Breast-feeding Mothers Living In First Food Deserts

Most people are aware of the positive effects of breast-feeding. But in many areas of the country, breast-feeding is not the cultural norm, and there's little support available for mothers. Host Michel Martin talks with Kimberly Seals Allers, the co-author of a new report on so-called "first food deserts," and a nursing mother, Areti Gourzis.

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MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. They say it takes a village to raise a child, but maybe you just need a few moms in your corner. Every week, we check in with a diverse group of parents for their common sense and savvy advice.

For years now, we've been hearing that breast is best. Breastfeeding has all kinds of positive physical and emotional benefits for mother and child and that's why it's good news that the Centers for Disease Control is reporting that more women are choosing to breastfeed, but many new mothers still find it very difficult, which is where someone like Nancy Sherwood can step in.

NANCY SHERWOOD: OK. I'm going to weigh her and then we'll try nursing and see how that goes. OK? So the scale is out here.

UNIDENTIFIED WOMAN: OK.

SHERWOOD: And let me...

MARTIN: Nancy Sherwood is a lactation consultant with the Breastfeeding Center of Greater Washington. That's in the Washington, D.C. area. She offers practical guidance, but also support for mothers who want to breastfeed. Yet, our next guest says support in ways large and small are exactly what's missing for too many moms. Kimberly Seals Allers has co-authored a report, which is released this week. It's called "The Life of a Breastfeeding Mother in a First Food Desert." She's with us now. And, for additional perspective, we've also invited Areti Gourzis to join us. She is an IT manager and mother of two.

Welcome to you both. Thank you both so much for joining us.

KIMBERLY SEALS ALLERS: Thank you for having me.

ARETI GOURZIS: Thanks for having us.

MARTIN: Kimberly, let me start with you. I think people know by now what a food desert is. That's a place where it's harder to get nutritious and affordable food. Maybe there are a lot of convenience stores selling food with a lot of fat, salt and sugar, but no full-service grocery stores, for example, where you can get fresh and wholesome food.

So the whole idea of breastfeeding, though, is that the food is where mom is. Right? So what's a first food desert? How is that possible?

ALLERS: So our first food desert is a neighborhood where there really isn't any access to support. So a food desert is all about accessing, whether that's a - like, to you, as you mentioned, a healthy fruit or a vegetable and the fact of the matter is that because of the current climate and our cultural forces, women need more than their actual physical breasts to breastfeed. They need support. They need the infrastructure there to help them do so, and so many communities lack this basic infrastructure.

And, in the same way that we want food access to mean hyper-local, that you don't have to travel long distances to get great food, we want the same thing in all of our communities, that a woman does not have to go very far to get the support that she needs to give her baby the optimal nutrition.

MARTIN: I wanted to talk about some of the things you identified in your report and the reason I think that that's important is that the devil is in the details and these are things that, if you haven't been through the experience of breastfeeding, you might not understand is important.

You talked about the number of places - you focused on a couple of areas where the rates of breastfeeding are rather low and you said that things like doctors don't refer people to lactation support groups, and even if they did, they're not readily accessible.

What are some of the other things you identified?

ALLERS: Well, this was very key because we know that a mother is going to rely on the doctor for support and for information and for resources, so for example, when we went to Birmingham, only one out of the 25 doctors - and that includes OBs and pediatrician offices that we surveyed - actually had someone to refer a mother to. So this is very critical. We also looked at the access to a breastfeeding support group. We also scanned the neighborhoods to look at what was the infant formula marketing and other marketing around other infant foods, even things like dolls with bottles to understand the influence that that may be in that community.

We also surveyed employers to find out if they were - they actually had a nursing policy in place. We even looked to - went into public places and surveyed in the libraries and museums and anyplace a mom wants to go; the mall to see if they had nursing mothers rooms.

MARTIN: Let me jump in here. You said that, in Birmingham, three of the five malls did not have a designated nursing area, as well as four of the five centrally located libraries, where as you noted that women who resided in the suburbs relied on big box stores like Target or a Babies R Us where they do have these designated areas. And these stores either don't exist in those inner city communities, or if they did they did not have nursing rooms. And what difference did that make?

ALLERS: Well, that makes a big difference because the idea is that we want feeding your baby in the healthiest way to be something that a mother can do as she goes about her day. It should not be a proposition that only exists for you if you want to stay at home. I mean, who would sign up for that? So, if a mother can not go about her day - whether that's shopping, where she eats, where she recreates, where she plays, where she works out - if she can not go about her regular day and be able to feed her baby as she, you know, as she has chosen to feed her baby, then that is a problem.

And so these, you know, all the public places were surveyed to really understand that, if a mom is just going about her day, taking an interest in going to the library, the museum, can she feed her baby?

MARTIN: And one more thing, before I turn to Areti because I want to hear from her experience. One of the other things you flagged in your survey is high levels of discomfort with breast-feeding in public or high invisibility rates. Let me just put this in sort of colloquial language. People were mean about it. For example, you said that in Jackson, Mississippi, 75.6 percent of the man on the street survey respondent said that they were uncomfortable seeing a mother breast-feed in public. One of the respondents said, we got bathrooms for that.

