How do we normalize breastfeeding?

So World Breastfeeding Week is over and now we're into "National Breastfeeding Month" in the United States. It would seem that we need literally a month to devote to this subject because when it comes to our attitudes on breastfeeding, the rest of the world thinks we're nuts and can't understand our problem.

How exactly do we normalize breastfeeding? And what does that mean?

Some are all about the doublespeak: "I totally support your right to breastfeed, as long as you do it in private or very discreetly." Which sounds an awful lot like "I think breastfeeding is the best thing for babies, but I just don't want to see you actually doing it."

This Victoria's Secret mannequin
leaves nothing to the imagination

Sometimes when I'm out and about I observe things that make me scratch my head like "Seriously?" It's not a wonder we have issues.

1. We need to respect the breast. I'm sorry, but one thing I can't stand is hearing (especially women, for some reason) referring to them as "tits." And when men start basically making cat calls like "I'm all for anything that involves seeing boobs in public," that doesn't really help, either. Sexual euphemisms for your breasts are not helping with the double-minded attitude that people have about breasts and what they should be used for, or that they even have more than one function.

The popular nursing cover "Hooter Hiders" further emphasizes my point: when we're talking about breastfeeding but referring to them as "hooters," I don't know about you but I automatically think of the restaurant chain. Completely pointless.

Not only does the giant apron draw more attention to you, but the name
"Hooter Hider" seems to sexualize the act of breastfeeding. I cannot
wrap my brain around the conflicting messages here. It's like
nourishing your baby, with a touch of vulgarity. Bleh. (And while
they say it's a "top must-have for breastfeeding mothers," I have never
seen anyone use one of these things.)

By sexualizing the breasts even when promoting breastfeeding, it's like shooting yourself in the foot. Case in point - these idiotic promo ads from the Ad Council. Are you serious? Is this really doing any good?

Once again, Americans prove how incredibly juvenile they are about using the breasts for something other than sex.

On the other hand, New Zealand takes a radical approach and actually shows (gasp!) someone breastfeeding. Wait - there's no tarp covering her and she's nursing - and you really can't even tell. How is this possible?

2. Sort of dovetailing off the above point, just say the word breast. I dare you to. Target has a clever tactic of calling it natural feeding in their stores. They can't even say "Breastfeeding" on the sign above the display, even though I'm sure 100 percent of the product packages featured in that section do. Maybe we could get over our sexualization of them if we just matter-of-factly, maturely, called them what they really are?

3. And dovetailing off of that, get rid of the ridiculous marketing. Again with the Target display, I was dumbfounded when I saw this there the other day:

Not only do they not call it "breastfeeding," they don't show anyone actually breastfeeding anywhere in the picture: there is an entire display of bottles with formula in them, and a canister of powdered formula in the foreground. What?!

This was even more disturbing. The mother and baby featured aren't nursing, either. This would have been a perfect opportunity for Target to actually feature a mother doing what the sign advertises, right?

Stranger still is the sign underneath - that immediately equates "natural feeding" with using a breast pump. Some women, obviously, will use them, but this seems to make you think you must buy one, you need one, so you don't have to actually be seen feeding your baby. Truly bizarre.

4. Just do it. I can't think of a better way to normalize it than actually feed your baby somewhere. Who knows - the more women we see nursing in public, the more it can possibly change attitudes and even encourage just one mom. As much as people complain about "exposing" little Johnny and Susie to it as kids, children do need to see that relationship to understand the basic function of the human body, whether mom likes it or not. I'd much rather explain to my child how their brother is fed than have to tell them why Susie's mother doesn't object when she wears next to nothing to school every day.

5. Be an advocate, whenever possible. This doesn't mean staging a "nurse in" or anything of that magnitude, but respectfully standing up for yourself and your rights as much as possible. I'm not saying defy police authority in the pathetic event that they might be called, but responding even keel and not getting angry probably helps a lot (no matter how much you want to smash the person's face in). Hand them a pamphlet with your state's breastfeeding laws. Tell them you're perfectly within your rights and carry on. It's sad that you even have to approach such a thing as infant feeding looking for a fight, but some people will confront you no matter how much you're covered simply because they know what you're doing under there. 

Advocacy shouldn't include, however, being a "nursing Nazi" (a term I despise) and even if you do think formula is poison, keep those sentiments to yourself. Getting up in a mom's face for not breastfeeding is not going to make her turn around and lactate, either.

