Breastfeeding gets a lift from advocacy, education campaigns

Breastfeeding gets a lift from advocacy, education campaigns

The Kid’s Doctor

By Sue Hubbard, M.D.

An editorial concerning breastfeeding was published last year in The New York Times. It was written by Courtney Jung, who is a professor of political science at the University of Toronto, and it was quite interesting to me as she wrote that “the moral fervor surrounding breast-feeding (sic) continues unabated, with a steady stream of advocacy and education campaigns, hospital initiatives, social pressure and workplace and insurance regulations designed to push breast-feeding (sic) numbers still higher.”

The World Health Organization developed “10 steps to successful breastfeeding” in hopes of increasing breastfeeding initiation and duration around the world. Hospitals have been designated “baby-friendly” (aren’t they all supposed to be?) if they adhere to these steps as well. But the United States has done well with breastfeeding rates as 79 percent of mothers initiate breastfeeding.

Most, if not all, of the new mothers I make rounds on are proponents of breastfeeding. They have read the books, gone to classes and are determined to be successful at it. But over the years I have actually seen more and more new mothers becoming overwrought and wary of breastfeeding, fueled by the “rules” that they are being required to follow. With that being said, having someone tell you that “you must breastfeed your baby in the first hour after birth,” that “your baby must remain in your room 24 hours a day,” that your baby “may not have a pacifier,” and your baby should “breastfeed on demand” promotes anxiety and leaves many a new mother exhausted and tearful within a day or two of having a baby.

While breastfeeding is “natural” it also requires some practice, and the only practice is really “on the job” training. Some babies just latch on quickly and are pros immediately, but not all babies will become proficient at breastfeeding in the first day or two. The mothers are told to “let the baby nurse on demand” and some mothers have had their babies at the breast for hours on end and are exhausted, with sore and bleeding nipples. I have walked into too many hospital rooms with a mother in tears, a fretful baby and a “helpless” new father. Some feel as if “they are failures” as mothers before they even are discharged, and at the same time are having serious doubts about continuing to breastfeed. They are sure that their baby will catch serious illnesses and have a lower IQ if they don’t breastfeed, but how can they maintain this constant breastfeeding and no sleep and never put a pacifier in their baby’s mouth? Is there only one way to be successful at breastfeeding?

I loved breastfeeding, but it was a long time ago and we were instructed by caring nurses “to just go home and put the baby to the breast every two to three hours”. While that may not have been the best education, has the pendulum swung too far? Will giving the baby one bottle when a mother is having postpartum anxiety and sleeplessness really harm the baby? Should a mother have to sign an order allowing her baby to have a pacifier? While guidelines for breastfeeding are helpful should they be so rigid that a mother “gives up” on breastfeeding because she can’t follow 10 steps in the first 24 to 48 hours?

The New York Times article was quite interesting, and I had to agree with many of the author’s points. Supporting a woman’s choice to breastfeed is admirable, and policy changes promoting maternity leave and flexibility are definitely needed to encourage women to continue to breastfeed. But is all of this breastfeeding advocacy crossing the line? A mother should choose to breastfeed because she wants to, and that does not mean if her baby does not breastfeed in the first hour that she will never bond with her baby or be successful at breastfeeding. Some women are unable to breastfeed for a multitude of reasons, and that decision should not label her as a “bad mother.” Again, breastfeeding, like a woman’s breast, is not “one size fits all.”

(Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.)

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