Wednesday, January 28, 2015

Why can't she just cover up?

One of the comments that gets repeated every time there is a discussion about public breastfeeding is "Why can't she just do it elsewhere, give the baby a bottle or cover up?"

To begin, lets establish why it is unacceptable (and illegal) to ask a breastfeeding mother to leave a public space while feeding her baby. Breastfeeding needs to happen wherever the baby happens to be. If a human is hungry, nobody has the right to withhold food from them. A baby has the right to have its need for sustenance and hydration met promptly, with neither the baby or mother feeling uncomfortable for any reason whatsoever. Asking a mother to leave a public space is infringing on her right to partake in normal society and expecting her to be at the mercy of her baby's feeding schedule, which if a mother is demand feeding as per the recommendations of practically every health agency in the world, mean that her own freedoms will be severely curtailed. Nobody has the right to expect her to go elsewhere when all she is doing is trying to maintain normal social contact, - which is vital to maintaining her sense of normality, which in turn helps to prevent Post Partum Depression -  and she is just trying to give her baby sustenance. Her baby is also a member of society and has the right as well as the need to be socially integrated. 

These are SOME reasons why breastfeeding mothers should never be expected to feed their baby from a bottle. 

A baby who is being exclusively breastfed simply cannot have anything other than breastmilk. Any foreign substance - even water - can cause serious digestive issues. The virgin gut is very, very delicate and needs to be treated with extreme care. So asking a woman to feed her breastfed baby a bottle of formula so that she wont "offend" anyone by nursing is simply not good for the baby or for the nursing relationship. So why can't she just express?

The WHO has ranked the optimal infant food in this order:
1. Breastmilk from the mothers breast.
2. Expressed breastmilk in a bottle, from the mother.
3. Expressed breastmilk in a bottle, from a donor.
4. Commercial formula.

There are many reasons why milk suckled directly from the breast is better for the baby and the mother, for the sake of brevity I will only list a few of them here.

Firstly, safety concerns - milk suckled directly from the mothers breast contains no external contaminants. A bottle by its very nature is a potential hazard. It can harbour germs, toxic chemicals and even mold, and unless scrupulously cleaned and sterilised after every use it can pose a health hazard to the baby. The milk may have been stored too long, be sour, or even contaminated by the bag it was frozen in, and may harbour antigens. The bottle itself poses a risk, there have been many recent studies done on the hazards of BPA in plastic bottles, which was removed from most infant bottles, but replaced with BPS, which has been found to be as potentially dangerous.

Babies who are introduced to bottles or dummies often develop nipple confusion. The bottle is usually easier to suckle from so they don't want to work harder at suckling from the breast. To put this in layman's terms, nipple is flattish when it goes into the baby's mouth. as the baby sucks, it changes shape and becomes more "tube-like". A baby instinctively knows that the nipple goes into a pointy, firmer shape, milk starts to emerge. A teat or dummy is already shaped in this way so the baby begins to prefer this "food giving" shape and starts to refuse the breast, which requires more effort to transform. Most hospitals have changed their policies and will only offer babies dummies if the baby is not going to be breastfed. Any midwife or lactation expert will tell you that if you are breastfeeding, avoid bottles and dummies at all costs.

Breastmilk is perfectly calibrated for the baby's current physical needs. Unlike formula which is homogenised and contains exactly the same ingredients at every feed, breastmilk will alter significantly in make up from feed to feed. Every time a baby's mouth makes contact with your nipple your breast re-calibrates its output to suit the child's current physical state. If the baby is too warm or if its saliva is thickened, the body will make more watery milk to satisfy thirst. If the saliva contains bacteria or viruses, the body will insert the right antibodies into the milk as well as increasing the amount of immune boosting ingredients. Expressed milk often doesn't not contain much of the fat-rich hind milk which is available at the end of the feed. The consistency and calorific content of the breastmilk changes during the feed. It starts off watery to quench thirst and then gradually becomes thicker and creamier, and more "hunger satisfying". Expressed milk will also not contain the necessary antibodies if the baby is coming down with a virus, so will not as effectively help to fight infection or address any current issues such as dehydration. 

