My Feminine Mind: January 2011

From time to time, whenever there is a breastfeeding controversy, caused by some ill-informed employee or manager asking a nursing mother to leave the public place or remove herself to the restroom, invariably in the comments section on the news story there will be statements to the effect of, "I don't understand why women can't just pump and bring their milk with them when they go out in public or else give their baby formula in public." Others don't understand "why women can't just cover up or go to a private place to feed their baby and then return when the baby is done eating." I thought I might do my share in addressing some of these concerns.

I think a lot of such statements comes from ignorance regarding how important breastfeeding is to an infant, to a mother, and to society in general. Though this list is by no means complete, it contains some of the benefits of breastfeeding:

Approximately 900 infant lives would be saved in the US annually if 90% of women exclusively breastfed for six months. ¹
A 2001 government study estimated that $3.6 billion would be saved annually if 50% of US women followed the recommendation of exclusive breastfeeding for 6 months. (Presently only about 12% do). Because health care costs have risen since 2001, it is likely that the savings amount has increased. ¹
Breastfed babies tend to have a higher IQ than their formula-fed counterparts. It is believed that this is because of the amount of direct skin-to-skin contact that breastfed babies receive, which is extremely important to infant brain development. ²
Breastfed infants may receive protection against Multiple Sclerosis as an adult. ³
Mother's milk contains antibodies that are given to the nursing child. Thus, breastfed infants have lower risk of ear infections, diarrhea, upper respiratory tract infections, urinary tract infections, reflux, and general stomach upset. ⁴
Breastfed infants have lower risk of developing allergies later on. ⁴
Breastfed infants have lower incidence of obesity as children and also when they are adults. ⁴
Breastfed infants have lower incidence of diabetes, and they receive protection against many cancers and even heart disease as an adult. ⁴
Breastfed infants receive protection against childhood leukemia. ⁴
Breastfed infants are at greatly reduced risk of SIDS. ⁴
Exclusively breastfed infants do not get constipated.
The longer a woman breastfeeds, the more protection she receives against all feminine cancers. ⁵
Breastfeeding releases oxytocin in the mother which reduces her stress level and helps her feel bonded to her child. In fact, breastfed children have a lower risk of being abused by their mother than non-breastfed infants. ⁶
Breastmilk makes infants sleepy, which also lightens caregiver's load.

Though the benefits of breastfeeding are substantial, breastfeeding, especially in public, can be very difficult to do. When I was pregnant with my first child, knowing some of the benefits of breastfeeding, I knew I wanted to give my child the best start. I remember the first time I breastfed in public. My daughter was 9 days old and we went to church, the youth mass at my parish. I think there may have been a row of teenage boys behind me. In the middle of church my baby started to fuss. I rocked her, I lightly jostled her, I gave her my finger. I may have even tried a pacifier. None of these things were working though; I became stressed and my daughter was becoming increasingly noisy. I really didn't want to nurse her there. It would have been so easy to leave the pew and go to the entry area of the church and feed her. But then I thought, "Women shouldn't have to feel this way. Breastfeeding is natural and healthy. Infants have a biological need to nurse often, and they should be able to eat whenever they are hungry." I wished that the sight of a nursing woman was at least as common as the sight of a baby eating from a bottle. So I sat down, used a receiving blanket as a cover, and fed my child. What I felt was...embarrassment. But I sat there and continued to offer the sacrifice of my embarrassment for the needs of my child. I don't know what the expression on my face was, but my husband leaned over and asked, "Are you okay?" I stoically nodded yes. I may have been turning red. I thought, if I remove myself from public view to feed my child then I am contributing to a culture that shames women for feeding their children. If I remove myself, I'm enabling a culture in which other women will feel the way I did at that moment. I felt angry for feeling embarrassed. I recognized that it was unjust that a culture should make me feel this way for doing something so profoundly amazing. It echoes the misogyny inherent in comments that degrade or otherwise diminish the ability and immensity of pregnancy. I don't want to make women who choose not to nurse in public feel guilty. Mothering and learning to breastfeed has many challenges and only the woman herself can decide if she can take on the challenge of combating social norms and attitudes. But for me, at that moment, despite the embarrassment I felt, I also felt resolve that what I was doing was necessary not just for my child but for other women.

In regards to the question about why can't a woman just bring her milk in a bottle when she's going to be in public with her infant, for me the question is not "Why can't a woman just pump?" but why WOULD she pump? Firstly, pumping takes twice the amount of time that nursing directly from the breast does. I find disturbing the request to heap more responsibilities and burdens on mothers than those she already has. I feel a lot of sexism is inherent in such requests. To me this mirrors the cultural loads that women already have to bear that men do not, primarily centered on our "duty" to look flawless at all times, the pressure women feel to spend enormous amounts of time waxing, tanning, shaping, putting on makeup, plumping, slimming, and so on. To bring expressed breast milk, one has to take the time to set up the pump, then actually pump, carry the milk, it must be stored properly, one has to still feed the baby, and clean the bottle and pump parts. Why should a woman do all this when she could just lift her shirt and feed her baby? Furthermore, milk from her breast is always the perfect temperature and there is never any waste.

