Friday, September 7, 2007

Guardians of breastfeeding

Can this be true? TEN percent of 6 month olds are being breastfed in the US?

Six month olds are tiny little new babies, most with one or no teeth yet. And NINETY percent of them are drinking formula?

I am astonished and sad.

We really need to figure out what is happening to all these nursing mamababies from the point that they leave the hospitals as nursing duos to the time when only one in ten of them is still together a mere six months later.

Are they leaving the hospitals with idiotic misinformation, reeling from their overmanaged births, completely unprepared for what breastfeeding a newborn is really all about?

Do the people who write the glossy pamphlets they slip somewhere into your going-home-kit even have a clue about human lactation or nutrition?

Are there ever, ever pictures in those pamphlets of mom and baby laying on their sides, in bed, maybe with hair greasy, maybe with their shirt off, red and botchy baby in a diaper...or is it always the same fully dressed mother in the glider, with her perfectly sturdy and also similarily outfitted 3 month old, no boppy pillow, no rashes, shoes tied, house tidy, oh so perky, "8 to 12 times a day"?

Who could live up to that? What does that image have to do with anything besides selling glider-chairs?

Has the entire hospital staff been bottle fed every four hours?

I direct this at hospital birthing mothers because they are in the vast majority in our country. 95%, I think? (correct me if i'm wrong)

I picture midwives not afraid to tell the mothers and family members what to expect in newborn care and feeding. Thats its all day all night no clocks no clocks no clocks. I picture midwives being available for phone calls and for real advice and for house calls 1, 3, and 7 days after birth. Or more.

I picture the UC moms being so self educated that they certainly would be able to handle realism and information and hopefully they have someone to call if things get squirrely.

So, what is happening to these moms and babies? Why are they quitting? What is the average age of quitting, I wonder? I have a bad feeling it is at about 2 weeks old when the hell and agony is too much, perhaps. Before they get to the happy-cherub part. Before they gain confidence. before they can see the sparkly bright eyes and before they can get into the fact that it is simple and convenient and awesome. Before they even have their milk in right. Before they are not bleeding and not hobbling and not sweating and not swimming in a sea of breast pads and maxi pads and laundry and pain pills and chaos, they are already quitting.

I blame so many things, but the lack of postpartum support, EVEN TO THE MOMS WHO "FEEL AWESOME", has absolutely GOT to be the number one factor.

Maybe it is their girlfriends, the ones who didn't nurse, the ones who don't have children, teasing them, asking them to go dancing, asking them when are you gonna wean, asking them doesnt it hurt? dont you feel like a cow? are you gonna do THAT in the restaurant? Being as uneducated and ignorant as most Americans are.

Maybe it is their husbands, partners, lovers, all with the same questions, hang-ups, fears.

Maybe it is their mothers, mother in laws, grandmothers, telling then they are nursing too frequently, offering to "take the baby for the night", telling them horror stories, making them go do that in the back bedroom so Grandpa doesn't faint away dead at the sight of a clavicle.

Mom+Baby belong in bed, or on the couch for a while. But boy oh boy does this " serene surrender" conflict hard with just about every single thing and symbol and vision and false advertising imagery we have ever learned or known or seen in these modern times. You know, celebrities, parenting mags, media lies, urban legends spread by well meaning in-laws...

We might read about "other cultures" whose women have a babymoon, a lying-in, 22 days, or a month, and we might smile for a moment and think "wow, how cool." But do we stop and see what that is rooted in?

We might tell our friends and sisters who just had a baby "call me if you need anything", but do we mean it? What about after the first couple of days postpartum? Do we stop and see reality?

Do we offer booties and layette sets or do we leave a hot pizza on their porch, ring the doorbell, and drive away? Don't we have 10 dollars for a family we know and love?

Have you ever been a laundry fairy for a new family, (something we requested specifically after the birth of both our 3rd and 4th children and did not recieve?) How nice it would be to have them just put their clothes out on the porch and have them returned folded and fresh. What a little deal it would be to you and what an incredible blessing it would be to them. The new family. Community.

Have you ever just went and sat with a new mom, kept vigil with her on her couch, helped make the boppy and the water bottles and the leaking all seem fun and funny and normal and cool?

I am so sad for the nursing mamababies who quit, 9 out of 10 of them according to this study, before they even hit the half year mark. I hope this can change, but pinpointing exactly what happened would be complicated. Between all the "I didn't have enough milk" and whatnot, many of these people probably don't know what happened, really.

If only we could all be guardians of breastfeeding initiation and continuation rather than just lip-service supporters who remain isolated from each other.

I think newborn mamas and babies need much more protection and guradianship than pregnant women do. Most women's bodies do all the work of growing a baby, and outside of the basic needs for nutrition and rest, the vast majority of women can and do grow their embryos and fetuses just fine. But apparantly 90% of women in our country haven't been able to sucessfully nurse their children for even 1/2 a year.

Something HAS to be done.


Sgt Howie said...

Wow, ten percent? That is truly sad.

