Opinion: We Need to Talk About Breastfeeding
By Wendy Wisner
I write a lot of articles about breastfeeding and, each time one of them appears online, there is a type of comment I can count on seeing. It goes something like this: “Breastfeeding is fine. I get it. Do it all you want. But why do we have to keep hearing about it?”
I understand that feeling. As a lactation consultant, even I get tired of talking about breastfeeding! I also know that mothers who have had bad experiences with breastfeeding can feel sensitive about it. Some moms may understandably feel that breastfeeding advocacy is stigmatizing them as having failed in some way. No mother should ever be shamed for not breastfeeding. Breastfeeding is not the measure of a mother’s worth or her ability to nurture her children.
But for moms who do nurse, breastfeeding is a meaningful part of parenting. These moms are proud of what they have accomplished. Many want to celebrate the obstacles they overcame to make breastfeeding work. That alone is reason enough for us to share and celebrate breastfeeding—especially because seeing positive breastfeeding experiences encourages new mothers to persevere, and helps normalize breastfeeding for all.
Beyond that, the main reason we still need to talk about breastfeeding is simple: America is failing breastfeeding mothers. They are not well supported to meet their goals; they face daily harassment; and in many cases, their rights are not sufficiently protected by the law.
If you ask pregnant moms whether they want to nurse once their baby arrives, most would emphatically answer YES! Every family wants to do what’s best, and the benefits of breastmilk are well-known. Many mothers have heard the recommendations outlined by the Academy of American Pediatrics and other health organizations (the AAP recommends six months of exclusive breastfeeding, and a year or more of breastfeeding overall).
But while the majority of women initiate breastfeeding in the hospital, that number drops dramatically soon after they leave the hospital. For example, in New York, where I live, 80% of mothers start off breastfeeding, 37% are exclusively breastfeeding at three months, and 16% of mothers are exclusively breastfeeding at 6 months. By 12 months, only 31% of women are breastfeeding at all. You can check your state’s breastfeeding rates here.
What happens in those days and weeks between the initiation of breastfeeding and the three month mark when it goes downhill?
Most hospitals have a lactation consultant on staff to help mothers after delivery. But did you know that some hospitals don’t employ these lactation consultants on the weekend? So if you have your baby then…well, sorry. Also, many hospital lactation consultants only have short amounts of time to see the many mothers who need help. I have learned that most breastfeeding problems take a while to solve: you need to observe the baby nurse, examine the baby, examine the mother, take a health history of the mom and baby, and offer counseling and education. Many (but not all) mothers leave the hospital having received minimal breastfeeding help.
Then the mothers are on their own. Maybe things go well with breastfeeding. But most new mothers have questions.
They might call a breastfeeding counselor, a family member, or a friend. Often, this can help a great deal. But if a mother has a more complex situation, she needs hands-on help, someone who can watch her breastfeed, and see what’s going on. Enter the private practice lactation consultant. Some are covered by insurance. Some are not (despite the guarantees outlined in the Affordable Care Act, not all insurance companies are properly covering lactation consultants). Some lactation consultants are helpful and non-judgmental. Some are not. Regardless, a mother may or may not be able to find one, or afford one.
There is little structural support mothers have to breastfeed—from ill-equipped hospitals, minimal insurance coverage for lactation consultants, and maternity leaves that are way too short.
We need to talk about the fact that many more low-income mothers and African-American mothers are negatively affected by all this, and thus have disproportionally lower breastfeeding rates.
We need to talk about the fact that women are harassed daily for breastfeeding in public even though 49 out of the 50 states have laws protecting a woman’s right to breastfeed in public. We need to talk about the fact that there are no fines or consequences for breaking these laws.
We need to talk about the 2010 Affordable Care Act, which contains a provision mandating employers to give time and space for mothers to pump. We need to talk about the many loopholes in that law, including the fact that the pumping breaks are not required to be paid, certain business types are exempt, and there are no guidelines written into the law to enforce it. We need to talk about the moms who have gone to court to defend their rights to pump at work, and the mothers who frequently lose their jobs in the midst of these fights.
We need to talk about how formula is handed out like candy at some hospitals, even when mothers specifically express their desire to exclusively breastfeed. We need to talk about how formula is mailed to most new mothers’ homes without them ever asking for it. We need to talk about the fact that formula supplementation can drive down a mother’s milk supply, even though the formula ads claim otherwise. We need to talk about how much easier it is for a mother to find a bottle of formula to give her baby than to find good, affordable help to solve a breastfeeding issue.
We need to talk about all of this, and more. We need to tell our stories of how the system is still failing us. We need these issues to be exposed. Yes, there are mothers who just don’t want to nurse (their reasons are none of my business and I respect their decision). And yes, there are moms and babies who have very difficult experiences because of biological anomalies. But I have seen too many mothers fail at breastfeeding simply because there isn’t enough built-in support in our country for them to get adequate education, support, and time with their babies to establish and continue breastfeeding.
I get how annoying it can be for people like to me be talking about breastfeeding all the time. And I wish it didn’t sometimes feel like a slap in the face to non-breastfeeding moms to hear about it. I wish it didn’t seem like discussing breastfeeding is somehow furthering the “Mommy Wars.” But the fact is, until we solve these issues—until breastfeeding mothers are given the respect, rights, and very necessary help that they deserve—we need to talk about it. In fact, we need to raise our voices and shout about it.
Wendy Wisner is a mom, writer, and lactation consultant (IBCLC). She is the author of two books of poems (CW Books), and her writing has appeared in such publications as The Washington Post, Huffington Post, Brain, Child Magazine, Scary Mommy, Club Mid, Role Reboot, Your Tango, and Mamalode. Find Wendy at WendyWisner.com. Follow her on Facebook and Twitter.