How can we effect a change to make a Breastfeeding Culture?

[Maggirayne]

I've really been wrestling with whether changing the laws makes actually a difference or helps.

Having a law in place protects (hopefully) BFing moms. But what other ways are effective?

But how do we most effectively make a difference?
Krystyn posted this in the "another perspective on discretion"

Originally Posted by krystyn33
And yes, NIP and the over-sexualization of breasts is an important issue, but I'm not sure it causes the poor BFing success rates as much as lack of paid maternity leave, lack of adequate time/space for pumping in the workplace, poor birth and hospital practices, bad advice from uninformed doctors and other medical professionals, lack of postnatal support and care in general, and so on. There's a lot of work to be done and many ways we can act as lactivists--we don't all need to think alike and have the same methods.

ITA It's a host of issues, but right now for me, the modesty/discreet issue is dividing lactivists(in my state regarding a current bill). So, I'm going to start a spin-off.
This is said spin-off.

[FelixMom]

I'm in Canada, so I hear and see anecdotally that more moms are at least attempting to initiate BFing because we have a year's maternity leave.

I do think that it will take a critical mass of women and men who are supportive of a baby's right to BF and a mother's right to nurse to effect change.

I recall my late mother telling me that in China in the 1950s, there was on-site childcare in the schools, and female teachers with nurslings were allowed a 15-minute break every hour to go to the nursery and nurse their baby. Sadly, with the widespread availability of domestic (tainted) infant formula, BF rates in China have steadily fallen since the 1980s.

The Nordic countries have been particularly progressive in addressing family needs and work/life balance. I hear that in Sweden, both parents can work part-time until a child is 7 yrs old, when formal schooling begins. Both are entitled to some amount of parental leave, not just the woman. I'd love to know what their secret to success in having that type of legislation.

Okay, some Americans out there might find this distastefully *socialist*, even *gasp* bordering on "communism", whatever that means. But is it not in society at large's best interest to have healthy babies and families who are NOT stressed out? A family in which both parents have to work outside the home is living the poverty of time. With the mad rush for dinner, homework and bedtime in the evenings, there's little room for quality. But many families with young babes are resigned to this fate. And perhaps the BFing relationship is stopped earlier than both parties would want due to these financial pressures.

I guess it's a matter of building that critical mass of people who do care about the future generation to pressure politicians into creating a family-friendly society. Not just for those with young children. Everyone has parents who will eventually become old and frail, demanding more healthcare services and necessitating time and energy of their able-bodied adult children to care for them. I've had former colleagues who turned down promotions because of the lives of frail parents with health issues hanging in the balance.

[krystyn33]

IMO paid maternity leave and protections for pumping at work should take priority over NIP legislation. Sure the latter is important, but I would guess much fewer of us are asked to leave a public place for NIP compared to the amount of women who are forced to supplement or wean early because of work demands.

Aside from legislation, we need postpartum care with accurate, informed BFing support available to every mother and infant.

The more moms who successfully breastfeed (per the AAP recommendations at least), the more we'll tip the scale and see more support for BFing rights and protections until it is the norm.

[elanorh]

On the personal lactivist level, I think the most important things we do are:

1. Assuming that our friends/relatives/acquaintances will breastfeed - and supporting them in that (that is, instead of asking whether they plan to nurse, saying, "X was my favorite breastfeeding book, Y was the lactation consultant I used, here's the card for the local bf support group, call me if you have questions." (Obviously not quite that abruptly, but that's the gist of it).

2. Model breastfeeding. Nurse with confidence when and how our babies require.

3. Address anti-NIP or anti-breastfeeding or anti-pumping/WOH comments we hear with a positive attitude, information, and a polite refusal to give credit to those statements.

4. When and as appropriate, provide good information/resources to mothers or family members who may have been misinformed (not pushy at all in this - it takes finesse because I think these conversations can easily turn into the Big Mean Lactivist moment if we're not very careful).

**
On the movement-wide level, I'm not really sure whether we should have to focus on one particular issue (i.e., pumping availability at work, or NIP) --- I do think that any step forward in one area, incrementally advances the other goals as well. And perception can definitely impact things.

So, I can see how NIP legislation and a society where more women are seen more often nursing in public, could certainly create an environment where bf-friendly workplaces seem reasonable too. "I see women breastfeed all over the place, shouldn't they be able to pump at work?"