ALLERS: Yes.

MARTIN: Meaning that people were mean about it, if you try to breast-feed in public. Talk a little bit about that, if you would.

ALLERS: Well this is very key because obviously, a mother wants to feel comfortable to breast-feed her baby anywhere. Now, we were in the Southeast and there are a lot of modesty issues, a lot of discretion issues but we know in this country that breasts have been over sexualized to the point where, you know, we're OK to use them to promote chicken wings and beer, but if we see a mother feeding her child, we're uncomfortable. This is a problem. And so we find that in these areas there's a very high level of this discomfort by breast-feeding in public and a mother is not going to feel comfortable to do it if she feels like she's in a place where she's going to get looks, stares, people are going to be, you know, giving her the side eye. This isn't the environment for which mother should have to feed their babies.

MARTIN: I found that noteworthy because I don't think anybody would say to a grown man who was eating a sandwich, go to the bathroom and eat that.

ALLERS: Absolutely.

MARTIN: When has that ever happened?

ALLERS: Absolutely.

MARTIN: Areti, talk about your experience, if you would. Now you are not in a first food desert. You live in a metropolitan area where there are a lot of professional women. Certainly, women on the Hill, on Capitol Hill, for example, working in Congress, have made it clear that they would like the opportunity to breast-feed - and there are places for that. But you still found it more challenging than you talked about. Talk a little bit about that, if you would.

GOURZIS: Yeah, it's a little stressful. I mean you have to, in my situation I'm not nursing my baby. I nursed her the first six weeks, but it was a struggle because she wanted to nurse all the time so I was literally, I couldn't do anything. She was attached to me every minute of every hour of every day. So I decided to start pumping because I knew I was going to go back to work anyway. And so even the pumping, I pump six or seven times a day, so every three to four hours, from about 5 AM until about 11 PM at night I have to find a spot to go pump. So my issue is a little bit different in that I need to find a private place where I can hook everything up, take the 20 minutes I need to pump, and then clean all my pump parts and get everything packed up again and put away.

MARTIN: And you want it to be a clean environment.

GOURZIS: It has to be a clean environment. And...

MARTIN: You can't go to the restroom at a gas station, for example.

GOURZIS: No.

MARTIN: That's not going to happen. And this is an issue that Kimberly flagged in her report too, about employer sensitivity to this. Do you mind talking about that?

GOURZIS: So I think my employer - I haven't gone back to work, and I'll go back in a couple of weeks, but we've talked about it and I think he'll be very sensitive to the issue. They have designated nursing rooms but it's very hard if you work in an office environment and you have meetings every so often. I just can't leave in the middle of a meeting to go pump, but my body may be telling me hey, it's time to go pump, so there's a different form of stress where you're just on the clock, basically.

MARTIN: We're talking about access to support for breast-feeding. We are speaking with Areti Gourzis. She is an IT manager and mom of two. We invited her to talk about her experience breast-feeding with two children. And also with us, Kimberly Seals Allers. She is the co-author of a new report about this.

Kimberly, could you talk about your experience, if you would? I noticed that you've been interested in this issue, writing about it and sort of being active on this issue for a number of years, doing research on this question. Can I assume that this arose from difficulties you had trying to breast-feed your kids?

ALLERS: Yes. I had my own unique challenges with both of my children. I was able to successfully breast-feed my daughter for 12 months but in the early days I really struggled and, I mysel,f found my, you know, I found myself driving 13 miles to get back to the hospital to find a support group. I didn't have any multi-generational support, that is my mom didn't breast-feed, and so I didn't really have anyone in my circle that I could call. And I think what we're discussing is that even people, you know, like myself and like my fellow guests, is that, you know, here we are having, you know, a quote/unquote "good job and education" and we struggle. So if people who have access and resources are struggling then what is it for, what is the experience like for a mother who doesn't even have that, who can't get in her car and drive the 13 miles that I drove to get to the breast-feeding support group - or as we saw in the report, the 23 miles to get to get to a breast-feeding support group in Birmingham. You know, what is her experience and how, it's really almost impossible.

MARTIN: Well, let me talk, let me jump in on that because for people who haven't been through it, I think it would help to understand why you think that matters. Because I think you can hear somebody saying right now OK, well, women have been having babies since the beginning of time and, you know, back in the day there were no breast-feeding support groups, there were no fancy lactation rooms with, you know, Zen fountains and all this other thing, and somehow babies still got fed. So what's the problem? What's the big deal?

ALLERS: Well, the difference is our lives are more complicated. You know, usually back then we were probably just staying at home and we were allowed to be in the home. But, you know, to the point all of us here are working mothers, so our lives are a lot more complex. The demands on mothers are just never, you know, have are at a level they have never been before. And so I think these expectations are becoming burdensome on mothers, and because of that stress - whether it's the stress of trying to do your best - there's a lot of stress to be a good mommy, bad mommy, we have all types of names for all sorts of mommies, you know, I mean motherhood is nothing like it was before. Then we look at the cultural pressures. We look at the economic interest in infant feeding. The profit mode of that is to be made based on how we feed our babies and how we've been influenced by that marketing. And we look at our own discomfort with our own bodies and our own breasts. And so it's more difficult for us.