One way I could put my money where my mouth is, for instance, is to write a nice letter to Target asking them why they're complete asshats about the way they "promote" breastfeeding. Perhaps some positive changes will take place as a result; or maybe they'll just send me coupons for free formula. *snark*

A history of breastfeeding in public

When you're deciding on whether to make the commitment to nursing, undoubtedly for some the idea of nursing in public is daunting. Even experienced mothers have told me they never fully "mastered" it, and we all have our own individual levels of comfort when it comes to doing it. Add an older kid to the mix, and suddenly it's like juggling a three-ring circus with one hand.

Lots of people think breastfeeding
is the best thing for baby. They
just don't want to ever catch you
doing it. Isn't there a tarp or tent
somewhere you can use to huddle
under?

I've had to think really hard about those times I nursed in public, and honestly I can't remember a whole lot. I think I mostly hid out in fitting rooms (and even a few bathrooms, but usually not for the reason you'd think - usually because as soon as I sat down to nurse a baby, the sudden, overwhelming urge to use the bathroom often hit me). I preferred those places not so much because I didn't want people seeing me nurse my baby, although because I was a bit clumsy with things that might have been part of it; but more because when I nursed, I wanted to spread out, get comfortable, and just sit. That meant I could lean back, hang my leg over a chair and get comfy. Although yes, in some ways, I was not in the mood to be stared at, harassed - even potentially - and felt generally uncomfortable and paranoid.

To think - those feelings and anxieties, over something real or perceived - can actually keep a woman from wanting to nurse at all. I had one playgroup buddy who refused to nurse even in front of us other moms, women she'd known and worked with for nearly a decade. One day I saw her bottle-feeding and realized it wasn't so much to get her daughter "used to" the idea of getting a bottle; it was because she was embarrassed to be seen doing it in front of us. Other moms propped themselves up while at my house, and even though we weren't the closest of friends, they still found a way; and yet, as I sort of watched them, it made me feel slightly weird to be sitting there as they were feeding their babies. Why? I nursed my own children; I fully supported them and wanted them to feel as comfortable as possible while relaxing in my home. Why did I feel strange about it, then?

I think because even as a nursing mother, I had seen few moms like me - nursing their babies in the open, in private, anywhere, really. How sad. How pathetic. How trained we've become (some of us, anyway) because we don't want to invite criticism, controversy or because we are made to feel like we should give more of a crap than necessary about everyone else when really, it's our babies we should be focusing on.

When people say they "don't want to see you flash your boobs in public," I wonder if they have any idea, really, that women decades before us did just that to feed their babies, often in public. What else could you do - it's not like they had tank tops and two-piece sweatsuits at their disposal in 1946. Women typically wore dresses that buttoned up the top, and that was their idea of "nursing clothing." Some dresses were styled somewhat to accommodate, many images simply show a mother unbuttoning her dress or blouse and simply feeding her baby.

So when someone tells you they don't want to see a breastfeeding mother "showing her boobs," just tell them, "Really? Because that's the way they did it 60 years ago." You know, back when everyone was conservative and puritanical, right?

'The Cornstalk Madonna,' by Orin Crooker,
Hoopestown, Ill. c. 1916. One of my
favorites.

Yeah, nowadays barely-there bikinis, thongs and cleavage are all the rage. But I bet if you sat down and decided to feed your baby, you'd be asked to leave (as many mamas have been).

At the beach. In front of people. c. 1930s.
Photo credit: Joseph Schwartz/Corbis. 

But if you're ever at the pool and happen to run into Ice-T's girlfriend, just remember that this is okay, got it? 

Most onlookers drool in approval -
but if this were a nursing mother,
I'm sure there would be an
uprising and police would be
on the scene in minutes. 

This one has always made me laugh - the only one
who apparently gets a rise out of it is a young boy who
is maybe 8 years old. The rest are like, "eh, whatever."
Source: Jennifer James/mothering.com

Babies sometimes get hungry in all kinds of places - regardless of whether they've just been fed or not - like just when you're getting ready to leave to go someplace. It looks like, throughout the ages and no matter what mode of transportation was available, this has always been the case. LOL

Notice how none of the women looks uncomfortable, and the one to the nursing mother's left doesn't seem to be saying, "OH. MY. GOD. I cannot believe she has the nerve to whip that thing out in public while we're all sitting here!"

Caption: "A mother is traveling from Louisville, KY
to Memphis, TN on a Greyhound bus. Here, she is
waiting in the Chattanooga bus terminal and breast-
feeding in public in September 1943."
Source: Jennifer James, mothering.com

I've included the above image in a past blog post, but I never realized that another image is also included in the set:

This could either be a look of consternation that says,
"Did I miss the train?" or "What was that, Gertrude? I
couldn't hear you." Now it's "Ok, when is the angry
flashmob going to show up with the police to
escort me off the property for feeding my baby?!"

