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Breastfeeding – A Retrospective View Across Culture and Time
I’ve been meaning to write this story for some, but was prompted by a recent email I received from a young mother asking for my advice regarding breastfeeding in public. Her baby was four weeks old and breastfeeding was going very well. Except she felt uncomfortable breastfeeding in public. She wrote about the reaction she received when she breastfed her child around her NCT class; none of whom are breastfeeding. One mother actually turned away. It was a terribly traumatic experience for this new mother and undermined her confidence.
I feel that I have a unique view on this topic. I have breastfed six children… notice that I said not successfully because few nursing relationships are without their difficulties. I have breastfed in four countries (the picture is of me nursing Emily outside the Louvre in Paris), five US states and three decades. My partners come from three distinct cultures including upper class white, Mexican-American and British of Afro-Caribbean descent. I have trained and worked as a peer counselor through two organizations…and in two countries…over several decades. What have these different experiences taught me?
Let’s start with my American perspective from the 1980s to 2000s…
My first memory of breastfeeding wasn’t until I was 15 years old. I was bottle fed…my brother was bottle fed…all my cousins and every baby I ever saw was bottle fed. It wasn’t until my youngest cousin was born that I knew anything about breastfeeding. My mother’s youngest sister was quite a maverick and decided to nurse her second child. I don’t know how old he was when they turned him away, but I’m pretty sure it was somewhere between six months and his first birthday. In all that time I saw her nurse him only once and then only fleetingly. When he started to dry, she would simply disappear into a bedroom to do some unimaginable ritual. That one time I definitely had to use the bathroom and to get there, I had to walk over this scary ground. I’m not sure which of us was more embarrassed by the brief glimpse I had of the inch of exposed chest above his little blond head. But it was hardly an auspicious introduction to this feminine art form. I sometimes wonder how I became such a committed nursing mother from that simple beginning.
When I was breastfeeding my oldest son in the US more than two decades ago, I remember feeling just as uncomfortable as the new mother who wrote to me. I spent a lot of money on specially made tops so I could breastfeed discreetly. Even then, people would stare rudely or make comments under their breath. But one of the strongest memories was of the missionary from Nicaragua who visited our church. She burst into tears when she saw me nursing my son. Our pastor translated that her tears were of regret that she had not breastfed her child because in their culture formula was considered more beneficial… due to a large part of advertising dollars spent in this poor 3rd world country.
In the early 1990s, I had the privilege of being part of a new program through the Women, Infants & Children (WIC) project. WIC offered food stamps and formula to low- and moderate-income (working poor) families. To give formula costs them more than $100 a month, while providing nutritional supplements to nurses costs them only $32. This program was nothing less than state sanctioned peer pressure. She identified women who had participated in the program who were breastfeeding. These volunteers were jointly trained by WIC and La Leche League. Before pregnant women received their supply of food coupons, they had to attend an educational session with a peer counselor where the benefits of breastfeeding were presented. Then we took contact details of all expectant mothers, including due dates. We called her several times during her pregnancy to discuss it further. When they had their baby, we visited them either in their homes or in the hospital to offer help to get them off to a good start. This project and many others like it in the US have made a dramatic impact on the number of new mothers of low and middle incomes who choose to give birth to their babies. Dramatically, 63% of African American mothers are now breastfeeding while just twenty years ago less than 15% did.
Fifteen years after the birth of my first son and almost a decade after this project, I had another child. I was living in California at the time. I have to say that those years and perhaps the more open culture of southern California meant that breastfeeding even in public was not a problem. I went back to work when my son was 8 weeks old and my employer was happy to accommodate breastfeeding and pumping. Our pediatrician was a grandson who, if possible, was even more pro-breastfeeding than I was. While the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding until six months, Dr. Jones recommends not adding solids until nine months to a year. He felt that introducing them earlier increases the chance of children developing allergies. Even my militant breastfeeding couldn’t quite meet this laudable goal when my eight-month-old son stared longingly at every bite of food I took.
In stark contrast, however, was the visit we took to my partner’s family home in Mexico when my son was a few months old. It was like stepping back in time… or worse. I remembered again the tears of that Nicaraguan missionary. No one…and I mean no one is breastfeeding despite the poverty. Families would come to his uncle’s store and buy expensive formula and two or three eggs and bread for the rest of the family. Of course, at this point I had become what could be considered a militant about breastfeeding and considered it my personal mission to expose as many people in that small Mexican town as I could to the sight of my son nursing at my breast.
When I moved to the UK with my youngest daughter in 2006, one of the biggest adjustments was the different views on breastfeeding. When we first registered with our doctors, I was thrilled with the new perspective of health visitors… until my first visit with one. My daughter was eight months old and still nursing well, even though I had added solids a few weeks earlier. I was shocked and bewildered when my HV stated in an authoritarian tone…You need to wean that baby. After my shock wore off, I politely educated her that I had always followed the World Health Organizations recommendation to breastfeed until at least two. Our visit quickly turned into an argument as she claimed it was only for third world countries. From that moment I simply avoided health visitors.
A few months later, I was pleasantly surprised when, in the same clinic, they handed out flyers for a new breastfeeding peer counselor program. I signed up again and was happy to be one of the first to complete the training again. But after time I became disillusioned. Unlike the WIC program I previously worked on, we were directly under the PCT, which meant we were instructed to never serve anything that mothers were told by health visitors…even if we knew it was blatant misinformation.
One thing I know, I am happy that my daughter was born in the USA. She was a month early. While she had no trouble breathing, her digestive system was another matter. She had jaundice, difficulty in pooping and barely gained weight for the first two months of her life. From my personal experience as well as my peer counseling work I know that if we were in the UK I would have been pressured to fill up (not that I would have listened).
So what about this new mom and the thousands of others like her? Is there no hope that the UK will become like the Los Angeles I left with babies feeding from exposed breasts every time you visit the mall? I have seen glimmers of such hope. One is my daughter’s swimming class. Of course we are in the preschool group, but the baby class is right for us. The teacher encourages the mothers to breastfeed on the steps of the pool after the lesson to create a positive connection in the minds of the babies of water … and milk. I was also very encouraged a few months ago by the teen black mother, who interacted so positively with her baby and discreetly fed her on the Piccadilly line.
But if the UK is to successfully increase the number of mothers breastfeeding their babies, we must not only provide the expert advice needed to get them off to the right start, but we must provide a supportive culture that’ t recognizes the unique value of the nursing relationship. It was not an easy or short battle for the US… and the war is far from over, given that in the southern states breastfeeding rates are even lower than the UK… but given the physical and emotional benefits to mother , baby and society, it is one worth undertaking.
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