Today, October 15, is Blog Action Day 2008 and the theme this year is poverty. Angela, at Breastfeeding 1-2-3 has proposed a focus on breastfeeding and I think that is a worthwhile link to make. Starting our children off on a good basis is surely one of the issues to be addressed when confronting poverty.
I remember that books that I read when I was pregnant revealed an inverse relationship between income and rates of breastfeeding, that is: that the less money that you had access to, the more likely you were to use formula to feed your child. It surprised me from a purely economic point of view. If money was tight, why wouldn’t you breastfeed to avoid the cost of formula? Of course, the issue is far from that simple. An Australian study from August 2008 explains the tendency not to breastfeed:
Women from lower socioeconomic backgrounds were less likely to breastfeed for various reasons, including a lack of family support, less ability to seek help with breastfeeding problems, less flexibility with working arrangements, and concerns about breastfeeding in public.
A Canadian study breastfeeding from multicultural perspectives from 1997 explains that formula-feeding is perceived as the norm in Western society and thus a behaviour to be modeled in developing societies.
It is interesting to note that the adoption of commercially prepared infant formula in developing countries is so frequent that some anthropologists see the continuation of breastfeeding as an inverse indicator of acculturation to Western ways (Bader, 1979 as cited in Henderson & Brown, 1987). In other words, researchers suggest that the rate at which a particular cultural group adopts bottle-feeding and decreases breastfeeding can be used as a measure of the extent to which that culture has replaced its traditional beliefs and practices with those of the Western world.
Of all that the West could share with the developing world, it shames me that we have shared a propensity toward a less-healthful approach to infant feeding. It makes me think of the adoption of white bread, a nutritionally inferior product that was initially available only to those who could afford the costs of over-processing the flour but which soon became sought-after by all in society, to the detriment of their health.
According to a number of sources, James P. Grant (past Executive Director of the United Nations Children’s Fund (UNICEF)) stated, “Breastfeeding is a natural safety net against the worst effects of poverty”. This seems emininently logical but what are the concrete steps that must be taken to encourage higher rates of breastfeeding among those in poverty?
1. Increase the number of Baby-friendly hospitals, which includes: helping mothers initiate breastfeeding within 30 minutes of giving birth; showing mothers how to breastfeed and maintain lactation, even if they should be separated from their infants; giving newborn infants no food or drink other than breastmilk, not even sips of water, unless medically indicated; giving no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants; and other criteria.
2. Increased breastfeeding help in the community, like Well-baby drop in sessions and La Leche League meetings but especially peer support programs.
3. Paid maternity leave to allow for the establishment of good breastfeeding routines.
4. Work with employers to establish locations and policies conducive to pumping breastmilk when the mother does return to work
5. On a personal level, and with no research to back me up, I think that breastfeeding mothers should breastfeed their babies in public because it is normal and important and should be seen. Those who are nursing or have done so in the past should talk about their experiences. Again normalizing the experience seems important and you establish yourself as a resource should the person have a question or need a bit of support.
6. Institute or continue public education campaigns that promote breastfeeding in culturally-sensitive terms for various communities. I would argue that this would include using humour to appeal to younger mothers.
More thoughts on breastfeeding and poverty will be shared through this month’s Carnival of Breastfeeding.