And I can see how more supportive maternity leaves/workplace policies could at the same time, create a longer breastfeeding relationship which would also mean more women nursing in public .... It's kind of a circle, isn't it?

I think sometimes feathers are ruffled here when we compare breastfeeding in public/lactivism with the civil rights movement ... but I do believe that the synergy between citizens advocating for their rights, and legislation supporting those rights are an example from which we can learn. And my arm-chair opinion is that having laws in place to protect and support rights, definitely helps build awareness and support (and confidence). I will freely admit I don't have a huge background in civil-rights history, so am willing to stand informed/corrected if there are other takes on it.

I think a crucial part of the battle is creating informed HCPs who could advocate and educate for and with their clients. In fact, I think that focusing on HCP education re: breastfeeding could eventually help create the 'critical mass' of support and information which might bring about a larger social change in re: breastfeeding initiation and duration. Until our HCPs are as united in their support of breastfeeding as they are in their disapproval of smoking, or their support of exercise --- then we will continue to lack the "authortative support" that lends credence to our goals.

[julie128]

I think we need to get more teens to bf. there will be a "trickle up" effect as these young moms age and become mentors for first time moms who are older than they were at their first birth. Every program for pregnant teens needs to teach the risks of formula, the benefits of breastfeeding, and skilled support people to help them through the first few weeks and beyond.

[star thistle]

I really do think doctors are the first line of defense. We live in a world where doctors are god and people would trust them implicitly with their life (and their baby's life). And, in spite of the prevalence of homebirthers and women who get prenatal care/birth with midwives on MDC, only 1% of pregnant women birth out-of-hospital. It is absolutely up to the doctors to push the breastfeeding agenda if breastfeeding rates have a chance of rising in the US.

Pre-pregnancy support: gynecologists who introduce breastfeeding with literature and supportive materials in their office before a woman is even pregnant. During pregnancy: ob/gyns who discuss birth plans and breastfeeding as a matter of course, who make it a priority to get the baby on the breast as soon as it is born and who don't push surgery or meds that make both mom and baby too drugged to ensure that first super important hormonal connection. Hospitals that value rooming-in, with nurses who don't rush baby off for a bath or needlessly intervene for testing. IMO, the first hour baby is alive is the most crutial in establishing a good nursing relationship. Well-baby support: pediatricians that stress the health benefits of continuing breastfeeding, understand the differences of breastfed vs. formula fed growth, and don't hand out, suggest, or push formula. On-going support: all doctors need to accepts the reality of and make their patients aware of the health benefits to the mother brought on by breastfeeding and extended breastfeeding, reducing risk of breast and ovarian cancer among others.

Until the medical community supports breastfeeding fully, I really think only the minority who do the research themselves and already have the convictions will attempt without support and subsequently succeed. Breastfeeding would serve as preventative health care for both mom and baby, but it does seem to me that few doctors view preventative health care as an integral part of their patients' health plan. I'm sure the reasons are many, job-security, pharmaceutical funding and politics being a few.

If breastfeeding was treated as a public health issue, if initiatives were put into place by gov't to support breastfeeding as a preventative care measure (as much as vaccines even), if hospitals profited from uncomplicated natural births as much as surgical births, and if doctors made the same money caring for a healthy breastfed child as they did with one who required active health management and on-going care....

[Maggirayne]

Originally Posted by elanorh

So, I can see how NIP legislation and a society where more women are seen more often nursing in public, could certainly create an environment where bf-friendly workplaces seem reasonable too. "I see women breastfeed all over the place, shouldn't they be able to pump at work?"

And I can see how more supportive maternity leaves/workplace policies could at the same time, create a longer breastfeeding relationship which would also mean more women nursing in public .... It's kind of a circle, isn't it?

It really is and hard for me to know what to do.

Originally Posted by elanorh

I think sometimes feathers are ruffled here when we compare breastfeeding in public/lactivism with the civil rights movement ... but I do believe that the synergy between citizens advocating for their rights, and legislation supporting those rights are an example from which we can learn. And my arm-chair opinion is that having laws in place to protect and support rights, definitely helps build awareness and support (and confidence). I will freely admit I don't have a huge background in civil-rights history, so am willing to stand informed/corrected if there are other takes on it.

