New Mexico Mercury

Editor’s note: World Breastfeeding Week runs from Aug. 1 – Aug. 7. Info on local events at the bottom of the page.

“Do you plan to breastfeed?”  This question is asked amidst the heavy moments after the birth of a baby and the simultaneous birth of a parent. It’s an interesting and culturally important question. It’s a question that pushes aside the many voices and influences a woman has navigated while deciding how to feed her baby. It’s a question that makes breastfeeding sound like a switch with two positions, yes or no, instead of the process of learning, interruption, and delayed success it is for so many women.  At the same time, it is indefinite: not “Will you breastfeed?” or “Are you ready to start?”, but “Are you going to take a stab at it?”

During the months leading up to that moment, mothers are the target of an onslaught of parenting images, advice, and marketing, in large part focused on infant feeding.  First, there is a sort of pregnancy radar, where the images of motherhood that were always vaguely present in countless areas of life suddenly stand out.  From entertainment to a day in the park, newborns and early motherhood are cast in a sharper light.  Next, friends and family begin to share their advice and experience. Partners have their ideas and values. Meeting with an obstetrician or midwife, another voice enters the mix. Then, with the purchase of the first infant items, the mailbox is flooded with advertisements for newborn products.  There are seas of parenting magazines, pregnancy books, and maternity videos. Even if such publications are not requested by the mother, they still appear next to her at every prenatal check-up.  Caregivers at the maternity ward deliver free diaper bags packed with brochures and samples.  Free canisters of formula are offered by mail and through care providers. 

By the time a woman is asked whether she plans to breastfeed, it is nearly impossible to be neutral on the question.

Breastfeeding and formula feeding are often cast as arch enemies battling for a new mother’s choice.  On one side is the formula industry, armed with aggressive marketing and a cultural foothold. There are many detailed, thorough articles tracing the history of formula marketing and its effect on breastfeeding.  (See Looking Back on the History of Formula Advertising or The History of Infant Feeding, published in The Journal of Perinatal Education.)

On the other side is breastfeeding advocacy, perhaps most famous for their “Breast is Best” phrase, promoting the benefits of breastfeeding which have proven in study after study to improve physical and mental health in babies, children, and mothers.  It seems there is a breastfeeding benefit for nearly every modern ailment. For the child, there are fewer infant ear infections, decreased chances of childhood obesity and diabetes, and an increase in a baby’s IQ. For the mother, breastfeeding lowers the risk of cervical and breast cancers, lessens the economic impact of a newborn, and can help the mother’s body heal from birth. 

So if breastfeeding has been proven to have powerful benefits, why has it been in a heated battle with formula for 30 or more years? Monica Esparza, co-chair of the Albuquerque chapter of the New Mexico Breastfeeding Task Force, points out that formula companies did a fantastic job aligning their product with modern life. Monica says, “Formula marketing advertised formula feeding as just the same as breastfeeding, and in a world that is constantly on the move, it just seemed easier. Breastfeeding as a norm had died off, and people were not seeing breastfeeding anymore.” With less exposure to breastfed babies, mothers can also be set up to fail at breastfeeding because the baby’s behavior can be very different from a bottle-fed baby.  “We’re used to a different kind of behavior because a baby who is bottle fed usually sleeps longer stretches because the milk doesn’t digest fast enough. We’re used to measuring [the amount baby eats], and breasts don’t do that.”   By removing breastfeeding as a norm, formula companies created a self-sustaining culture of formula feeding through inexperience and lack of exposure.

With the loss of breastfeeding experience in the community, the support helping new mothers to navigate setbacks and difficulties in breastfeeding vanished. If a woman’s mother and grandmother did not breastfeed, Esparza points out, she is unlikely to have a close and trusted source for questions and concerns. She is less likely to realize just how common many breastfeeding difficulties, and their solutions, are to other women. This is likely a frequent experience in New Mexico, where the breastfeeding initiation rates are relatively high (80% in New Mexico compared to 60.5% nationally), yet only half of those women will successfully breastfeed to the age of 6 months.

The theme for this year’s World Breastfeeding Week is Breastfeeding Support: Close to Mothers.  This focuses on rebuilding the mother-to-mother support network lost in the culture of formula feeding. Peer-to-peer counseling is especially important in New Mexico, where race, poverty and education play a part in lowered breastfeeding rates. The same information on breastfeeding provided by a healthcare professional, coming instead from a familiar voice, can have a different effect on the strong cultural norms behind infant feeding choices.  Esparza says of herself, “As a Hispanic mom, we are raised with a lot of myths and ideas from our mothers and grandmothers [about breastfeeding]. If a Hispanic mom comes in with the same background and says, ‘My mom told me the same thing, but here are the facts,’ then the mothers’ hearts are more likely to open up.”  While women interested in providing peer-to-peer support can seek out formal positions in WIC or advocacy groups, it’s important to remember that personal relationships and simply breastfeeding in the company of others help rebuild the breastfeeding community.

