The first week in August was World Breastfeeding Week. I started this post then, but a few unexpected things came up, so it took a while to finish. I have since learned that the entire month of August is National Breastfeeding Month--so I am not too late to put it up!
Every once in a while, when there’s nothing better on the DVR, my husband and I have found ourselves watching “What Would You Do?” on ABC. It’s a little bit contrived, and host John Quiñones makes some rather ridiculous comments, but, still, it’s a somewhat interesting look at social psychology. The show hires actors, stages some uncomfortable situations in everyday social settings, and waits with hidden cameras to see how people will react. In the first episode we watched, a café manager quite affrontingly insists that a breastfeeding patron “get out of [his] restaurant” because he doesn’t want to have to see her “jugs.” The response to the heated exchange between these two actors is probably the most divergent of any we’ve seen so far on the show. Of the patrons who spoke up, a few came to the mother’s defense--one even pointed out that the law was in her favor--but several others sided with the manager, despite his belligerent tone, saying they would never do that in public and suggesting that she go sit against the wall where no one could see.
Unfortunately, scenarios like this actually happen rather frequently. As an example of the situation that inspired the segment, “What Would You Do?” interviewed one mom who was forced to leave a restaurant after breastfeeding there. Another memorable incident occurred several years ago when a woman was told she couldn’t nurse her infant in the changing room at Victoria’s Secret. (Yup, that’s the same store that fills its window displays with practically naked and provocatively posed women.) Both of these women filed lawsuits. Once the business owners figured out that what their employees had told these women was against the law, they were quick to offer settlements and public apologies. That‘s right--most states have laws that allow a woman to breastfeed her child anywhere she is allowed to be.
But, isn’t it indecent to be pulling your hooters out in public? Turns out, more than half of the states with laws protecting a woman’s right to breastfeed also exempt her from any indecency laws. But most mothers don’t expose anything at all when they breastfeed in public. They are either self-conscious enough about displaying their nipples or considerate enough of other people’s insecurities that they cover up with a blanket or use their shirt to hide any exposed breast tissue. But it should be reassuring to mothers that even in the (likely) event that their squirmy babies kick off the cover, or pull up the shirt, or unlatch suddenly to look around, that we are legally protected almost everywhere in the country. Furthermore, if we want to, we have the right to pull out and expose our entire breast while nursing. Anywhere we want to. (Here's the law in Texas, and a handy little card you can print out to show anyone who asks you to move or cover up.)
Even with the law on our side, though, a lot of people will still have a problem with mothers who breastfeed in public. We are often asked why we can’t just prepare a bottle instead. Well, here’s why, plain and simple: it’s not as good for babies, and it’s also just a pain in the ass. Many babies who breastfeed refuse artificial nipples, first of all. And, even if they’ll take a bottle, it can be really difficult to pump enough milk to fill one for a public outing. Milk production self-adjusts to meet baby’s demand, so occasional pumping in-between regular feedings isn’t likely to yield very much. The fattier hindmilk can take considerably longer to let-down when pumping as opposed to allowing baby to suckle, so pumped milk might not have the calories and fat baby needs. But even if a mother is able to make a bottle for an outing, then there’s the issue of how to keep it properly chilled and how to warm it so that it’s not too cold when the baby is ready to drink it. Then, there’s the issue of the mother’s health and comfort as well. Mothers who breastfeed need to empty their breasts when it’s time for their babies to eat. Otherwise, they can become painfully engorged with milk--which could increase the risk of mastitis. And, skipping a feeding can tell the breasts to slow down on milk production, so baby might not get enough the next time he feeds.
So, if pumping isn’t the answer, why don’t we just use formula when we’re out-and-about? First of all, despite the improvements made to infant formula over the years, it still just isn’t as good for our babies as breastmilk. The American Academy of Pediatrics now recommends that all babies be exclusively breastfed--that means no formula, cereal, or other solids--for a minimum of six months and that nursing should continue until at least the first birthday. If 90% of moms complied with these guidelines, the AAP claims, over 900 babies’ lives and $13 billion dollars in health care costs could be saved annually. (Currently, only about 40-50 percent of moms breastfeed at all up to the six-month mark). The Texas Department of State Health Services has launched a campaign calling breastfeeding “nature’s health plan“ and urges hospitals to do everything they can to encourage mothers to breastfeed by following the “Texas Ten Step” guidelines. Most of these 10 Steps are a drastic change from the standard hospital procedure of recent decades. The World Health Organization doesn’t even want formula makers to distribute samples to new mothers, or advertise to the general public. Why such a strong push to get mothers to breastfeed, and to protect us legally when we choose to do so?
