New Focus on Breast-feeding Observed Globally

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Over 100 countries recently observed "World Breastfeeding Week," an event designed to promote breast-feeding as the most healthful nutritional choice for babies. To support the concept, New York City hospitals are no longer including baby formula in their gift bags to new mothers. Activists from two women's interest groups discuss the politics of breast milk vs. formula.

MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Just ahead, we're going to continue our criminal justice series by taking a look at how ex-offenders fare when they try to reenter the workforce. The results might surprise you about what is really seems - I'm sorry - about what really seems to be holding them back.

But first, World Breastfeeding Week wraps up today. A hundred and 20 countries across the world observe the week to promote breastfeeding as the best choice for infant nutrition. And in conjunction, New York City hospitals removed free formula samples from their new mother gift bags. The packages are still available to new mothers upon request. Sure, everybody says breast is best, but is it really that simple?

Joining us to talk about the politics of breast versus formula feeding is Faye Wattleton. She is the president of the Center for the Advancement of Women. Also with us is Kim Gandy, the president of NOW, the National Organization for Women. She joins us here in the studio. Welcome to the program.

Ms. KIM GANDY (President, National Organization for Women): Thank you.

Ms. FAYE WATTLETON (Co-founder and President, Center for the Advancement of Women): Hi, Michel.

MARTIN: Kim, why don't you start? What do you think about this initiative?

Ms. GANDY: Well, you know, it's interesting that they think that they can affect what is a huge public policy issue with something simple like taking free coupons out of the swag bag. It really is not going to make a difference. The reason that so many women don't choose to breastfeed for very long is that it's not a choice.

MARTIN: Why isn't it a choice?

Ms. GANDY: They get to work, that - we know that women don't have much family leave to begin with, or much maternity leave. So when they get back to work, it's made impossible for them by their employers. You know, I hear from women who talk about crouching in the porcelain corner of the bathroom at work, which is the only place they can plug in their pump, trying to pump because they have no place to do it privately, and then getting in trouble because they took more than 15 minutes to do it.

MARTIN: Faye Wattleton, what about you? What do you think about this?

Ms. WATTLETON: Well, my view is that this is an enormously complex issue that has cultural socioeconomic dimensions. And it's the sexual connotation that trumps its real fundamental purpose, which is the feeding of the young. Yes, I think there are many ways in which society can support women breastfeeding. But their partners very often object to their breastfeeding as well. So it's a multilayered issue.

MARTIN: Faye, you're a former nurse. Isn't that right?

Ms. WATTLETON: I have two degrees in nursing, and one of them in midwifery. But, you know, this is a 20-year debate. We had this debate back on the '80s.

MARTIN: So that was going to be my question. Sure. Hasn't this been (unintelligible) around a long time.

Ms. WATTLETON: Yes. It's been for a long time. The Nestle Company was providing samples in the delivery and exit packages for women in developing countries. And what we see - particularly because low-income women tend not to breastfeed at a high, as at as a high prevalence as their affluent sisters - is that women will try, when they don't have other means, will try to stretch the samples. And the children end up malnourished.

MARTIN: Why wouldn't it make sense to not send a double message? I mean, breastfeeding is free. Right?

Ms. WATTLETON: Well, that's true. And that's, I think, what the WHO, the World Health Organization, and the International Alliance for Breastfeeding are all coming together to try to promote it and looking at the many facets that impose upon a woman in considering breastfeeding. And, of course, the education dimension is very important.

Ms. GANDY: And, in fact, I think that we are making the need for breastfeeding, or the advantages clear. Three-quarters of new moms start out breastfeeding.

MARTIN: Yeah. Exactly. Exactly. Three-quarters of new mothers start out breastfeeding…

Ms. GANDY: (unintelligible)

MARTIN: …but by six months, less than 20 percent are still nursing. Why do you think that is?

Ms. GANDY: Well, it's actually 11 percent in six months, and the reason is because it is made so difficult. Sometimes their partners don't want them to do it. But the hardest thing is going back to work. If you work on a line job, you work in a factory, you don't have enough breaks to be able to pump. If you work in a cubicle, you don't have a private place to go to and pump.

MARTIN: Oh, how about if you travel, and the airlines won't allow you to take liquids…

Ms. GANDY: Exactly.

Ms. WATTLETON: Well, that's a whole new one.

MARTIN: (unintelligible) unless you are - I mean, I guess what I'm saying is it's not just the low-income problem. It's also for, you know, elite women, presumably, who are trying to go back to work, and you cannot take liquids on the airlines unless you have a small child with you. So what are you supposed to do with your supply?

Ms. GANDY: Well, and you can't. And you can't. They've made it difficult to impossible. And so if those, like Mayor Bloomberg, really want to do something to make this more possible for women, then they need to make it public policy that lactating moms have enough breaks to be able to pump breast milk at work, that there's a private place for them to do it, that the equipment is there for them to do it.

And of course we need to continue with the public education that it's good for the babies and it's good for the moms. It has benefits for mom as well. But you can't just put a guilt trip on women and say you're a bad mom because you're not doing this when, in fact, it's been made difficult or impossible for her to do it by her employer. What I'm…

MARTIN: Faye, do you have any concern that the part of the message this sends is that, you know, you're a bad mother if you don't breastfeed, and that it lays, as Kim put it, a guilt trip on women?

