What would help the breastfeeding rates?

[myfairbabies]

I'm writing a paper on breastfeeding and need to include how to solve the problem we have with it in this country. I will go more in depth than just making a list, but it would help if I could get some more ideas! I was thinking this should include federal laws for nip and working/pumping mothers, educating doctors and nurses (how would they do that, classes on breastfeeding in med school? or just make them refer to the lc?), have ads in the media about the benefits, stop all formula ads, normalize it by showing nursing in the media- tv, movies, magazines, books etc (though not something you could make them do), and better education and more lc's. Anything I've totally forgotten? Any ideas are welcome! Thanks!

[turtlewomyn]

Sounds like you have it mostly covered. I would also say longer maternity leave. It is hard to be a working/pumping mom (I knew a mom who quit cold turkey around six months or so because she was tired of coworkers walking in on her while pumping, in her locked office - with a DND sign on the door! , I don't think she was pumping enough milk either, and in an environment like that.... it makes sense) I think more women could breastfeed longer if they had six months off to nurse, before having to go back to work.

I also think that all nurses that work on the post partum floor should have to be IBCLC's. Seriously. I know that takes a lot of work, but the only LC's that really helped me were IBCLC's.

[Momtwice]

More support and less sabotage.


http://aappolicy.aappublications.org...rics;115/2/496

Find solutions to these problems: (from AAP link above)

Obstacles to initiation and continuation of breastfeeding include insufficient prenatal education about breastfeeding132,133; disruptive hospital policies and practices134; inappropriate interruption of breastfeeding135; early hospital discharge in some populations136; lack of timely routine follow-up care and postpartum home health visits137; maternal employment138,139 (especially in the absence of workplace facilities and support for breastfeeding)140; lack of family and broad societal support141; media portrayal of bottle feeding as normative142; commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising143,144; misinformation; and lack of guidance and encouragement from health care professionals.135,145,146

[SPOpa]

Originally Posted by turtlewomyn

Sounds like you have it mostly covered. I would also say longer maternity leave. It is hard to be a working/pumping mom (I knew a mom who quit cold turkey around six months or so because she was tired of coworkers walking in on her while pumping, in her locked office - with a DND sign on the door! , I don't think she was pumping enough milk either, and in an environment like that.... it makes sense) I think more women could breastfeed longer if they had six months off to nurse, before having to go back to work.

I also think that all nurses that work on the post partum floor should have to be IBCLC's. Seriously. I know that takes a lot of work, but the only LC's that really helped me were IBCLC's.

What she said! I couldn't agree more with every single thing.

[Momtwice]

Also, the media are a Huge obstacle to breastfeeding as you pointed out. Each person brings their own bias.

Sit coms make fun of breastfeeding. But the news shows are even worse.

This blog below has some very recent stuff going on. The question I have is, did Meredith V. and Elizabeth H. and Dr. N. Synderman actually lie? Or are they so culturally brainwashed they have a mental block to the truth? This blog has all the primary sources, the author's opinions are her own (and I tend to agree with her, but for a paper you would want to come to your own conclusions.)

Be sure to read "The New York City Formula Lies" and then "ABC News Got it Right." Follow the links to the original sources. This is by an MDC mom.
http://www.breastfeedingsymbol.org/2...la-media-lies/

[Momtwice]

You could also talk to some Canadian MDC'ers about how their government gives them a year off and I believe a financial stipend but I'm not sure.

[bananababies]

Originally Posted by turtlewomyn

I also think that all nurses that work on the post partum floor should have to be IBCLC's. Seriously. I know that takes a lot of work, but the only LC's that really helped me were IBCLC's.

I think this is a FANTASTIC idea. My first birth was in a hospital, and while the nurses wanted to be helpful, they really didn't have that much experience with breastfeeding, and were kinda stumped. The only nurse that was able to *really* help had recently transfered from a hospital where all the post partum nurses were experienced LC's. Not so with the rest of the nurses on my floor. The actual LC was so so so busy, she didn't have a lot of time to spend with me. She was great, but very rushed.

[readytobedone]

national maternity leave

i think all women should be able to take one year off of work after the birth of a child and receive some monthly payment from the government. if more women could be with their babies all day long and not have to worry about pumping/bottles/freezer stash/pumping at work when they have a meeting during pumping time/where to pump--

then i think a LOT more people would BF the full year.

i am VERY pro-BF, but honestly, if i'd had to go back to a 40+ hour per week job at 6 weeks PP, i really doubt i'd make it 6 months, much less a year. at 6 weeks, i was still barely able to function, much less worry about a job and the logistics of maintaining a BF relationship :

[mommy2caroline]

In addition to more workplace support for breastfeeding moms, how about more cultural support - taking the pressure off the moms who feel like they *have* to go back to work? I know of some whose DHs insist that they go back to work... and others who just feel like it's "what they should do." It seems like a lot of people look negatively at SAHMs as "slackers" (at least, I have gotten that perception some, along with "oh, you're so LUCKY!" No I'm not! It's a bleeping SACRIFICE! My dh isn't just raking it in!) who aren't "pulling their weight" in our economy.