The more we study babies and mothers, the more we understand how beneficial breastfeeding is to both groups. Though there are many advantages to breastfeeding, here are a few: Breastfed babies receive passive immunity from their mothers, and come down with far fewer illnesses; many never get sick at all until after they are weaned. They are less likely to develop allergies or eczema. Fewer breastfed babies die in the first year of life. They tend to develop social and psychomotor skills before their formula-fed peers. Children who were breastfed as infants have been shown to have slightly higher IQ scores, and they have lower incidence of obesity, diabetes, and leukemia. Adults who were breastfed as infants have decreased risk of heart disease. Additionally, mothers who breastfeed have a decreased risk of developing breast cancer later on. They take less than half as many days off work to care for sick children.
Conversely, while formula makes it possible for many infants to survive, it has definite drawbacks. One of the most common reasons proponents of breastfeeding give is that formula is expensive. Even the cheapest formulas run about $100 per month; if a baby needs a special one, it might be as much as $350. But besides financial cost, there may be some deleterious effects on health with formula as well. There are some who suggest that infant formula is not only unable to provide the natural benefits of breast milk, but that it might actually cause harm. Dairy cows are frequently injected with hormones to artificially increase their milk production. These excess hormones make it into the milk, and when that milk is used to make infant formula, those hormones are ingested by babies. In China, babies started developing breasts after drinking formula made with hormone-laden cow's milk. Many formulas also contain soy, either as a supplement to or a replacement for cow’s milk. Although soy has been heavily advertised as a healthy food, it actually contains high levels of phytoestrogens. One estimate puts the amount of estrogens ingested daily by an infant who is exclusively fed soy formula at amounts equivalent to that in five birth control pills. These effects of soy are still largely hypothetical, but worth considering. Excess estrogen levels are known to be causing menstruation in girls as young as three years old, and can also adversely affect boys’ development as well. The Texas Department of State Health Services website says: "The WHO Code recommends that all women choosing to feed formula to their infants, first be informed of the hazards associated with artificial feeding and be instructed in how to properly use it."
For working moms, it might still seem easier to just switch to formula, since it can be difficult to pump and store milk at work. But those who do choose to continue providing breast milk for their babies now have a right to do so under federal law. Employers are required to give moms “reasonable time” to pump milk during the workday as often as they need to do so, for at least a year. The law does not require employers to pay workers for time spent pumping, but they have to provide a space for women to do so other than a restroom.
I think it’s important to point out that breastfeeding isn’t possible for everyone, nor is it always easy to do. Many times, moms who feed their babies formula come under just as much scrutiny as those of us who don’t. I don’t want to make anyone feel as if I judge her for her choice not to breastfeed; I do want to provide as much information as possible to help other women evaluate the choices they make. If, knowing as much as possible about the benefits of breastfeeding over formula feeding, a woman still needs to choose formula for her child, then she should have my support. I think it’s important to utilize as many resources as possible to help establish breastfeeding, starting with hospital lactation consultants, La Leche League, and experienced mothers and grandmothers. It is rare that a woman actually cannot breastfeed or that a baby cannot learn to latch, but it does occasionally happen. It is probably more common that a mother would need to take medication that would pass through her breast milk to her child and cause him harm.
What if you can't breastfeed but don't want to use formula? Milk banks exist for babies who are born prematurely or have other special needs, but banked milk is ridiculously expensive. Wet nurses still exist, too, but I imagine the average mom would not be able to afford their services, either. A dear friend of mine was disappointed to realize she would not be able to breastfeed, and knowing how important it is for her baby, she asked friends if we would be willing to give her any extra milk. She also found a Craig’s List-style website where mothers who need milk can connect with mothers who are willing to donate their extra milk. Even a little, she said, would be better than just formula. And I think she is right. I admire another friend who struggled to get her second baby to nurse, and pumped milk for him for an entire year. Even though these efforts might seem Herculean, I think they are just moms who want to provide the best for their babies, and they are willing and able to go above and beyond for them.
To close, I’ll share this video from The Bump that inspired this post’s title. I hope that if you’re able, you’ll whip ‘em out, too, and feel supported when you do.
