The Politics of Breastfeeding

When Barbara Walters commented recently that being seated near a breastfeeding mother on a flight had made her "very nervous," the remark set off a torrent of so-called "lactivist" events around the country, at which breastfeeding mothers, their babies, and their supporters staged public "nurse-ins."

Their view is that breastfeeding is a natural, honorable act and should be no more controversial than sipping a latte or noshing on a sandwich in a café. After all, they argued, babies need to eat, and breast milk is one of the healthiest choices mothers can make for their infants.

Walters' comment landed her in a political hornet's nest, where increasingly conservative cultural mores butt up against generational shifts in attitudes toward mothering and women's roles, resulting in a new front of the culture wars.

Is Breast Truly Best?

For mothers of new babies, few issues bring the personal closer to the political. What was once a very private decision about where, when and how to feed a baby has become fraught with the incendiary politics that divide this country.

The American Academy of Pediatrics recommends that mothers breastfeed exclusively for the first six months of an infant's life, then continue for another six months as they introduce other foods, and thereafter for "as long as mutually desired." But that recommendation is based solely on nutritional and other health benefits -- for both mother and baby -- and excludes consideration of other issues that may prevent mothers from breastfeeding.

A number of medical factors might prevent women from breastfeeding, including an assortment of serious conditions -- being HIV positive, using certain drugs, or having a baby with galactosemia (an inability to process a component of breast-milk) are a few of them.

But perhaps the more common reasons not to breastfeed are pragmatic. In addition to the fact that many women are just uncomfortable breastfeeding their babies, many U.S. companies only offer up to 12 weeks of unpaid maternity leave.

So it may be the lack of acceptance of nursing mothers and accommodations for them -- both in public and in the workplace -- that lead many American women to give up nursing well before the recommended timeframe ends.

Breastfeeding: Shifting Trends

While breastfeeding was the de facto choice for virtually all new mothers up until about 60 years ago, at that time new mothers were rarely in public, much less in the workplace.

With the introduction of baby formula and the increasing number of women in the workplace, the popularity of breastfeeding declined by 50 percent between 1946 and 1956. By 1967, only 25 percent of newborns were being breastfed at the time of their discharge from the hospital.

In the last decade, however, the trend has reversed. In 2003, the last year for which statistics were available, 70 percent of new babies were being breastfed, up from about 50 percent in 1990, thanks largely to "lactivists" and increased public education about the nutritional benefits of breastfeeding.

But while breastfeeding has some undeniable health and economic benefits, some believe that breastfeeding proponents have fostered a new orthodoxy about motherhood that does more harm than good.

Frank Furedi, a professor of sociology at the University of Kent, recently took "breast-feeding zealots" to task for turning the choice to breastfeed into a moral mandate. He contends that women who bottle-feed have been made to feel like second-rate parents.

Breastfeeding advocacy groups, however, see their role as simply one of education. Mary Hurt, a spokesperson for La Leche League International, believes that any choice is the right choice as long as it's well-informed, and that the guilt associated with formula-feeding comes from regret when mothers are not armed with all the facts. "We don't find guilt in formula-feeding mothers who have made an informed decision," she says.

Breastfeeding on the Legislative Front

Today, many people occupy a middle ground in the breastfeeding debate. Whatever choice women make, they say, it should be a personal one that suits both mother and child. And whatever the mother's decision, it should be supported as much as possible.

La Leche League International and similar groups advocate legislative changes to ensure that any choice a mother makes is entered into freely, without the restrictions imposed by decency laws or lack of facilities; they have some legislators on their side.

In the last decade, lawmakers have proposed a number of laws to protect the right to breastfeed in public, but they vary from state to state and are often confusing, poorly understood, or inadequately enforced. Thirteen states have no laws at all to protect breastfeeding mothers.

In May, Representative Carolyn Maloney, D-N.Y., made breastfeeding a federal issue when she introduced language to amend the Civil Rights Act of 1964 to protect the right to breastfeed in public for new mothers. (She also proposed creating a performance standard for breast pumps.)

A health bill that has been introduced in the Senate by Senator Tom Harkin, D-Ind., would promote breastfeeding accommodations at work.

In the meantime, more and more companies are realizing that voluntary support for breastfeeding in the workplace can have a positive effect on the bottom line. For example, breastfed children tend to have fewer illnesses, so policies that promote breastfeeding would reduce absenteeism among new parents (who are able to and choose to breastfeed) and lower health care costs by an estimated average of $400 per baby over the first year. Advocates also contend that these policies improve employee loyalty, morale, and productivity.

The real bottom line? Mothers who make the breastfeeding choice should not have to run the gauntlet of legal restrictions and social recriminations.

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