One very simple reason it is preferable to feed directly from the breast is simply to maintain a good milk supply, to protect nipples from being bruised by the pump and to create better conditions for a long term and satisfactory breastfeeding relationship. Pumping for many women is exhausting, painful and time consuming. Many women, myself included, spend large sums on pumps and find that they cannot produce enough by pumping to provide enough for even one feed. And because the best way to get milk out of the breast is to suckle your baby, it will affect milk production too, because the breast should be emptied completely at every feed or it begins to produce less. Women that exclusively express will find their supply dwindling and often drying up completely. Finally, women that don't express should not feel forced to do so because they will be needing to feed their baby during an outing. To expect a woman who is accustomed to breastfeeding to buy bottles, sterilising equipment and a pump, and to spend valuable time pumping and freezing milk, to satisfy a prudish desire not to see her feeding her baby is ludicrous. 

On covering up:
So we have cleared up the reasons why breastfeeding happens in public. "But why can't the mother cover up?" you may ask "Can't she drape a cloth over the baby's head?" Well, I am glad you asked. Here are a few reasons why we shouldn't actually be expected to do this.

I cannot overstate the importance of a good latch when it comes to breastfeeding. As a mother who suffered through weeks of cracked nipples due to 2 days of bad latching in the hospital, bad latch nearly caused the end of my breastfeeding journey. To ensure a good latch I needed focus, two hands and a very clear view of my child's lips and jaw in relation to my nipple. To latch her on took all my coordination, and doing that while trying to clamp a towel between your neck and shoulder is just plain frustrating and uncomfortable. My daughter used to slip off and suckle the very end, which resulted in bruising and cracking. Feeding her with a towel over my shoulder - which I did do in the very beginning - meant that I wasn't able to always see how she was positioned.

Which brings me to my next point. Babies don't like it. Would you like to eat with a cloth draped over your head? My daughter put up with the cloth for about 6 weeks and then protested. Every time I tried to cover her, she clutched the cloth and whipped it off, making lots of indignant noise in the process. So I stopped using it. I found - as many mothers do - that the baby fighting the towel was guaranteed to draw more attention than simply feeding. Some mothers find that their babies are easily distracted and so they prefer to cover so that their child can get a full feed. That is their prerogative. Some mothers feel more reserved about showing the top curve of their breast and so, prefer to cover. That too, is their prerogative.But this does not mean that because some mothers are shy, and some babies are easily distracted, that all mothers and babies should be forced to cover up too.  

The next reason there should be nothing between a mother and her feeding baby is because babies have a need to constantly get visual reaffirmation from their mothers. Babies respond to human facial expressions, can tell the difference between happy and sad faces and communicate by means of mirroring facial expressions. Studies have been done on an amazing phenomenon called gazelocking. Gazelocking is when babies stare deeply into people's eyes, thereby making a connection and fostering affection in the person whom they are looking at. It has been hypothesized that gazelocking began in caveman times, when babies would try to connect with as many of the humans in its tribe to ensure that they would feel connected and thereby, help the baby to survive and thrive. Babies gazelock with their mothers while feeding and that intense bonding helps to prevent Post Partum Depression in the mother, as well as create a more secure baby who feels connected to and loved by its parents. If you have ever seen newborn pics of mothers with their babies, many of them will be of a mother and child gazelocking for all they're worth. It's an instinct we should not be expected to ignore. 

And of course there are safety concerns. If you have ever spent a considerable amount of time with your head under a cloth you will know that after a minute or so, re breathing your own air becomes pretty intolerable. We all have an inalienable right to oxygen. Babies should not have to be stifled to protect other peoples misguided feelings about propriety. 

Basically what it comes down to is that opponents of uncovered breastfeeding only have one issue. They are offended by the sight of a baby on a breast. Their only issue is one of prudery. Supporters of breastfeeding have many, many, many reasons - backed up by science and fact - why breastfeeding needs to be a normal part of their lives and their children's lives. The fact is, if you say "I support breastfeeding but..." then you don't support it at all.