Perinatal care is overwhelmingly in the hands of male obstetricians in the US. They may know the benefits in the abstract but they have no personal experience with nursing and no stake in it. These men are never going to be the strong advocates for breastfeeding that the system needs. In fact, in the hospital birth system if you're planning to breastfeed that represents a potential complication that could delay your discharge if everything doesn't go smoothly and occupy a much in-demand LDRP suite. It's so much easier to hand you a packet and some product, thoughtfully provided by Enfamil, and shoo you out the door.

Our country is still stuck in a midcentury mindset about breastfeeding. It's a messy, slightly queasy affair (as evidenced by the comments on that clip I sent you about extended nursing) and a great inconvenience, better left to hippies and the third world.

Angi said...

I can't agree with you more. When you have a baby in the hospital, at least with three out of my four, they send you home with a diaper bag "donated" by Similac or Enfamil, with a little sample of formula and coupons. Gee, that's really helpful. I think the first two weeks of nursing goes by in slow motion and a lot of mom's don't think they can get through the cracked, bleeding sore, engorgedness of it all.
Also, has anyone else noticed that at every pediatrician visit they ask-how many times a day does she eat? and how long on each side? When I finally said, "oh, she eats at least twelve times a day or more" he told me that I was going to wear myself out that way and I'd better not feed her that often--right after he told me that she was in the 3rd percentile for weight and she needed to grow faster. Breastfeeding has been one of the best experiences of my life and I don't want baby #4 to grow too fast because she will outgrow it eventually. But it wasn't always that way. Baby #1 was a "nursing failure" and even with a midwife, lactation consultant, and pediatrician, nobody could help me figure it out and after being threatened by the ped "if he doesn't gain weight by thursday I'm putting him in the ICU" DH begged me to give up and put him on formula...three weeks old. It was horrible. If only I had known about the AP hippie mom two doors down who I met a month later and who gave me Dr. Sear's Baby Book and encouraged me to throw away the "baby wise" book another mom had given me. She was a true guardian for breastfeeding and I love her to this day for helping me rescue breastfeeding for my next three children.

tanya@motherwearblog said...

The 10% figure refers to exclusive breastfeeding, so the number is actually higher if you count mothers who are breastfeeding along with formula or solids. So it's not *that* bad, but still pretty awful.

There are so many things that get in the way of breastfeeding, from birthing practices, to histories of sexual abuse, to our culture's in ability to see breasts as anything other than sexual, to aggressive formula marketing. But if I had to name the top ones I see, it's lack of *good* help in the first few weeks, when the drop off is really steep, and then our horrible "maternity leave" - the worst in the developed world and just about every developing country, too. For so many women pumping is not an option. A close third would be the way formula is permitted to be marketed here, including those hospital bags. According to the CDC, the % of women who say that 'formula is just as good as breastmilk' *doubled* between 1999 and 2003, so they're doing something right!

I guess that the good thing about this is that it's not impossible to change some of this. It's happened before, when enough women got fed up enough to do something about it, and we can in fact change laws in this country...

(love your blog!)

Tanya (Motherwear Blog)

heather said...

10% is just so... discouraging.

I think a lot of it is a lack of support. There is often no breastfeeding support in the hospital and when there is it is often not experienced lactation consultants. I've seen so many nurses hand out nipple shields that were NOT needed... and then you have the nursing relationship being threatened before it has even begun. Then sometimes there is a lack of spport at home from either husband or extended family. And society is far from supportive of nursing moms (as evidenced by the Applebee's incident.)

So these moms have the free formula samples and figure they might as well use them. When the going gets tough they don't know what to do... It's very sad that our society views formula feeding as "normal."

Anonymous said...

I was able to bf my daughter because of support I gained from my mother, dear husband, and an awesome LC in the area. She decided to stop breastfeeding at 19 months.

I am a nurse, and have seen the bottle pushing first hand.

It is sad, but until there is universal support for all mothers, I can understand why the majority makes a choice to use replacment nutrition.

Rebecca said...

This was such a powerful post! I'm sure it made a lot of us out here take a good look about how we can encourage breastfeeding one mama at a time. (It had that effect on me anyway!)

I actually just heard a great article on this exact issue on NPR the other week. (I just searched their website for it to no avail. Arg!) The piece featured interviews of two prominent breastfeeding advocates. The reporter started from the premise that many hospitals are doing away with formula samples in their swag bags. Both women interviewed sadly agreed that they didn't think that was going to make much of an improvement.

The consensus was that the BIGGEST obstacle (along with all the things mentioned in your post) to continued breastfeeding was women returning to the work force. They claimed that many women simply switch to formula at that point. And those that do attempt or want to pump at work are thwarted by their work environments. Employers often do not allow long enough or frequent enough breaks for a mother to pump sufficiently. Imagine the waitress or the cashier. They're shit out of luck. And even women with desk jobs can rarely find a private place or enough time to pump. Imagine, you have a 15 minuet break and the only place you can find privacy AND an outlet or your pump is in the ladies restroom...

It seems one of the biggest things that needs to happen for moms to be able to continue nursing past the 6 month mark, is a business culture and employers who respect and value breastfeeding. Moms at work MUST be provided with a clean private spot to pump and sufficient breaks to do so. I'm afraid that until women DEMAND those things we are going to continue to see a society of children nourished by formula.

mama k said...

