Tag Archives: babies

Barriers to Breastfeeding: Disappointing but Not Surprising

Debbie says:

I was born in 1951. My mother wanted to breastfeed me, but breastfeeding was completely out of fashion among affluent white people. Her doctor said, “Well, go ahead, I guess, but I can’t help you. I don’t know anything about it.” So when she ran into issues, she asked the the Black women at the bus stop, waiting to go home from their jobs as cleaning ladies and maids in the Jewish neighborhood of Baltimore where I was born. They apparently thought she was kind of dumb, but were very helpful. (I never asked her why she didn’t ask her mother …)

Breastfeeding_paolopatruno9Photo by Paolo Patruno.

Things change. Now breastfeeding is what affluent White mothers do, and harder for working, unemployed, or impoverished Black mothers. And bearing in mind that not every mother can breastfeed, and not every  mother wants to breastfeed, there’s no doubt that parents and babies are well served by having breastfeeding as an option.

According to the United States Breastfeeding Committee, one of the leading experts
on the current state of breastfeeding in the U.S., breastfeeding is the “most effective
global public health intervention for child survival.” Breast milk provides critical
nutrients to babies when they need them the most, supporting a variety of early
developments in the body, including brain development. It also transfers necessary
antibodies from mother to child that protect against disease, and wards off other early
childhood dangers such as SIDS and asthma.
The Center for Social Inclusion has released a long, detailed report in .pdf form, detailing the issues that contribute to making breastfeeding challenging. Two things make this report especially important: first, the focus on structural racism:
Often, when we think about racism, we focus on individual attitudes or behaviors,
which is important. Sometimes, we look at how particular institutions treat people of
different races differently, which is also important. But to truly understand the root
causes of racial inequity and thereby produce solutions that work for everyone, we
need to take a structural race approach. That means looking at the First Food system
through the lens of policies, institutions, and people—together.
and second, the storytelling style, focusing on three fictional mothers:
Sarah is White and lives in a suburb of Detroit. Her husband is a doctor at the nearby
hospital, and she volunteers full-time for a local nonprofit. Nicole is Black and lives in a
small town in Alabama. She is a teacher at the middle school and her husband is earning
his MSW through online classes at the University of Alabama. Lara is Latina and lives in
Los Angeles with her husband and mother. She and her husband both work for (and met
through) the city’s transit agency; her mother runs the home and receives Social Security.
The report follows all three women through their breastfeeding journey, interlacing their stories with statistics and information about breastfeeding in their various communities. The information is detailed, clear, and excellent, and the conclusions are convincing.
At each stage, smart policy interventions with robust implementation can make it easier
for all women to choose to breastfeed if they want to.
We seek policy interventions that truly address the root causes that are linked to
breastfeeding outcomes, especially lower rates for women of color. We know that
no single policy alone can dismantle structural inequity. This takes reform, including
diversification of the medical sector and those providing services, as well as changes to
and better implementation and promotion of existing policies like the ACA breastfeeding
provisions. But it also takes transformation, including directing funding streams to
challenge all barriers at the neighborhood level. We therefore need a variety of policy
and practice interventions that support women and communities of color to truly achieve
higher breastfeeding rates for all mothers.
The report goes on to detail these interventions; read the whole thing.
Why is breastfeeding a body image issue? For me, it’s because breasts have been fetishized, banned, turned into objects of the male gaze, commodified, judged, and generally objectified, often at the expense of remembering their biological function. So it’s important to me to remember what breasts do and more important that anyone who wants to be able to provide food for their babies from their breasts should be supported in doing so.

Geeking Out on Mothers’ Milk

Debbie says:

One of the many good things about Nicholas Day’s article in Slate about the science of breast milk is that, pretty close to the beginning, he goes out of his way to say that “conversations about lactation always seem to require disclaimers,” and his is that lack of breast milk

has never been a death sentence. Hundreds of years before halfway-decent formula, infants were fed gruesome substitutes for breast milk (mushed bread and beer, say)—and although many more died than those who were nursed, many also survived. So the lesson of the new science of milk isn’t that formula is some sort of modern evil. (It isn’t modern or evil.) It’s that milk is really complicated—and evolutionarily amazing.

Of course, this is important because of how intensely mothers (at least white, middle-class American mothers) can blame themselves if they can’t nurse or don’t like it or don’t do it for two years or whatever the current thinking is. In my history, the story was the opposite: my mother wanted to nurse and it was thoroughly unfashionable. Her doctor wished her well but said, “I can’t help at all; I don’t know anything.” And nursing is, contrary to many people’s beliefs, often neither simple nor intuitive. So when she ran into trouble, she went to the African-American women waiting on the corner for the bus to take them (to? from?) their jobs as maids (this is Baltimore in 1951) and got their advice. I’ve always admired that–and wondered why she didn’t ask her own mother, who almost certainly nursed all three of her children.

But I digress.

In the article, Day relies mostly on the work of Katie Hinde, a Harvard assistant professor who studies breast milk in humans and rhesus macaques, and writes an occasional blog called Mammals Suck … Milk (Day shortens the name, which I think is a pity). According to Hinde, breast milk is not very well understood. L. Bode at the University of California San Diego recently published a paper demonstrating that some of the carbohydrates in breast milk are indigestible by babies … instead, they feed the bacteria in the baby’s gut, and perform a wide variety of health protection tasks in the process.

Hinde, whose field is evolutionary biology, focuses more on what she calls “milk as signal.” In rhesus macaques, “The composition of early milk seems to mold infant temperament. But—and here’s the twist—the males were much more sensitive than the females. Roughly, the more cortisol, the more bold and exploratory the male rhesus macaques were.”

Although evolutionary biology is a more sophisticated and scientifically defensible field (by far) than evolutionary psychology, nonetheless this is probably very simplistic gendering and might not withstand a more nuanced examination. There is so much data, beginning with the now almost 15-year-old Biological Exuberance, undermining binary descriptions of animal sexual/gendered behavior that I can’t trust statements like:

In rhesus macaques, daughters stay in their social groups their whole lives,” Hinde notes. “They form a bond with their mother that only ends when one of them dies. So it might be that mothers are nursing their daughters more frequently and that helps establish this bond.” In contrast, the sons end up leaving the group—and fattier milk means they nurse less often, which means they can spend more time playing with strangers, developing skills they’ll need later in life. The milk, in other words, reflects and cements the social structure of rhesus macaques.

And, of course, Day (if not Hinde) feels perfectly free to hint that these findings will illuminate human behavior.

Nonetheless, there’s more in the article about the complexity of the content of mother’s milk, and the whole thing is worth reading. I only wish that, as a culture, we were able to extend our observation of chemical/biological/hormonal/tactile substances and experiences that we know we don’t understand without trying to fit them into our extremely reductive concept of two immediately identifiable, vastly different, and non-overlapping genders.

Thanks to boingboing for the pointer, and to whatever link list got me to boingboing to find it.