Beyond nursing mothers, the New Mexico Breastfeeding Task Force seeks to reach the wider community of voices influencing parents. Their work covers everything from health benefits to ways to support nursing mothers. It focuses on a mother’s partners, parents, grandparents, her healthcare providers and delivery staff. While aiming to increase the number of women who initiate and stick with breastfeeding, support of mothers who did not breastfeed out of preference or inability is vital to the cause. 

However, the battle cry of “Breast is Best” leaves many mothers who use formula embarrassed or defensive about their choice.  Emily, a mother who underwent breast reduction, gave birth via C-section, and whose newborn stayed in the NICU, says this combination of factors made breastfeeding almost impossible. “I totally believe in and support the Breast is Best deal,” she says, “but when you're in the trenches it can be really tough to not internalize that message as ‘that other thing that you're doing is second-best’".  Some mothers even fear the assumptions of others when they bottle feed expressed breast milk. Mary is in a same-sex partnership and would often bottle-feed milk her partner pumped, but despite having a bonding experience and feeding breast milk, she was “paranoid of judgment from breast-feeding activists who saw me giving him a bottle and didn't know why.” The guilt doesn’t end with the breastfeeding period, either. Yet another mom, Leslie, told me of her son, “He's four now and he gets sick more often than his brother, who has been breastfed. Cue the guilt.”

Many mothers who struggle with breastfeeding wish it were treated like a choice with many benefits without attaching the heavy emotional weight behind the claim that breastfeeding is the ultimate care a mother can give and the primary way to bond with their child.  The desire for ultimate authority over their bodies and parenting choices can also be chaffed by breastfeeding advocacy. Erika tells me, “I think what feels offensive, maybe obtrusive, about questions like ‘Did you try Fenugreek?, Are you diabetic?, Is the baby latching well?, Are you pumping?, Have you called LLL?’… It’s that these questions are not always preceded with, ‘How are you feeling? What have you done so far? Wow, that's a lot. You must be exhausted.  Do you have support to breastfeed? Do you want support to breastfeed?’"

Behind formula feeding are millions of dollars in marketing: commercials on TV, ads in magazines, coupons in the mail and free samples that call at the 2am feeding.  Behind breastfeeding advocacy are grassroots organizations, peer support volunteers, and a small group of health professionals, who sometimes may be overzealous in their attempt to make their voices as loud as those of a major industry.

Asked whether the New Mexico Task Force addresses the emotional weight formula feeding moms carry in their mission to bring support to breastfeeding mothers, Esparza says, “It takes a village to raise a breastfeeding child. It’s all about finding common ground. We’re all trying to raise our babies.”  She suggests looking for ways both experiences could help make breastfeeding more successful for new mothers.  “Where did you not see that support that could have helped you breastfeed, so we can help other moms who want to try?”  Ultimately, Esparza says, what mothers need is a revival of the traditional community support lost in the culture of the modern nuclear family. “Moms today are expected to be superheros, up and around as soon as they are out of the hospital. In some cultures, mom takes care of baby and the community takes care of mom for 40 days. It’s called the cuaretena. We don’t see that here.”

The end of the matter, a mother named Carla told me, is this: “The best thing for baby, in my opinion, is a happy, supported mother.” 

The local chapter of the New Mexico Breastfeeding Task Force welcomes all parents and community members to their meetings. Below is some info on local events for World Breastfeeding Week throughout New Mexico:

http://www.breastfeedingnewmexico.org/WBF_Chapter_activities.html

Albuquerque’s Events:

11am - 1pm on Friday, August 3rd
First Nations WIC
5608 Zuni SE, Albuquerque
Reception with light refreshments and door prizes
Still needed:  donations, 'vendors' to sit at tables and answer questions about available services for breastfeeding families

9am - 11am Friday, August 3rd
Southeast Heights WIC
English/Spanish celebration with games, prizes, food!  Breastfeeding Peer counselor will be available for questions and support.

9-11am Saturday, August 4th
NE Heights WIC and Inspired Birth and Families
3916B Carlisle NE, Albuquerque
Thousands of breastfeeding women and their babies/children across the world will gather in their own communities to take part in this synchronized Big Latch On to help raise awareness of the importance of breastfeeding.

4-7pm, August 9th                                                                                                                
Northwest Valley WIC and First Choice Clinic
Celebration to include jumping castles, fire truck, face painting entertainment and refreshments.

(Creative Commons feature image via Flickr by Aurimas Mikalauskas.)