Aside from sheer convenience, there are other reasons why women should not be encouraged to pump or feed their infants formula in public.

The World Health Organization and the American Academy of Pediatrics recommend that infants be exclusively breastfed for the first six months of life, receiving no other fluids (not even water) or other supplementation. ⁷
I feel there is wealth privilege at work in such requests. Breastpumps and formula are very expensive and not all women can afford to buy them.
For IQ development, it is the skin-to-skin contact that is especially beneficial, and receiving milk directly from the breast as often as possible is ideal.
Breastpumps are not as efficient in emptying the breast as an infant is. A woman who pumps too much may begin to have supply issues. For her to maintain an adequate supply of milk for her baby, again, direct nursing from the breast as often as possible is necessary.
Studies show that when women do not feel comfortable nursing in public, they wean earlier, which impacts the health of their children and the women themselves. ⁸
For women to get the benefits of postpartum infertility, it is important that the child nurse directly from the breast. If a woman ecologically breastfeeds this will naturally space her children approximately two years apart. (For myself, as I worked when both my children were infants, I had to pump during work hours so it was important to me to nurse directly from the breast outside of work as often as possible to delay my fertility return.) ⁹
For extremely young infants, it is generally advised that the child not get a bottle or pacifier until breastfeeding is well established so that there is not nipple confusion. Babies have to work harder to get milk out of a breast than they do a bottle, so some new infants will prefer the bottle and then refuse the breast, which can then affect the mother's supply and so on.
The composition of breast milk changes throughout the day to perfectly fit the needs of the infant. Ideally, if a woman must pump, the infant should receive that expressed milk at approximately the same time of day at which she expressed it. ¹⁰

In regards to a woman going to a private place to feed her child, I feel this also places extra burdens on the mother. My children often nursed during mass. It kept them quiet and happy. Me coming and going during the service or babies screaming is a bigger distraction to others than me feeding them. Secondly, if I had to remove myself each time they wanted to suckle I would show up to church just to miss the whole thing. If I had to remove myself when my children wanted to nurse in a restaurant, I would not get the benefit of participating in the social atmosphere (which I need especially as an extrovert); I would likely have to eat cold food, and my dinner companions would have to wait for me to finish the meal that I could not eat at the same time they were eating theirs because I was off nursing somewhere, perhaps in the most unsanitary room on the premise like the bathroom as some suggest. As an aside, there are already often lines in women's bathrooms, so I feel it would be inconvenient to use up a stall to breastfeed when it could be used for its intended purpose. Once again, after all of that, I would probably feel like why should I even bother trying to go out to eat. This would have further intensified the isolation I felt as a new mother.

Any public place which I would have to remove myself in order to feed my child would be highly inconvenient, lengthening the time of the outing and making any companions wait for baby to finish. Or, if I was alone with my infant, perhaps I would have to go to a place where I would not be allowed to bring my cart (e.g. a bathroom or dressing room) and so leave it unattended while baby ate. Under such restrictions no wonder only 12% of women in the US still breastfeed exclusively at six months!

In regards to asking women to cover up, covering up with a blanket or nursing tent is not always possible. Having a blanket over my infant's head always made her extremely sweaty underneath. I'm sure it was also stuffy. It can also be difficult, especially with a very young infant, to get a good latch if one can't see what she's doing. And my second child did not tolerate a blanket. If I attempted it, she would cry loudly and flail arms and legs, which risked exposing my breast (which kind of defeated the whole purpose). It was much easier to just pull up my shirt and let her happily nurse. With her head there, not much is visible, much less than many cleavage-showing shirts anyway that I never hear anyone complain about, or hear about women wearing them being asked to cover up.

Breastfeeding comes with enough of its own challenges and we ought not add to the list of challenges that mothers face by further marginalizing new mothers and making public breastfeeding shameful. If you want to combat homelessness and poverty, help prevent cancer, allergies, asthma, and otherwise limit a lot of unnecessary deaths in general, encourage and support women who nurse in public. We need all the support we can get.

Links:

Breastfeeding and Early Weaning from PhD in Parenting

Breastfeeding Support and Normalcy from KellyNaturally

Breastfeeding and the law

Sources:

1. http://www.foxnews.com/health/2010/04/05/study-breast-feeding-save-lives-money/

2. http://www.ajcn.org/content/70/4/525.abstract

3. http://www.breastfeeding.com/all_about/all_about_ms.html

4. http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496

5. http://www.askdrsears.com/html/2/t020700.asp

6. http://pediatrics.aappublications.org/cgi/content/abstract/123/2/483

7. http://www.aap.org/breastfeeding/faqsBreastfeeding.html