This one has always cracked me up, too. This couple
is more excited about saving their farm after the
Great Depression than wasting time worrying about
what everyone thinks about her baby eating. Even
the adviser they're talking to is casual and normal
with them, not all "Mrs. Jones, would you like a
receiving blanket to cover up with? Shall I ask
if there is a nice bathroom stall or dark closet for you
to nurse your baby in?"
Source: Jennifer James, mothering.com

(It was always my dread that my baby would be hungry while I waited at the pediatrician's office - not that I didn't want anyone seeing me, but that a) all those sick people would be breathing on me and b) that I'd have to run to the bathroom, which was across two waiting rooms on the other side of the office. Then, while I was in there, they'd inevitably call my name...)

Anyway, I remember not long ago having a discussion with NICU moms that nurses actually wanted to put up a freaking screen while some of the moms nursed. I've also heard some horribly sad stories about NICU nurses being completely unsupportive - to the point of literal sabotage - of moms who wanted to nurse their babies there. Unreal.

Caption: "Mothers nursing their babies
while waiting their turn to see the doctor,
a nun standing nearby. Location: Paris, France.
Photographer: David E. Scherman.
Time/Life Magazine, August 1, 1946

There are lots more - if you want to see them, visit my gallery on Facebook here or the Facebook fan page Historic Photos & Prints of Breastfeeding. 

Subversive marketing tactics: Nestle "milk nurses"

In light of the recent flak Mayor Michael Bloomberg has been getting for his breastfeeding campaign in NYC hospitals, it's important to go back in history a little and explore the origins of that "little bag of freebies" - which might not be as harmless as we think.

For more than a century, Nestle has become a household name - associated with everything sweet and good. But what you may or may not know is that when it comes to marketing their infant formula, they often left a very bitter taste in the mouths of many mothers and infants worldwide.

"Milk nurses" in South Africa. "Some firms
used "milk nurses" as part of their promotions.
Dressed in nurse uniforms, "Milk nurses" were
assigned to maternity wards by their companies
 and paid commissions to get new mothers
to feed their babies formula. Mothers who did
so soon discovered that lactation could not be
achieved and the commitment to
bottle-feeding was irreversible." -
Business: Its Legal, Ethical, and
Global Environment, by Marianne M. Jennings

Nestle made its presence known in South Africa more than half a century ago with "milk nurses," women who were either actually nurses or those dressed to look like ones - who represented the company. Poor women with little, if any, access to clean, running water were then persuaded to try their products, and soon the baby would be accustomed to getting a bottle of formula instead of mom's breast. In time, the breast milk would dry up - but so would the cash flow necessary to buy more formula to feed the baby.

Problems ranged from mothers reconstituting formula with contaminated water, which often led to diarrhea and even death, or watering it down to make the product last longer - which led to malnutrition. One blogger notes:

A fellow nutrition student of mine was formerly head of the Nestle milk nurses in Kenya. She told me that she and her staff not only were qualified, they were among the most senior nurses in the country and wore uniforms indicating this. She said that regular government nurses then had to “obey” the Nestle milk nurses!

Meaning, there is a systematic method of coercion: whether real or portrayed as such, these "milk nurses" were an established presence on behalf of the company, and by showing a special uniform as a display of power and authority, seems to suggest that anyone who questioned them was "in trouble."

Nowadays we think of those typical goodie bags as no big deal, and with heavy government subsidization of formula, it's not that difficult to obtain more when you run out. However, the problem of reconstituting weakly to make it last longer, doesn't seem to be isolated to foreign countries with indigenous tribal people: the same thing happens here in the US. Whether it's simply greed or ignorance, I don't know, but hearing comments like this one make me want to scream - is it still a mother's choice not to breastfeed, even if it's a completely ill-informed one?

People here in America do this too. I've seen a woman water hers down and sell the remaining WIC cans on craigslist.

Although there are WIC programs that do encourage breastfeeding among low-income mothers, it's obvious that the memo might not be as widely-circulated as it should be.

Some ask, "How is Nestle responsible for people who water down their baby's formula?" By marketing heavily to a nation who cannot sustain using their product. The level of abject poverty in many African nations is something even our poorest cannot comprehend, and seemingly few understand the role that these powerful milk "nurses" played in convincing a woman that her own milk was inferior.