Really? After reading the Reluctant Lactivist's blog on Human Right v.s Hegemony, it is pretty clear to me that breastfeeding is about the baby's right to eat.
I'm curious how people disagree with that. Do they feel that breastfeeding isn't as big of an issue as racism? Granted, breastfeeding mothers are dragged behind trucks, but disregard for others' biological state of being seems to strike at human rights, regardless of how 'bad' they are being treated.

Originally Posted by elanorh

Until our HCPs are as united in their support of breastfeeding as they are in their disapproval of smoking, or their support of exercise --- then we will continue to lack the "authortative support" that lends credence to our goals.

Yes! But this is where it comes down to money: formula companies have money to throw at doctors; breastfeeding mothers don't.

Originally Posted by julie128

I think we need to get more teens to bf. there will be a "trickle up" effect as these young moms age and become mentors for first time moms who are older than they were at their first birth. Every program for pregnant teens needs to teach the risks of formula, the benefits of breastfeeding, and skilled support people to help them through the first few weeks and beyond.

Oooh, hm, good point. And they are the 'next' generation.

Originally Posted by hucklebearie

I really do think doctors are the first line of defense. We live in a world where doctors are god and people would trust them implicitly with their life (and their baby's life).

Until the medical community supports breastfeeding fully, I really think only the minority who do the research themselves and already have the convictions will attempt without support and subsequently succeed. Breastfeeding would serve as preventative health care for both mom and baby, but it does seem to me that few doctors view preventative health care as an integral part of their patients' health plan. I'm sure the reasons are many, job-security, pharmaceutical funding and politics being a few.

If breastfeeding was treated as a public health issue, if initiatives were put into place by gov't to support breastfeeding as a preventative care measure (as much as vaccines even), if hospitals profited from uncomplicated natural births as much as surgical births, and if doctors made the same money caring for a healthy breastfed child as they did with one who required active health management and on-going care....

Heh, yeah. Sigh, it keeps coming back to money.
And I agree strongly that birth and how it happens in the hospital has a huge impact. Of course, you consider the 30% C/S rate, hmm, what is the successful BF rate following C/S? But that practically sets up 30% of women for difficulties, right?

But the doctors say that women need a 'choice' we don't want to make moms feel bad for choosing formula, is that something we lactivists should address on a wider scale? Or is it just an excuse not to support breastfeeding?

[StoriesInTheSoil]

I agree about encouraging teens and young moms to breastfeed. I feel like they are more open to new information and are bringing less previously held bias into the situation. Personally, I am trying to start a program for teen moms in my hometown that encouraged breastfeeding in the high schools.

[mysticmomma]

I'd like to see LC's and CLE's reaching out to FP's and Peds to provide seminars on bfing to the care providers.

[krystyn33]

Originally Posted by Maggirayne

After reading the Reluctant Lactivist's blog on Human Right v.s Hegemony, it is pretty clear to me that breastfeeding is about the baby's right to eat.

Thanks for sharing that link--caused me to reconsider my thoughts on the NIP debate. While I still think telling those who are uncomfortable with NIP that they should just "get over it" isn't going to open any minds or garner support, I do think "this is not about you" is an appropriate response. It is absolutely about the baby's right to have his or her needs met, on cue, and our right as mothers to meet those needs unimpeded.

Here I think we're up against the culture which believes babies can be spoiled--that they need to be "trained" to be more convenient for adult caretakers--in addition to the culture which is hung up on the woman's breast as sexual object.

[songbh]

Originally Posted by krystyn33

Here I think we're up against the culture which believes babies can be spoiled--that they need to be "trained" to be more convenient for adult caretakers--in addition to the culture which is hung up on the woman's breast as sexual object.

I agree with this insight. I think this helps to explain why toddler NIP draws so much more flack than newborn NIP, even if the negative comments often focus on the alleged inappropriateness of the mother's behavior rather than the baby's age.

I'm sure this is also part of the dynamic in incidents involving younger babies as well. I've been ascribing stupid comments like, "Just nurse before you leave the house!" to ignorance about how breastfeeding works, but clearly part of that response is also an assumption that babies should be on a schedule and don't really need to eat between those scheduled feedings.

Sometimes the hostility in our culture towards its youngest members just blows my mind. Someone here wrote in another thread about a fellow passenger on an airport van saying she'd rather hear the baby scream for the whole drive than see the mother breastfeeding. One presumes one's fellow travelers don't routinely include sociopaths or sadists, and so I guess we have to blame the culture for that one.