I am going to do this very thing Thursday. My dear friend had a "typical" hospital birth resulting in (one of the 30%) c-sections.
Her DH had to go back to work and there she is at home to fend for herself and learn this nursing thing all by herself.
I will say that the hospital seemed very supportive of the nursing. Wouldn't even give them formula for baby because it would undermine their choice to breastfeed. !!!
I of course told them that was great. LOL
I hope that I can provide some encouragement to her... oh and to teach her the laying down position. That's a lifesaver!

The stats are so sad, but I think it starts with us. We must be that support system and share the correct information with love and empathy. :)

Housefairy said...

Mama K--email me privately at if you want to help a c section mom...

She is one lucky mama tp have you there for her, but I couldn't lay on my side or even turn my body for over a month, so, c section provides even more obstacles.

I will tearfully, fitfully, angrilly admit that newborn care after my c sections were the most horrible, painful, lonely and desolate times of my life.

But maybe your friend isn't left home alone to die in the care of other kids--and it looks like she will have a visitor--you!

I will say that after a few weeks I was able to be rolled onto my side by my husband who would then wedge pillows all behind my back to keep me that way, and then I could nurse on my side, baby off my incision.

Trish said...

This post made me think back to my first days with my first baby.

It's amazing for me to look back and realize that I continued breastfeeding! When I think of all that seemed to go against me I realize that it's the stubbornness that used to get me into trouble as a kid that got me through the bumpy beginning with my new baby. For women who aren't as STUBBORN I can imagine throwing in the towel for sure!

I had a lactation consultant available to me, but there was a fee involved. We couldn't afford that. My baby was a sleepy baby who wouldn't wake to eat. For a full week I couldn't get her to wake up. She was tiny to begin with, but she dipped under the 6 # mark after the first week.

Fortunately my pediatrician was thrilled that I was exclusively bfing, so he was supportive. My mom was supportive. But my husband's family...
"how can you measure how much the baby is getting?"
"why is she so skinny? Maybe your milk isn't good enough."
"why does she cry all the time? Must be the breastfeeding."
"you're spoiling her by feeding her so much!"
I could go on.

My sleepy baby eventually woke up and nursed well. I did break down and feed her some formula with a spoon because I was terrified that she'd dehydrate. But if I hadn't been SO STUBBORN about my belief that breast really is best it would've been SO EASY to give up. And WIC, after all, would've paid for the formula!

That's just sick.

CNH said...

Sometimes I just want to bang my head against a wall.

I am a part of many mainstream and 'mixed' boards and it bugs me when someone weans early and all the posts read "you gave your baby the best possible start" or "you did better than me, I quit at ::insert amount of days/weeks/months here::"

Don't we owe our little babies our milk for at least a year? Good God, my CAT gave her kittens her milk until they were able to subsist on solids alone. ALL other mammals do.

It just makes me so sad.

Rixa said...

I had awesome postpartum support from my husband. I laid luxuriously in bed for about 10-12 days and didn't do anything except nurse, sleep, think of baby names--and spend a lot of time on the internet! I didn't even go downstairs for 4 or 5 days, and even then only did once or twice in the first few weeks. My mom came 11 days after my daughter was born and helped with cooking and housework. And bringing me water, and nursing pillows, and diapers...all that good stuff.

I am still nursing exclusively after 10 1/2 months (okay, 99.9% exclusively since she is begging for tastes now) and am so proud of that. Not proud in the I-am-better-than-you sense. But it's a big accomplishment.

Housefairy said...

I am so glad you were stubborn-- I think thta's what got me and Greta through, too--we had a rough start and I wasn't even planning on becoming some big advocate of anything--I just guess I saw her dear little fat cheeks and how happy she was when she nursed, and I had the sense to know that it certainly must be "best" and "meant to be", and so we truged along until it didn't hurt anymore and wasn't awful anymore, and she nursed for YEARS.

I had supporters in the form of my husband who was "proud of me", and my mom, who nursed me and my sister for a few months, but sadly, most likey due to her own unsupportive husband and 1970's pediatrician advisement of not feeding us until such and such o'clock, she switched us to formula, my sister and I.

My pediatrician thought it was all bad, and we fired her.

My friends thought it was vaguely wierd, and were kind of frustrated with my seeming inability to go out and par-tay like their other pals who formula fed did...(I was 22 when Greta was born, those arent our friends anymore)

My mother in law didnt know what to think. She was very uncomfortable, and yet very curious. "How will you know if she's getting enough? How long are you suppossed to do that for? When can she have cereal? When can she take a bottle? When can she sleep over? Do you have to take special vitamins?"......after 4 kids she knows what staunch breastfeeders we are now, and she has had more exposure to what was, as a first time grandma in 1997 fully admitted, "Just something nobody did when I was raising my kids".

that is very cool that you got the rest and support we all deserve when we as mama/babies are just starting out. Its hard to get that kind of care when/if there are other children and dad has to go back to work immediately...again back to the climate and culture that is so flagrantly against what is right for its actual citizens.