One blogger says she was told by a high school teacher about this situation in South Africa, and promptly thought those women must be "stupid" for believing these nurses. Then when she grew up and nursed her own babies, she said, she ran across this image and it opened her eyes:

Photo credit: UNICEF. Source:
http://www.jemjabella.co.uk/2010/jemjabella-is-a-nestle-free-zone/

The babies in this photo are actually twins. At the mother's permission, she posed for this photograph, taken by a UNICEF worker, after learning that even some breast milk could have helped her daughter to thrive like her brother. Healthcare workers convinced this mother, however, that there was no way she could provide enough milk for both babies, so she faced a difficult decision. Her daughter apparently died the day after this photo was taken. Now that's guilt.

Some ask, "Why didn't workers do this? Why didn't workers tell her that?" Because they have a product to sell. Much like drug reps, hospitals and doctors are often given copious amounts of the stuff for those who truly cannot nurse or don't wish to, in exchange for other goods, I've read. When you have healthcare professionals spewing out this kinds of misinformation, vulnerable mothers are more likely to believe it.

Many have chosen to boycott Nestle as a result; still others ask, "How does this affect me?" The same thing happens here all the time: studies have shown that poorer families are more prone to water down infant formula to make it last, even while getting government subsidies. What if, when those women were in the hospital, they were actually encouraged to breastfeed? With generations of dysfunctional attitudes and perpetuating myths about breastfeeding, how can you expect them to?

More reading:
Poor parents found to water down baby formula: study
Cash-strapped parents warned after Florida infant nearly dies from watered-down formula
China finds cancer-causing toxin in baby formula
Nestle dupes moms, kills babies in Indonesia - DailyMomtra

Understanding Mayor Bloomberg's "formula ban" in NYC hospitals

World Breastfeeding Week 2012 logo: "Understanding the past,"
and how it's negatively influenced the breastfeeding relationship
for countless mothers over literally decades, is key to
understanding initiatives like Bloomberg's in NYC. 

The internet is in a tizzy over the recent decision of NYC mayor Michael Bloomberg to "ban" infant formula and 'keep it under lock and key' in the city's hospitals.

Many people exhibited a typical knee-jerk reaction - ranging from mumblings about 'breastfeeding Nazis' to a woman's choice on how to feed her child. While it should be her choice, it's clear that we understand how that choice can be heavily influenced by a variety of factors, including the media's influence. First of all, it's not a ban. That would mean that all cans have been removed, that there isn't a drop of infant formula to be found anywhere within New York City hospitals.

I think for the staunchest of breastfeeding supporters, or mothers who fully know the benefits and intend to nurse their babies, this ruling means little - because they're already doing all that (or intend to, at any rate). There are those who make the decision based on all the facts and say, "You know what - this isn't for me," mothers who plan on returning to work full time, have stressful situations at home or little support in their efforts, or a variety of reasons - which include just not wanting to. If you don't want to, I doubt this move is going to stop you and no hospital employee should have a right to refuse you infant formula that you know you want to use.

But I do believe there are many women who are on the fence about their decision - whether it's really right for them, whether it will be hard or easy, or who just don't know enough to make a truly informed decision. These ambivalent feelings might run deeper than we realize - and no doubt stem from an upbringing in a culture with 'ubiquitous bottle feeding,' as one of my readers put it. Plainly put, if you are a mom-to-be who, like many other women, was never raised around anyone who nursed a baby, never saw it done anywhere, anyplace, then you are probably more likely to not give a crap and say 'Why not choose formula? It's there, why not use it?'

If you are surrounded by mothers who never nursed, friends who say things like 'it hurts too much, it's too difficult,' etc. etc. you have to wonder what kind of support they were getting. The further back in our society you go, you hear tales of women unwittingly given medication to dry up their breast milk, because nursing was just not en vogue in those days (of which we are not that far removed). Women who were told (and still are, depressingly) that 'their nipples were too big/too small,' 'formula is the same thing as breast milk' and a host of other inanities. Couple that with the overt sexualization of breasts in our culture, because no one has been actually used to seeing them do their primary job on a regular basis for at least the past 40 years or so, and it's a wonder any woman ever has a successful breastfeeding relationship.

I can see where Mayor Bloomberg is going with this - and why he seems adamantly nutso to those who don't understand or see the big picture. If you don't realize the history in this big debate, you're going to think the man is trying to strip women of their freedoms and force those inferior formula feeders to give birth in the hospital's janitor's closet.

