Earlier this year, researchers in Scotland examined the disjunction between the idealism of exclusive breastfeeding and the reality that many families experience. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life for all babies. Other organizations, such as the American Academy of Pediatrics, recommend that all babies consume breast milk for the first 12 months of life for maximum developmental and immune benefits. According to the Scottish study, most women find these goals unrealistic, despite the known long-term benefits of breastfeeding for both mom and baby.
Breastfeeding can reduce the incidence of diabetes, asthma, obesity, ear infections, upper respiratory infections, and SIDS. In fact, the World Health Organization has been quoted to call colostrum-the breast milk that a mother makes in the first few days after a baby is born-"baby's first immunization" because of the immunological benefits that it confers to newborns. According to the authors of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, "exclusive breastfeeding for six months by 90% of U.S. mothers could prevent 911 infant deaths and save the U.S. healthcare system US$13 billion." Research has also shown that babies who have been breastfed excel in speech and language development and have higher IQ levels. Breastfeeding also provides myriad health benefits for mothers as well-there is a significantly lower incidence of aggressive breast cancer, osteoporosis, cardiovascular disease, ovarian cancer, and diabetes in women who have breastfed.
If a mother and her infant have so much to gain from breastfeeding, why are exclusive breastfeeding rates at 6 months postpartum only at 15% in the U.S., according to the CDC? Despite much promotion of the benefits and joys of breastfeeding, these low rates are likely due to a lack of support within in the infrastructure of the health care system and in our communities at large. In fact, the mothers interviewed in the Scottish study said that the lack of support from healthcare providers, family members and friends contributed to their decision to stop breastfeeding before their baby was 6 months old.
The unfortunate reality is, not all healthcare professionals fully support breastfeeding and what's more-not all healthcare professionals are knowledgeable or skilled in providing breastfeeding support and counseling during nursing challenges. Many women receive some education in breastfeeding prenatally say, during a childbirth education class, but then get very little continued counseling during the postpartum. Furthermore, the women in the study are right when they said that many healthcare providers paint a rosy picture of breastfeeding, choosing only to speak of the beautiful bonding experience that the mother-baby nursing dyad has during breastfeeding or the long term health benefits. Too few of us actually talk about the common challenges and pitfalls that a woman may face while establishing breastfeeding out of fear of discouraging new mothers from getting started. In the end, however, the women who are challenged by getting a good latch, sore nipples, pumping at work, or getting chided in public while nursing often feel blindsided by these challenges or feel guilty about not achieving the "ideal picture" of a breastfeeding mother. These are but a few of the challenges that breastfeeding mothers may face.
To say that many women are not getting the support that they need from their communities to continue exclusive breastfeeding until 6 months postpartum would be an understatement. While some companies support breastfeeding by having on-site lactation consultants, clean places for expressing breast milk, and on-site day care centers, many employers still do not have good systems in place to support a mother who needs to express her milk every few hours to maintain her milk supply for her growing baby. Despite the fact that many states have laws that protect a woman's right to express milk in a clean place other than a bathroom-for up to 3 years after the birth of their baby-some women are asked to pump in the tiny stall of the company bathroom. Others struggle to get the break time that they need to express milk every few hours to prevent engorgement which can lead to a breast infection.
Breastfeeding mothers have been escorted off of airplanes, asked to leave restaurants and courtrooms, and shuffled into dressing rooms of major department stores while breastfeeding their infant. The reasons cited? Some members of the public find breastfeeding lewd, offensive or inappropriate. In Maine, the law states "a mother has the right to breastfeed in any location, whether public or private, as long as she is otherwise authorized to be in that location." Raised public awareness of the rights of nursing mothers is greatly needed to encourage mothers to continue breastfeeding and maximize the health benefits for her and her baby.
So where do we go from here? First we need to change the cultural attitudes around breastfeeding in the U.S. Breastfeeding our babies is the way that nature intended for us to nourish and nurture our offspring. There are often a number of key moments in the first 6 months of a baby's life where mothers are faced with the decision to persevere through the nursing challenges or to switch to formula or exclusively feeding solid foods. However, more support from knowledgeable, skilled healthcare providers who utilize a non-judgmental approach to counseling that extends beyond the first 6 weeks postpartum is paramount during these critical times. Let's be open and honest about the realities of breastfeeding-which can be hard and frustrating at times and beautifully transcendent at other time. By supporting one another, we can chip away at the goal of exclusively breastfeeding for the first 6 months of life day by day, one feeding at a time.
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