Baring Breasts for Baby

by Rebecca Ephraim, RD, CCN

Some time ago I was at a family gathering where a thirty-something shirttail relative recounted his absolute disgust at the sight of a woman seated across from him at a restaurant breastfeeding her baby. Oh, the horror of it all! In an effort to put it into perspective, I pointedly asked this man (who by the way, is single, handsome, and a college-educated professional) if he had to choose, would he rather sit across from a breastfeeding woman or a cigarette smoker blowing second-hand smoke his way. Almost without hesitation, he chose the smoker. I have since discovered that this, um, ahh, conservative-minded chap has plenty of company.

My shock at his disgust prompts me to take a closer look at the issue. As I have chosen a lifestyle without children, I’ve not personally had to make decisions as to how and when I would breastfeed. But women who do nurse are unfortunately forced to confront their beliefs as to what’s best for their babies and square it with how the rest of us react to them breastfeeding in public. And, as I’ve observed, many are intimidated by an American culture that tends to browbeat well-intentioned breastfeeding moms, which has in turn pressured more than a few into prematurely abandoning breastfeeding and its wonderfully healthful benefits.

The ten-plus breastfeeding moms I interviewed made it clear that they had not encountered overtly nasty remarks or deliberate acts of indignation as they nursed their babies in public. Reactions are subtler, they say. For instance, one mom, Jan M., notes that despite her attempt at being discreet when nursing her daughter, Emma, in public, the body language of some annoyed passersby is unmistakable: "It was very clear people would realize what’s going on and avert their eyes and huff away. There would be some isolation...and not full support. I would not feel that people were as open [as they should be]."

More than twenty states have enacted legislation clarifying that women do have the right to breastfeed in public. Although it’s perfectly legal anyway, these states are taking legal measures to encourage more mothers to breastfeed and to alter the public perception that breastfeeding is a form of indecent exposure. There are numerous reports of mothers who have been nursing in restaurants, malls, and libraries being told to stop or remove themselves from the public eye. This is mostly because some spectator complains to a manager that the nursing mom is making him or her uncomfortable. Ironically, moms who are experienced at breastfeeding usually can put their babies to their breasts without anyone noticing; it’s the new, inexperienced moms who draw more attention by thoroughly covering themselves to reveal nothing yet unwittingly announcing to the world: "See this shawl I have draped over my shoulder? I am nursing a baby." And these are usually the moms most intimidated by a critical look or a suggestion that they are doing something very wrong. Of course, all women who want to nurse their babies in public should draw self-confidence from the fact that what they are doing is the legal, right, and best thing for their children.

It behooves us, as a culture, to look more closely at why some people are so disturbed by seeing a woman use her breasts for their most basic biological function. Tracy W., a first-time mother who continues to breastfeed her twenty-month-old daughter, Huntley, is still dazed by the public’s response. "It’s unbelievable! People have skewed views of what breasts are for....They have a purpose and their purpose is for our babies. And that’s the only reason they are there. They are not there to be perky and perfect; they are there to serve our babies."

However, this is not to begrudge men the excitement of the sexual dimension of breasts! Rather, according to Texas A & M University anthropologist Katherine Dettwyler, we need to remember that the sexual allure of breasts is simply a learned behavior, "It is inappropriate to let the very Western cultural idea that breasts are for men overshadow their primary biological function for feeding children.... I am not suggesting that it is wrong or immoral or perverted to experience sexual pleasure [as long as] using our breasts for these purposes doesn’t lead to...breastfeeding being defined as sexual behavior."

Despite our concern with the attitude of the public-at-large, the biggest challenge that nursing moms often seem to have is dealing with their family’s feelings toward breastfeeding, particularly when the baby is older then six months. In several interviews with mothers a major comment was "My family is not supportive of my choice to breastfeed." Tracy W., the mom nursing her 20-month-old, says her husband’s side of the family — and sometimes even her husband — is turning the screws. "They ask me‘How long you gonna nurse that baby?’" Her standard lighthearted comeback is, "Until she’s done!" Tracy is frustrated: "People don’t understand the whole bonding issue as well as the nutritional value the child gets."

American mothers who breastfeed their babies after birth number about 64 percent. By the time six months rolls around that number plummets to 29 percent. Could this drop in breastfeeding be blamed on the negative reactions that women encounter from the public and their families? Perhaps. But much of the blame must be placed on baby formula makers who have done much to undermine positive views toward breastfeeding. A Le Leche League (LLL) leader, asking for anonymity in order to speak frankly, suggests that baby formula companies have been ultrasuccessful in luring (some) pediatricians and hospitals with hefty financial rewards to promote their baby formula products while edging out breastfeeding. As an accredited leader of LLL, an international organization dedicated to providing education and support to women who want to breastfeed, she hears an endless number of new moms speak of being plied with free baby formula. Many are upset that their newborns have been fed formula by hospitals without their approval. Given that the first introduction to feeding a baby is steeped in a culture that appears to value formula over mother’s milk, is there any question that this might make mothers doubt their judgment to breastfeed?

The promotion of infant formulas by hospitals and health practitioners is actually in direct violation of an international initiative launched by the World Health Organization (WHO) ten years ago. The program, which is designed to see hospitals solidly promote breastfeeding, stop formula distribution, and conform to a ten-step program to achieve successful breastfeeding, is called the "Baby Friendly Hospital Initiative." However, WHO monitoring reveals widespread noncompliance in not just developing countries but in our own "we-should-know-better" America. Sadly, as compliance is voluntary, there are no penalties for violation.

This issue is one of nutrition and health. Established studies show that babies who are not breastfed have higher rates of death, meningitis, childhood leukemia and other cancers, diabetes, respiratory illnesses, bacterial and viral infections, diarrheal diseases, ear infections, allergies, obesity, and developmental delays. Women who do not breastfeed demonstrate a higher risk for breast and ovarian cancers. Research covering the first two years of birth also shows that the longer a woman breastfeeds over that 24-month period the more benefits she confers.

Ultimately, the beauty of breastfeeding is that it serves us all by bestowing upon our society future generations of children who are apt to be more physically and mentally capable of building a better world. What’s truly obscene is the sight of young, often overweight, children munching nonstop on deleterious junk food; they may be destined to become the troubled adults we need to "baby" in later life.

If you have a particular view on this issue, we’d like to hear it.
Disclaimer: This column is for information only and no part of its contents should be construed as medical advice, diagnosis, recommendation or endorsement by Ms. Ephraim.
Rebecca Ephraim is a Registered Dietitian, Certified Clinical Nutritionist and a nutrition reporter specializing in integrative medicine issues. Click here for contact information.

© Rebecca Ephraim. All rights reserved.


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