[krystyn33]

Originally Posted by songbh

Sometimes the hostility in our culture towards its youngest members just blows my mind.

Perhaps that hostility is rooted in the repressed pain of unmet needs during infancy...

ITA, songbh.

[Skippy918]

IMO paid maternity leave and protections for pumping at work should take priority over NIP legislation. Sure the latter is important, but I would guess much fewer of us are asked to leave a public place for NIP compared to the amount of women who are forced to supplement or wean early because of work demands.

Agreed. I have a couple of friends who didn't have time to pump or they got flack from their boss or coworkers for needing a time and place to pump. Hence, their supplies dropped and they had to start giving formula. My BFF was so upset when she had to start giving her DS formula.
I really think maternity leave needs to be paid and at least 6 months with your job being held for you. At least for me, around the 6 week mark, we were still having BFing difficulties and there is no way I would have been able to go back to work at that time. My company has a 4 month (unpaid) leave and luckily I was able to use it all.

[Maggirayne]

Hi, OP here! i areally enjoying tihs discussion. It seems like such an insurmountable task trying to make a change, but you all are encouraging me!

Originally Posted by songbh

Sometimes the hostility in our culture towards its youngest members just blows my mind. Someone here wrote in another thread about a fellow passenger on an airport van saying she'd rather hear the baby scream for the whole drive than see the mother breastfeeding. One presumes one's fellow travelers don't routinely include sociopaths or sadists, and so I guess we have to blame the culture for that one.

Yes, um, have they had to listen to a baby scream on a multi-hour flight?! Yeesh! I understand it's hard for kids, but wow, I don't like listening to babies cry. (But then I get irritated with people and think, just nurse your poor baby, sheesh!)

Originally Posted by krystyn33

Thanks for sharing that link--caused me to reconsider my thoughts on the NIP debate. While I still think telling those who are uncomfortable with NIP that they should just "get over it" isn't going to open any minds or garner support, I do think "this is not about you" is an appropriate response. It is absolutely about the baby's right to have his or her needs met, on cue, and our right as mothers to meet those needs unimpeded.

Here I think we're up against the culture which believes babies can be spoiled--that they need to be "trained" to be more convenient for adult caretakers--in addition to the culture which is hung up on the woman's breast as sexual object.

You are welcome. I happened to find it at just the right time when I was defining my philosophy and worried about offending others, and it explained so well, why I didn't have to burden myself with other people's issues unnecessarily.

I think that people should 'get over it', but yes, that is not an effective way to communicate, thank you for saying this"I do think 'this is not about you' is an appropriate response."

Originally Posted by tinyactsofcharity

I agree about encouraging teens and young moms to breastfeed. I feel like they are more open to new information and are bringing less previously held bias into the situation. Personally, I am trying to start a program for teen moms in my hometown that encouraged breastfeeding in the high schools.

Wow! Hehe, altho' I can just imagine the fuss over a young mother BFing in front of her testosterone-laden male fellow students. But, teens can wear all sorts of provocative clothing. Has that come up yet? I'd like to hear more about how you're starting, etc.

Originally Posted by krystyn33

Perhaps that hostility is rooted in the repressed pain of unmet needs during infancy...

This week, I just read in an issue of the Compleat Mother about an author wondering if the disruption of taking a baby immediately or shortly after birth interrupts bonding and that child goes through life looking for that love and bond. I think it's part of breastfeeding as well. Issue #87 or 88 of 2008. The one of the African-American mom holding her baby and laughing.

And the hostility does shock me, but so much of our culture is focused on what we(adults) want, when we want it, and children are seen as a nuisance, not valued. They are literally playthings, especially when you consider how pets are called 'kids'.

[Zadee]

Normalize BF.

BF in public.

Tell non-nursing mothers the funny BF anecdotes the same way you tell them the other funny baby/toddler stories.

Give expectant mothers shower gifts that assume they are going to BF (someone gave me Lanisoh and I blessed her a lot during those first months - she also almost fell over apologizing when she realized she hadn't thought to check whether I was planning on BF but, really, people give women stuff for paper diapers and bottle feeding without thinking to ask if they plan to paper diaper or bottle feed so...)