Reading reports about it in the media don't help, either. Usually by the tone of the piece, you can tell there is some alarmism that says "How dare they!" Before we freak out and assume the worst when reading these articles, we have to ask ourselves: "Is this even true? How accurate is this piece, and how much do they understand the full history behind this problem?" If they're using sensationalist language, screaming headlines and defensive words meant to do nothing but get your hackles up, then perhaps it's best to move on.

Some examples: (from The New American, in a piece written by Michael Tennant)

Now New York Mayor Michael Bloomberg wants to take formula out of the mouths of babies.....In addition, any mother asking for formula for her baby will get a side order: a lecture on the benefits of breastfeeding....A mother’s choice not to breastfeed, on the other hand, will not be supported.

“The key to getting more moms to breast-feed,” Lisa Paladino of Staten Island University Hospital told the Post, “is making the formula less accessible.” In Bloomberg’s Big Apple, adults cannot be trusted to make wise decisions; the government must do that for them.

Lectured? I hope not. I think if a woman really knows the benefits and still doesn't want to, hey, that's great. Perhaps using the word 'lectured' is a bit harsh - and I'm sure she'll be no more lectured than a woman who is struggling with nursing and really wants to continue, who often hears, "Oh, that'll never work - just use formula." "Why don't you let us feed your baby formula? You need your rest." "Your baby's too big for you to breastfeed. Why don't you just use formula? It's right there. Besides, it might not work out."

Michael, do you have any idea how heavily these products have been marketed, pushed and sometimes given without the mother's permission, sometimes against, for decades?

This article, from The Examiner.com, gets in your face and pretty bombastic from the get-go:

Mayor Michael Bloomberg has devised a new and cunning way to force new citizens of New York to suck at the teat of the State by insisting that they suck at their mother’s.

Seriously? Grow up.

Keeping tabs on the amount of infant formula that flies out the door is probably not such a bad idea - after all, it's rather expensive stuff. I wonder if the author of this article realizes also that the US government subsidizes half of infant formula consumed in this country?

Of course, the first thing this does is stir up even more tension and derision in the mommy wars, without offering any thought or insight into the debate, nor its history in why we get so freaking defensive about what breasts are for in the first place.

Comments on one article (read it here) actually included "Breastfeeding is overrated," peppered with "My milk didn't come in after four days!" and "I supplemented with formula samples and then my milk dried up" are why these initiatives need to take place. There is just as much fervency and lack of support on the other side of the fence, coupled with myths and untrue "advice," that hopefully such a program can be helpful to those who need it. No one should make a mom feel guilty if she can't or doesn't want to breastfeed, certainly; but if you know nothing of it - as one writer admits - then what? Is that really an informed choice?

"I’ve never had a deeper understanding or appreciation of my breasts as feeding mechanisms. I’ve grown up thinking of them as sex objects and not as nourishment." 

It's the long-term influence of these companies, starting with our grandmothers and trickling down to us, that has played a tremendous role in our thinking today. Some argue that one bag of freebies isn't going to sway even the most determined mom - but it's amazing how fast that determination crumbles when you're surrounded by "booby traps:" unsupportive spouses, ill-informed but well-meaning girlfriends, aunts, sisters, mothers and yes, even doctors and nurses. The very people who could be making your journey easier are actually making it harder.

The resolution needs some tweaking, I think; but it's definitely a step in the right direction. And before you give yourself a heart attack after reading countless ill-informed, panic stricken headlines, realize that the measure hasn't even passed yet - which doesn't even mean it will. I've read that those hospitals seeking a "mother-baby friendly" rating are scrambling to put their own initiative into practice, which is great - and which will likely lead countless women to think all hospitals are that great and supportive when it comes to a mother's choice on how to feed her baby. They will likely not understand how, in one person's words, some hospitals in this country are "positively draconian" in their labor and delivery practices, extending to the breastfeeding relationship (think immediate, often completely unnecessary separation of mother and baby after birth, and so it begins).

Lastly, when you scan the headlines and read "Michael Bloomberg wants to ban formula," you must realize that no, it's not being "banned." If anything it saves resources for those who really do want to formula feed, instead of handing out expensive cans of the stuff to women who will likely throw it out or let it expire on kitchen cupboards somewhere. And it could cut down on the unscrupulous tactics of hospital staff shoving cans of it in your face the minute it appears the baby is having trouble latching, passes excessive gas or has to audacity to spit up. (See, that train goes both ways, ladies.) Considering that advocates decry the media's poor grasp of all things pregnancy, childbirth and breastfeeding, do you really expect them to get this right?