Not sure how this would really be accomplished... maybe some PSAs on it, like on how to cut costs so the mother can stay home (and then breastfeed longer)? Advertisers wouldn't like that and would likely stand in the way, because if people don't have the impulse buying and "keeping up with the Joneses" mentality, then they won't sell as much of their products... so they wouldn't like it to be portrayed that there are things that people really can live without. I don't know how to create a cultural mind shift... but it is one more thing that could be a help. I think that when formula becomes the norm, then mother becomes replaceable, and then - well, if she isn't needed anymore, she'd better be doing something to contribute to society (ie, working)... and this viewpoint is almost subconscious in our culture. So, somehow making it apparent that mothers are not "replaceable" and that their roles as mothers, first and foremost, is crucial in the early years... that could help; I just don't know how to accomplish it!

I agree with all the other factors mentioned... the AAP list is really good and all-inclusive; I wasn't aware they had written such a thing.

[elvenpath]

I think Formula should be by prescription only. I bet that would help dramatically.

[Rhiannon Feimorgan]

I'm not american, but from what i've read, changes need to be made to the WIC program so that it realy supports nursing women (and their nutritional needs) and makes it harder to receive formula (like needing a doctors note or something)

[Da WIC Lady]

Originally Posted by Rhiannon Feimorgan

I'm not american, but from what i've read, changes need to be made to the WIC program so that it realy supports nursing women (and their nutritional needs) and makes it harder to receive formula (like needing a doctors note or something)

With all the notes for special formula we get, it wouldn't slow many down. Having all formula feeders come in for checks once a month like we do with the special order formula might have an impact, but I doubt it. We have a lot of moms that are convinced that they need to use their bodies for relationship and financial security and refuse to breastfeed for fear that it will ruin them or the baby will be too clingy. Then there are the boyfriends that claim ownership of the mom's body for all intents. We aren't allowed to get involved in "domestic" problems outside of referring the woman to social services, mental health services, or the women's shelter.


I do everything I can think of to encourage my moms to breastfeed even if it's with supplements. I know a lot of the bf moms don't see the extras they get as being useful because all they see are the $ difference between their food package, which is larger than a post partum mom and gets it for longer, and what formula costs. The bf moms get a support group (which is poorly attended even with freebies advertised), free manual pumps to keep, a nursing bra, washable nursing pads, books, and electric pump loans when we have them available. I put up posters in all of our clinics I'm responsible for, I remind our staff to ask if a mom is breastfeeding instead of assuming they need or want formula, and I try to be as visible and available as I can. I've also been working on revamping the breastfeeding questionnaire we use for our pregnant moms to be less negative about breastfeeding. But I'm only one person and we have 5 clinics. The distance between the two most remote ones is 40+ miles. I live a mile from one of them, and the other two closer are about 15 miles, and the other two are about 10 miles apart. I suppose if my supervisor would do her job, it wouldn't be so overwhelming, but that is not likely to change any time soon unless whoever our new director is cracks the whip.

I know that services vary from state to state and clinic to clinic, but there are WIC people that do try to make a difference.

Anna

[Rhiannon Feimorgan]

I hope I didn't offend you, I have no experiance iwth the program whatsoever. I just keep reading on here how bfing mothers don't really get much from WIC while ffing mothers get all that free formula. I also hear of people who have said things like "why bother bfing? You can get free formula from WIC"

I'm sure that you, and many WIC worker like you do wonderful things to support the nursing morthers you work with.

And I agree that makeing formula harder to get isn't going to change those sorts of social problems you mentioned but for those on the fence, it can and does make a difernace.

I think the very fact that the govornment gives out free formula to families in need implys that babies need formula. They don't, not unless there is no mothers milk avaliable.

But then, I could be wrong about this. Like I said I'm not really that familier with what WIC does or doesn't do other than the formula. We have no equivilant program in Canada (and I belive our bfing rates are better than the US) If a mother(or father, or family) needs social assistance, she gets $X to spend on food, shelter and so on depending on her situation and how many dependants she has. If some of that money is spent on formula well then there is less money for other things.

It's not the only factor but it's part of the total picture.

