It has been an interesting experience moving from the East Coast to the Midwest from a breastfeeding perspective.  Breastfeeding was much more common, accepted, and encouraged in the East.  In my area of the Midwest, rural, the bottle is King.  I suppose it is not too surprising but very annoying that the local hospital where I had my last two children does not have a lactation consultant;  you have to take your chances with whatever nursery or post-partum nurse is on duty and hope they have some clue about nursing.  In my case, it wasn’t a problem since I am an experienced nurser, having nursed all my kids to about age 21-23 months.  But the new moms, or even ones who have nursed but have a new baby who won’t latch, are in trouble.  The lack of attention to breastfeeding is so bad that I had to have them put a big sign on my chart:  NO FORMULA, NO PACIFIERS, BRING THE BABY BACK FROM THE NURSERY AS SOON AS POSSIBLE.  Even doing that, my baby was once returned with a pacifier in his mouth….with hormones raging, it was about to get ugly in there.  The amount of misinformation perpetrated by trained health care professionals is depressing…the baby is not getting enough, you are not producing enough, your milk hasn’t come in yet, the blood sugar was too low, etc., etc.  Yes, the baby is rooting because he or she wants to nurse, it is innate!  Babies are born to breastfeed!  However, if you start their life by shoving a piece of hard plastic in their mouth over and over, they may have some nipple confusion and not latch on well.   Yes, they want to feed all the time because they are supposed to!  Is it tiring to nurse every one to two hours after you just had a baby or possibly major surgery?  Of course!  Is your child worth it?  I hope so!  One of my favorites was, “Oh you want us to bring the baby right back?  Most of the new moms want us to keep the babies in the nursery so they can get some sleep.”  WHHHAATTT?  The women in my practice who delivered at the local hospital and were told that they were not producing enough milk to nourish the baby is too many by any stretch.  First of all, colostrum is sufficient for a newborn as long as they are nursed regularly until the milk comes in, but people not experienced with lactation do not understand this and so the woman ends up feeling like a failure because she could not provide for her baby.  This concept of feeding a baby a bottle or starting cereal at 2 or 3 months so the baby will sleep longer just gives more evidence of an ideological shift toward children-rearing, i.e. children are ultimately a burden and not a blessing.  Yes, because breastmilk is so efficiently digested, their stomachs empty faster so you have to feed them more frequently.  Letting a pile of not-easily-digestible (usually processed) grains sit in your baby’s stomach is not the answer.  The American Academy of Pediatrics has recommended for years that babies be exclusively breastfed for 12 months. 

Of course, then you have to deal with the high discontinuation rates when a mom returns to work.  I have some sympathy for this as I feel it is usually a reflection of lack of education and support for the breastfeeding mom.  Too often, no one has really discussed with her how to go back to work, pumping, storage of milk, etc.  If the woman has no friends or family members who have nursed, she may be at a loss as to how to continue nursing and just give up.  I remember my mother-in-law asking right after our first child was born, “So when are you going to stop nursing?”  I tried not to be snippy when I replied, “I am going to nurse as long as possible.”  But I certainly had to teach myself most of this stuff because at the time, I had no family around and I was a Ob resident working 110 hours a week.  I didn’t really get uptight about that because it was such a big priority for me to breastfeed, so like anything else, I just incorporated into my schedule.  Since I had to be at the hospital to pre-round at 5 AM, I would get up at 4 to pump.  I also took my pump with me to work so I could pump during my 12 hour days.  At the time, there were several residents and attendings who were also pumping, so we had to be sure to label the breastmilk in the fridge!  Was it difficult, time-consuming, physically draining?  Sure it was, but, again, it was important enough for me for my baby to have the best possible start in life, so I just made it work.

Not all workplace environments are supportive of breastfeeding moms as a recent court case involved a woman who was fired for taking “unauthorized breaks to pump her milk.”  I guess it is true that male employees wouldn’t have to perform this task, but the Ohio Supreme Court said this did not constitute gender discrimination.  And how is that?  I am sorry but women get pregnant, bear the children and nurse them…so how do you possibly say this is not discrimination?  I know of women who have been forced to pump in a bathroom stall because there was no other place for them to pump at work.  Hard to do anything else if you work in a cubicle or don’t have a private office.  Hopefully, the negative publicity this has brought to the company in question, Totes/Isotoner, will cause other corporations to provide adequate lactation accomodations.  Read here about an inspiring woman who is working hard to make this happen in the workplace.  Of course, smaller workplaces may not feel compelled to have a lactation policy, but I feel that women should stand up for themselves and their babies, approach their bosses, and discuss what would be the best place and time for them to continue to be able to fulfill this very important duty.  After all, breastfed babies are healthier which means less sick days for mom!  One last rant, people who want to raise their eyebrows at nursing moms but put iced tea, Kool-Aid and even soda in their babies’ bottles…OK never mind, I need to quit!