Ms. WATTLETON: In our enthusiasm to encourage women, we should be careful and sensitive that it may be perceived by women, well, if I'm not doing what everyone says I should do, I must not be the mother that I want to be. And that's not the intention here. And that's why the education part of it is so important.

But we really cannot overlook the cultural dimensions of this, which are enormous. I would submit to you there - they really are stronger and more powerful than the public policy issues. I think that public policies can support and encourage the mentality and the attitudes about this whole area.

MARTIN: Talk to me more about this, Faye. You're saying that you think the cultural factors are even more important than the whole question of break time and the sort of the physical circumstances. Well, what do you mean and what makes you so sure?

Ms. WATTLETON: What I mean by that is how many women feel comfortable taking their breast out of their brassieres and breastfeeding in public? Because there has been such an enormous amount of attention to breast as sexual objects. The whole privacy issue is really a reflection of, you know, we need to go in a closed door to breastfeed our children - one of the most natural acts that a woman can perform. Just look at the behavior around it.

MARTIN: But isn't that partly a matter of public policy? You know, there was a story earlier this year, we have a woman - a family getting kicked off of a small flight up in Vermont because she wanted to breastfeed her child upon takeoff, and a lot of people will tell you that's the absolutely the right thing to do because it balances out the air pressure in the child's ears and has a calming effect. And this family was ejected from the flight. Isn't part of the cultural problem a public policy problem?

Ms. WATTLETON: That's not a public policy. I don't know of any airline that requires by policy a woman to be ejected from an airplane. I breastfed my child on airplanes for the reasons that you described. But obviously, there were people in the plane that were uncomfortable with that action. And so these are deeply embedded, deeply rooted attitudes about human behavior and the purpose of a woman's breast. And we really should be attacking what this means in terms of the way society views women in a completely natural, important to her health, important to her child's health behavior.

MARTIN: Data shows that African-American women are less likely to breastfeed, while Hispanics have higher breastfeeding rates. And, of course, Faye, you made the point earlier that the rate of breastfeeding increases with education, income and age. Any thoughts about why that might be?

Ms. WATTLETON: Well, I think we certainly know that among African-Americans, that we are disproportionately low income, and therefore fall into a category where probably the socioeconomic factor influences the behavior. We are more likely in as such to depend on public health services - that is public hospitals and public clinics - where there's very little time given to supporting low-income women in their efforts to breastfeed and are more likely to be simply given formula because that's the easy thing to do when a health system is trying to cope with numbers that it is not designed to care for.

MARTIN: Hmm. Okay. And finally, I want to ask each of you, what would you - since both of you support, obviously, breastfeeding and feel that these kind of Band Aid gestures are not very adequate - what would you recommend? And, you know, Faye, you made the point that this is a deeply rooted, these are deeply rooted sort of cultural issues. what do you do?

Ms. WATTLETON: This is a multi-layered cultural tradition, public policy-laden issue, and women still do not have the recognition and the status in this society that we deserve. And while there are people all about who do not - who seem to want to interfere with a woman's choice about childbearing, they seemed not to understand that after birth, there is an important public policy issue that can support her capacity to be a healthy mother and her child to grow into a healthy - into healthy childhood.

MARTIN: Kim Gandy, final thought about what you would do to support breastfeeding.

Ms. GANDY: I agree absolutely with Faye, that it is multi-faceted. But I think we can start with public policy. Other countries have passed legislation that treats breastfeeding as a protected activity under their sex discrimination laws and makes it unlawful to, say, arrest a woman in the mall for breastfeeding her child or throw her off of an airplane.

That would be a start. It would send an important public policy symbol to the country that this is something that's good, and it's not something that's obscene.

MARTIN: Oh, I'm so hesitate to open a can of worms because we have just a couple of minutes left, but I want to go back to the point you made. Faye, obviously, you're pro-choice and believe in choice and, Kim, as do you. But I think there might be some who would argue that abortion is one of the reasons that this country devalues motherhood.

That as a society, if we were less permissive about abortion, that it would perhaps elevate - the status of motherhood and perhaps there would be more support for the function for women in their role as mothers as opposed to a sexual object.

Ms. GANDY: I think it's quite the opposite.

Ms. WATTLETON: I think it is. I agree with you, (unintelligible).

Ms. GANDY: It's totally the opposite, because if anybody can become a mother simply by getting pregnant, in fact, even being forced into motherhood. If motherhood is something that we choose - as I chose with my two daughters -I nursed both of them, I chose motherhood - it elevates motherhood. If it's a choice, if the women who were mothers made that conscious decision, I want to be a mother and I want to do it well.

Ms. WATTLETON: And I, too, chose motherhood, breastfed my child for 10 months. I, in the earlier part of my adulthood, had an unintended pregnancy and chose to terminate that pregnancy. But that in no way undermined my desire to be a mother and to be a good mother, which I believe that I have been. And the value of breastfeeding for me was enormous for both my personal relationship with my child, as well as getting her off to a very healthy start.

MARTIN: All right. We'll have to leave it there. It is a complicated topic, as you've both said. And I thank you both for coming in to talk with us. Faye Wattleton is the president of The Center for the Advancement of Women. She joined us from our bureau in New York. And Kim Gandy is the president of N.O.W., the National Organization of Women. She joined us here in our studio in Washington. Thank you both so much.

Ms. GANDY: Thanks, Michel.

Ms. WATTLETON: Thank you for having us.

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