of mothers exclusively breastfed for the first six months, 741 deaths would be prevented and $10.5 billion saved. If the Healthy People 2010 goals were met, which call for 50 percent of mothers to continue breastfeeding for six months, 142 deaths would be prevented annually and $2.2 billion would be saved.

This would be tremendous.

It's time to look past the simplistic marketing and examine the big picture, which includes the entire breastfeeding culture and all its insidious players. Women and infants need this.

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Kimberly Seals Allers is an IATP Food and Community Fellow and a leading voice on the African American motherhood experience. She is the author of "The Mocha Manual to a Fabulous Pregnancy" (Amistad/HarperCollins) and two other Mocha Manual™ books and founder of www.MochaManual.com, a parenting and lifestyle magazine and blog for African American moms. She is a regular commentator for Babycenter.com and Essence.com and is the multicultural mom channel leader for LiftetimeMoms.com.