Breastfeeding: What A Long, Strange Trip It’s Been!
Ever wonder how breastfeeding practices have changed over the years? Well, on May 31, I retired from 30 years of breastfeeding promotion work at the Lexington-Fayette County Health Department.
So let’s look back at the long, strange trip surrounding this most human of behaviors!
In 1987 when I started, WIC (Women, Infants and Children) was known as “the formula program.”
Nationally back then, 52% of women started out breastfeeding – in Kentucky, it was only 24%.
Breastpumps looked like either a bicycle horn or two interlocked tubes, and they were inefficient and uncomfortable. In the whole state, there were only five International Board Certified Lactation Consultants (IBCLCs) – (one in Lexington).
La Leche League was the main place to get breastfeeding information and help, though they faced backlash as “lactivists.”
Moms could still receive drugs to “dry up” their milk (before we knew that these medications could also cause strokes), and were encouraged to feed on each breast only for five minutes every three hours.
Is it any wonder that moms didn’t meet their breastfeeding goals?
Since then, we’ve benefitted from significant research into breastfeeding and its health implications for mothers and babies.
A breakthrough study in 1992 showed that hospitalized babies who received expressed milk for only six weeks had significantly better health and IQs than formula-fed babies when measured later.
No health provider should question the well-documented protections of breastfeeding in reducing common childhood infections, in promoting a well-functioning immune system for mom and baby, in facilitating a strong maternal-child bond, and reducing the risk for diabetes, obesity and cancer.
Research has given us a clearer picture of breast physiology, milk production, and impacts of mother’s lifestyle on supply.
Moms used to think they had to drink milk to make milk. Now we know you eat foods full of soluble fiber to increase supply! Oatmeal, anyone?
Babies have become a bit less mysterious, too.
We’ve used ultrasound to see inside a baby’s mouth as he nurses. We’ve standardized measuring for tongue-tie and have trained dentists and others to safely treat it.
We understand that newborns breastfeed (seemingly) all the time because they have a body rhythm of one hour awake and one hour asleep.
We keep moms and babies together at birth because it is good for them.
Breastpumps have improved in portability, comfort and efficiency, and are a covered benefit in most health insurance plans.
Changes to WIC in 1989 earmarked money specifically for breastfeeding promotion. Hospital practices to improve breastfeeding, the Baby-Friendly Hospital Initiative, began in 1992.
The Family Medical Leave Act of 1993 protected moms from losing their jobs while on maternity leave.
The American Academy of Pediatrics published its first position statement supporting breastfeeding in 1995, and most other health care associations have followed suit.
Employers gradually provided support for their breastfeeding employees, but it wasn’t until 2010 that hourly-waged workers’ rights were placed into law in the Fair Labor Standards Act.
In 2006, Kentucky joined other states in affirming that mothers had a right to breastfeed in public.
In 2014 the Equal Employment Opportunity Commission ruled that breastfeeding is covered under civil rights law in the Pregnancy Discrimination Act.
But the more things change, the more they stay the same.
Mothers tell me, “The doctor said my milk wasn’t any good after three months.”
I get calls about mothers being harassed when they breastfeed in public, or when they want to express milk during their work shift.
I hear from mothers whose work hours have been cut or from women who were fired when they asked for their legally-protected accommodations.
Nevertheless, moms have persisted! In 2017, 82.5% of mothers started out breastfeeding in the U.S., and 75% in Kentucky!
We have nearly 175 IBCLCs in Kentucky, and many more lactation counselors and specialists. Four hospitals are Baby-Friendly designated.
Mother-to-Mother support is available through La Leche League, WIC Breastfeeding Peer Counselors and Facebook groups. We even have a Rock and Relax area at the Kentucky State Fair!
Although I’m leaving public health, I’m not leaving breastfeeding.
I’ll still be around to answer questions, educate elected officials, organize events and support women in achieving their breastfeeding goals. So please keep in touch. You can reach me at doraineb@hotmail.com.