Give books/toys to toddlers, young children that AREN'T bottles (and, yes, I know people feed human milk in bottles - I did - but bottles don't help normalize the idea that boobs are for drinking milk out of), don't feature bottles and show BF as a totally normal, unremarkable part of life

[jillc512]

Read the book, The Problem with Breastfeeding. The author compares breastfeeding with two other recent health-related behavior modification success stories: seatbelts and smoking cessation. Not too long ago, seatbelt use was low and smoking rates were high. What changed? Public perception. How? Public health advertising, and HCPs providing more accurate information on the risks of not wearing seatbelts and smoking. The advertising was/is dramatic -- crash test dummies ("Don't be a dummy. Buckle up.") and "The Truth" campaign (vilifying tobacco companies, showing babies and children without their parents/grandparents because they died of lung cancer). Did/do they make some people feel guilty? Probably. Does that matter if it is SAVING LIVES?

The CDC campaign that got canceled would have been a step in this direction. People have to WAKE UP in order to change their thinking and behavior.

[julie128]

Originally Posted by FelixMom

The Nordic countries have been particularly progressive in addressing family needs and work/life balance. I hear that in Sweden, both parents can work part-time until a child is 7 yrs old, when formal schooling begins. Both are entitled to some amount of parental leave, not just the woman. I'd love to know what their secret to success in having that type of legislation.

Extrememly high taxes. In some European taxes, you'd pay double what you pay in the States. They don't just get that family leave for free.

What we need to do here is to learn to live as though we are planning to take time off work when we have a baby and save for it and live on one income in preparation for it. For example, don't buy a house that requires two incomes to pay the mortgage if you want to be able to take time off to stay home with your baby. If you don't, well then, it doesn't matter.

I was thinking about something yesterday at a baby shower. The babies were born of a surrogate, so they are using formula (and supplementing with breastmilk that I provide). At the shower, two of the older girls bottle fed the babies, and I was thinking that they are in training to bottle feed in the future. It's not really possible to train for breastfeeding in the same way. You can observe breastfeeding, but you can never do it yourself until you do it. On a related subject, I would love to see all baby doll bottles disappear.

[Maggirayne]

Originally Posted by jillc512

Did/do they make some people feel guilty? Probably. Does that matter if it is SAVING LIVES?

The CDC campaign that got canceled would have been a step in this direction. People have to WAKE UP in order to change their thinking and behavior.

Heh, yeah, weird what we can and can't make people feel guilty for.

What CDC campaign? I missed it apparently.

Originally Posted by julie128

What we need to do here is to learn to live as though we are planning to take time off work when we have a baby and save for it and live on one income in preparation for it. For example, don't buy a house that requires two incomes to pay the mortgage if you want to be able to take time off to stay home with your baby. If you don't, well then, it doesn't matter.

Yes! I was discussing this with a friend. Even if a woman plans on having a career and working outside the home, she needs to plan as if she weren't. And girls need to start planning from high school. Often, once you get into college and trapped by student loans, it's too late to avoid working.

I am annoyed when people are like, "You're so lucky you're staying at home." Luck has nothing to do with it! My husband and I always planned on me staying home. We did not ever depend on my income for living. We are currently living in a two-bedroom apt.

So how can we teach girls to plan like that?

[jocelynr]

The CDC campaign had TV ads that showed pregnant women doing all kinds of horribly risky behaviors, such as riding a bull, or fighting with someone on one of those rolling log things. They said, you wouldn't risk your baby's life before he's born, why risk it afterwards (or something like that) and at the end showed some of the stats about the risks for formula feeding. They were interesting!

[jecombs]

Originally Posted by jocelynr

The CDC campaign had TV ads that showed pregnant women doing all kinds of horribly risky behaviors, such as riding a bull, or fighting with someone on one of those rolling log things. They said, you wouldn't risk your baby's life before he's born, why risk it afterwards (or something like that) and at the end showed some of the stats about the risks for formula feeding. They were interesting!

Correct me if I'm wrong, but didn't those ads get pulled because of pressure from formula companies?!?!

I also agree that we need longer maternity leave. I was able to take 3 mo. off when my DD was born and 2 mo of that was un-paid. I would have loved to take more time off, but we couldn't afford it. I think one the most daunting parts of BFing was finding time and space to pump once I went back to work. But, personally, I think finding time/space to pump is a poor substitute for actually getting to stay home with my baby. I would take any paid maternity leave over the "none" we have now!