Thursday, July 26, 2012

Does "Breast is Best" Create a Hardship?

Photo of PumpEase courtesy of
I just came across an interesting article posted in the New York Times in which Jane Brody attempts to use a recent serial  interview study from Scotland to prove a point. She says the American Academy of Pediatrics goal that women exclusively breastfeed for about 6 months is unrealistic and imposes undue hardship on mothers. She relies somewhat on her personal experience 43 years ago when she had her twin sons early by C-section and pumped her milk as they were being fed formula in the hospital. Obviously that wasn't a terribly auspicious beginning for Ms. Brody, and she didn't have the advantage of a supportive lactation consultant since the profession didn't exist 43 years ago. Her OB was quite supportive, but her pediatrician was not, and I must say that I really admire her determination to breastfeed her sons despite some incredible obstacles and without a strong support network.

However, the thing that concerns me the most is the perception of a continued lack of support for nursing mothers in the workplace. Federal law mandates not only that breastfeeding mothers be given break time whenever they need to pump, but it also says that employers with 50+ employees are required to provide a place for pumping that is NOT a bathroom. Many employers have made huge strides in accommodating nursing mothers; nevertheless, some companies may still be unaware of the legal requirement to support these employees. It is vitally important that the women who work in these companies make their HR people aware of their responsibility.

A Nurturing Moment actually has a special program in place specifically designed to help employers offer the best support available to mothers. The return on investment is incredible. Cigna conducted a 2 year study of breastfeeding employees and found that their workplace lactation program produced the following results:

  • $240 million annual savings in health care expenses
  • 62% fewer prescriptions
  • 77% reduction in absenteeism
Mutual of Omaha had the following results with their lactation program:

  • 83% employee retention after maternity leave (national average is 59%)
  • Healthcare claims per breastfed newborn averaged $1269 compared to $3415 for formula-fed infants.
That leads us into a discussion of my second major concern with Ms. Brody's article. She asserts that there is no research to back up the claims of the medical community that breastfed babies are healthier. It looks to me like Mutual of Omaha has done some research that backs that up!(Mutual of Omaha. (2001). Prenatal and lactation education reduces newborn health care costs.Omaha, NE: Mutual of Omaha.) Furthermore, the AAP statement is backed up by significant research. In fact, it contains 151 citations to support it's recommendations. The Academy of Breastfeeding Medicine has also responded to the Times article with a statement calling for enhanced support for all nursing mothers. 

This isn't about Mommy Wars or "Milk Wars." It's about a public health initiative. The worst thing that anybody can do is use guilt in an attempt to motivate a woman to nurse. Guilt is a lousy motivational tool. It is even more awful for anyone, breastfeeding advocate or not, to make a mother feel guilty about her feeding choice once that choice has been made. Life is just too short for guilt! 

So what do we need to do? First of all, we need to make sure that all mothers have access to good prenatal education about breastfeeding. They need to know that it may be challenging. They also need to know where to turn if they do have any problems.  Next, we need to realize that, as one mother so aptly put it, "It takes a village to breastfeed a baby." (thanks, Elizabeth!) That village includes health care providers, community support groups, family, friends, and breastfeeding professionals.  Finally, we all need to strive to make the workplace more supportive for nursing moms. Are you in management? Do you own a business? Do you know someone who does? Find out what they're doing to help their nursing mothers. Ask questions before you get pregnant. If your children are older, then see what you can do to smooth the way for younger women. If we all work together, we can help more moms succeed and avoid a lot of unnecessary guilt.


  1. Thank you for posting this Glenni. I was not aware of the Times article but I am all too familiar with the unique challenges breastfeeding moms face both at home and in the workplace. Though breastfeeding is as natural as the sun and sea it doesn't necessarily come naturally to all women (as many women who have struggled with poor latch, refusal to latch, and low milk supply can attest to-myself included.) I am the mother of two exclusively breastfed babies, each of which presented me with multiple and distinct challenges in our tenure together. Though I live in a very rich part of the country with many resources available to mothers, I found I had to desperately and aggressively seek help out on my own. Not once did my Harvard educated OBGYN speak to me about my breastfeeding plans or offer me information on which Lactation Consultants to call or what support groups to join, or even what to possibly expect in the early days etc.. As a new mother one is so overwhelmed by the enormity of your new life it is imperative to have not only support at home but to have support within the medical community as well. It is a rare mother who is lucid enough in the days after child birth to go looking through the phone book for breastfeeding support.
    Educating mothers on what to expect, providing referrals to support groups,
    providing names of Lactation Consultants, and explaining the basic supply and demand principal of breastfeeding before the baby comes are things that are imperative to a breastfeeding moms success. Had I had this basic knowledge before I had my daughter, things might have gone a lot smoother for us. I can only hope that with more education, further strides will be made to support women more at home, work and at our doctors offices leading to better breastfeeding success rates in this country and happier less stressed moms and babies.

    Boston, MA

    1. Elizabeth, you put this very well! Thanks so much for your feedback!