MARTIN: But also one of the other things that I thought was fascinating that you flagged was the question of, for example, one other cities that she surveyed was New Orleans, where the predominant source of employment is the tourist industry. And you said that you interviewed people who found it particularly for women who work in hotels and restaurants and other service jobs, where, just like Areti was talking about, having to take breaks to pump was perceived as slacking off, that you weren't fully present for your job - or that there wasn't a lot of understanding for that. Was that a common experience?

ALLERS: A very common experience. And I think, you know, to Arsti's point about meetings, I mean imagine if you work at Starbucks, you know. I mean it's one thing to think you have a day that could be, you know, that has to be scheduled around meetings, but really, for people who are in service industries, tourism industry, you know, it's much - it's even harder for them. And what we found is that employers - and many of the mothers, I should say the first to start - that they were very concerned as being perceived as slacking off. What we're hoping is that the new, you know, there is a federal law through the Affordable Care Act, that allows all mothers a break to pump, and that as we educate employers about the federal law, Break Time for federal Working Mothers Law, that this will be less of a burden for them. But it is something that's really difficult, and, of course, if you're not at a place with other mothers who can support each other or advocate for each other or whatever, then it becomes even a greater challenge.

MARTIN: Areti, talk about that, if you would. I understand that I'm asking you to talk about, you know, your workplace and some sensitive issues which can be hard at times. But even as a professional yourself, presumably with other well-educated people who understand the importance of the breast-feeding, both for, you know, for health and well-being - what's the hard thing, to put your hand up and excuse yourself and say what?

GOURZIS: So for me it's not hard because I'm not shy. I mean I just say it, I got to feed my baby, I'm the food source, got to go, sorry. So...

MARTIN: Is it perceived as disruptive? Is it perceived as, do you get looks?

GOURZIS: I think it will be perceived as disruptive a lot of times. And for me personally, because I haven't gone back to work yet, I already know what my client's going to say and how they are going to react so I'm anticipating what I need to do in order to mitigate sort of the upheaval that is going to occur from it. But I'll tell you, if you're committed to it, you're committed to it and you just got to barrel through it. My sister breast-fed three children and she works in a hospital. She's a doctor. She works 60, 70, 80 hours a week, and she just had to leave the OR sometimes and go pump and she said I'm sorry, I got to do it for my kid and people just had to deal with it. But was hard. It was hard to be that way.

MARTIN: And what about people who would say - Areti, I'm directing this question to you - that what about people who would say well, this is exactly why women need to be reorder their priorities. If they're going to have younger children - if they're going to have babies - then they should reconsider their employment. They should consider - there are people who feel that that's just, then that's just part of the deal.

GOURZIS: That's not practical. I mean people - I live in the D.C. area. We can't live on one income. We need both of our incomes. So I would love to be able to stay home for a year with my baby and just pump and nurse and, you know, not worry about anything, but that's just not life. Like, that's not how it works. You got to go out and work. You got to do you got to do things. And even if you, you know, could stay home, if you have other children too, you also have to be able to run around and do things for them, taking them to the doctor's appointments, taking them to school, you know, you're not in a situation where you can't just - all you can do is nurse your baby. That's just not life. That's not practical.

MARTIN: Kimberly...

ALLERS: And, Michel?

MARTIN: ...what would you say about that?

ALLERS: Oh, I agree 100 percent. I mean I think that what we haven't done is shown women how to breast-feed in the context of their actual life. And for the majority of women, our actual life means that we're going to have to work at some point, either in the home or outside the home. And I just wanted to make a mention of Areti's language, because we talk about barreling through, deal with it. See, this shouldn't be the experience. Like feeding your baby the way nature intended and the best way that can make your baby healthier, smarter and everyone else in our community, you know, better, should not be something that we have to barrel through. So...

MARTIN: And before we let you go Kimberly, there's one other interesting point you made in the report - we only have a couple of seconds here - you're saying that cultural familiarity does play a role. You're saying that having lactation consultants for support of people who look like you - for want of a better word - it really seems to make a difference. And tell me why?

ALLERS: That makes a huge difference. We spoke to mothers who, quite frankly, were a little uncomfortable, some African-American mothers who didn't necessarily feel comfortable with a white woman touching their breasts. You know, I mean depending on a lactation consultant's style, it can be very kind of in-your-face. We also spoke to head nurses who saw the difference when the African-American moms had a lactation consultant who looked like them, could understand some of their cultural barriers, some of the nuances that may be unique to their experience.

MARTIN: Well, speaking of nuance, this is one of the things you really helped us to do, is flush out the nuances of something that is right in front of you - as it were - but a lot of people don't understand, so thank you both for that.

Kimberly Seals Allers is a breastfeeding advocate. She's the author of a report on access to breastfeeding. It was released this week with the support of the Kellogg Foundation, and she was with us from our studios in New York. Here with me in Washington, D.C., Areti Gourzis, she's the mom of two and an IT manager, with me in Washington, D.C.

Thank you both so much for your time. Good luck.

GOURZIS: Thank you very much for your time.

ALLERS: Thank you.

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