[Da WIC Lady]

No offense taken. I understood that you aren't American and I value the perspective of someone "not from around here" as a better indicator of how the program is viewed. WIC provides juice, cereal, milk, cheese, eggs, and beans or peanut butter for pregnant women, post partum women, breastfeeding women and children ages 1-5. Infants get either formula or their moms get extra food, then at 6 months they get juice and infant cereal. Exclusively breastfeeding women get extra juice, carrots and tuna. We have nutrition education and promote healthy lifestyles at each visit, breastfeeding support services, and promote literacy with the books we give out to the kids. It's more than just a free formula program, although some people treat it that way.

Anna

[rachelagain]

I think this is a deeper problem- In America we are taught to think of ourselves first and if it doesn't fit what we want- it's thrown out and everybody tells you that's the best thing you can do.
I think it's really only going to change if we teach our kids to put others first.
Being a SAHM, cooking healthy food, activities the kids are in, eating nutritionally through pregnancy (avoiding junk food/caffeine/drugs), no pains meds for birth, breastfeeding, all of those things are done through sacrifice, a selfless act, as a pp mentioned.
I don't mean to offend anyone.

I do get WIC and am a bit disappointed that my "bonus" is tuna and carrots- sure wish I was in the area where I got a free bra and pump! But I know most of the ladies that get their formula through WIC would still FF even if they didn't get formula- because I know women like this! And at least WIC can give them the formula and guide the mothers so that the child is not malnourished.
If our culture thought BF normal instead of twisted it might help (know some women who think it's too sexual and it's gross to have that w/ a child)... but I honestly think it boils down to selfishness/selflessness.

[siobhang]

Originally Posted by rachelagain

I think this is a deeper problem- In America we are taught to think of ourselves first and if it doesn't fit what we want- it's thrown out and everybody tells you that's the best thing you can do.

I disagree a bit. I really don't think the average american is any more selfish or not than anyone else around the world - meaning that we are all on average fairly selfish, but we try to be kind to others and so forth.

But our standards and expectations for what is "normal" and "fair" are overwhelmingly dictated by a media saturated culture which promotes commericalism and consumerism over all other values. We are told we "deserve" a new car, we "deserve" a big house, a family vacation, etc. And with easy and cheap credit, more and more americans are seduced into thinking that they are just getting what they deserve and what everyone else (at least on TV) is getting too.

In regard to breastfeeding, I suspect that this huge amount of commercialism is another problem. If you can't buy something, then it disappears - it has no value, can't be measured, can't register. Think clean air, think community spirit. Where can you buy those?

This is why breastfeeding promotion often registers with women at the point when they can see it - through pumping milk, buying stuff or services to support it. Suddenly breastfeeding is "real" and a commodity and can be bought and sold.

Breastfeeding also can fit into that media image filled world - breastfeeding is what "good" mothers do. Hell, we are told over and over again that "good" mothers buy their kids expensive educational toys, or save for college, or install huge playground equipment.

Breastfeeding has already made forays into popular culture. yeah, it may be the butt of jokes in sitcoms, but IT IS NOW MENTIONED ON TV (vs before it was too "private" to be mentioned in public. NIP may be controversial but people are talking about it. The average non-parent is aware that breastfeeding does exist (even if they don't know anyone doing it or approve of seeing it in public). You cannot change what isn't even acknowledged.

And we won the fight saying that breastfeeding is ideal food (yeah, I know the language needs to be improved and too many people give lipservice to breastfeeding support). 30 years ago, people were NOT saying that breastfeeding was ideal. They were saying that formula was superior. So we have moved the conversation forward to where there is a general consensus that breastfeeding is best for baby and mom.

The next step is to make breastfeeding the default expected norm for all mothers. We need to move away from the "choice" rhetoric (which I hate when discussing reproductive rights as well as breastfeeding, since these are not fair choices). Choice falls into the commercialism "pepsi or coke" "McDs or Burger King" "all choices are equivalent" rhetoric. The women on MDC and who I know in real life who FF did NOT do so by choice. They did so by force.

I also would love to see us move away from the dichotomy of breast OR bottle. I know many women who supplemented - they DO breastfeed; it is just a question of how much they need to supplement. I know many women who weaned before they wished to; they DID breastfeed, their kid WAS breastfed.

I think by encouraging every woman who fed even the smallest amount of breastmilk to her child to think of her as a breastfeeder can help change our culture. Numbers matter. According to CDC, 73% of children were breastfed, even briefly, in 2004. By claiming those women, and encouraging them to breastfeed for longer, we can move away from the ugly "formula vs breast" fighting with something more positive.

http://www.cdc.gov/breastfeeding/dat...a/2004/age.htm

Sorry didn't mean to get so long. I got on a rant there...

Siobhan