Public Health, Economics and Breastfeeding Goals

This morning I noticed that at the top of The New York Times' "most-emailed" articles list was yet another post about the hardships of breastfeeding and the bullies in the medical establishment who continue to berate us with the message, "breast is best." This particular one was entitled, "The Ideal and the Real of Breastfeeding," by Jane E. Brody. It closely mirrored the feminist arguments of Elisabeth Badinter's recently published book, The Conflict: How Modern Motherhood Undermines the Status of Women. These authors and their followers commonly suggest that doctors, nurses and public health officials should stop making breastfeeding seem like such an important factor in infant health so as to avoid inducing motherly guilt. It seems not to occur to any of them that perhaps what Americans need instead is a set of laws, government programs, and business practices that support babies and their families.

Telling us that breastfeeding isn't important because in some cases it's rather difficult to accomplish is like saying that, since they are having trouble doing it, our school-aged kids don't actually need to eat more vegetables and fewer fatty foods even though they are suffering from poor health. After all, we wouldn't want to hurt their feelings, would we? No, in this situation, I believe parents generally agree that schools should make an effort to remove nutritionally abysmal food and drink such as French fries and pop from cafeterias. We need to help our children develop healthy eating habits and we know that surrounding them with excellent choices will go a long way toward making this happen.

Why, then, do writers such as Jane Brody insist that we change our stated societal breastfeeding goals instead of doing better to support breastfeeding parents? In part, they argue that breastfeeding isn't really as beneficial for babies as parents are made to believe. After all, Brody says, "No randomized, controlled trials – the gold standard of scientific research – have proved that breast-fed babies fare better, at least in industrialized countries." This is in fact because such a study would be impossible to perform. No parent would agree to breastfeed or formula feed randomly as decided by a scientist. Even if they did, some in the group assigned to breastfeed would fail to do so since not everyone who wants to breastfeed succeeds.

Nevertheless, it's easy to find solid evidence that shows breastfeeding is good for infant health, and, not surprisingly, good for business. Breastfeeding support programs instituted by employers result in 62% fewer prescriptions as well as substantial health care savings and reduced absenteeism, according to the insurance company CIGNA. Companies with lactation support programs also enjoy much higher rates of employee retention than the national average. Of course, insurance companies exist to make money – if they are convinced that breastfeeding saves health care dollars, I'm inclined to believe them.

Another large part of Badinter's argument against breastfeeding concerns the time and energy that it takes on the part of the mother. As a breastfeeding dad, I have certainly experienced firsthand this kind of commitment. However, it has little to do with breastfeeding and everything to do with the fact that human babies are extraordinarily needy, dependent creatures who prefer a consistent caregiver. Infants cannot feed themselves, take care of their elimination needs, protect themselves, or move any real distance on their own. If I don't look after my baby, some other adult must do it for me regardless of whether he's slurping breast milk or formula. Rather than bemoaning what I have "given up" to take care of my baby, I try to consider his needs as an infant. After all, he didn't choose to be here; we brought him into this world. Fortunately for me, being Canadian, I was entitled to one year of parental leave with employment insurance that paid a decent chunk of my previous income.

I wish that these authors would demand longer paid parental leaves. The current US standard six week leave is laughable – it is hardly enough time to get to know and support a new family member. Most of my friends have said they didn't get into the groove of breastfeeding (or parenting!) until at least six months in. To meet the minimum breastfeeding goals outlined by public health officials, Americans need much longer parental leaves as well as workplace lactation support programs for those who choose to go back to work. Let's change our attitudes and programs to support family health rather than redefining good health to mean good enough.

Sleep Deprivation Dreams

Last night involved tons of waking to nurse baby, so this morning my partner took him to the playground while I slept a bit. I had a dream that I was studying linguistics in university, and my bed was literally at the front desk of the department office. I kept being woken up by people talking to the secretary. It happened over and over again until I was furious. I put out a jar with a sign that said, "Each time you wake me up, please donate one dollar to the university's fund for building a new dormitory." Of course, I woke in real life from this dream to the sound of my baby crying and my partner saying, "I think he wants to nurse!"

Thank You!

We want to extend many thanks to all the people who have offered to help us with freezer space when we come to Toronto. The response to my last post has been amazing! Wow.

Megan Jackson's comment about dry ice really got us thinking. Ian phoned Air Canada, had his call dumped twice, and waited on hold for ages. Finally, the person he spoke to said, "We've never had a situation like this before. This is so interesting for me!" After much consultation with others and re-reading of her handbook, she put a note on our file stating that we had permission to travel with not more than 5 pounds of dry ice, for the purposes of keeping our baby's human milk frozen. Since dry ice immediately turns into a gas as it warms, our cooler must be vented.

It is necessary to work all this out in advance and only carry a limited amount because too much dry ice could asphyxiate animals that are traveling in the hold. Who knows how many gay men might be flying with coolers of breast milk and dry ice? I'd say hopefully more and more, as people continue to learn about the tremendous benefits of human milk for human babies!

We will store Jacob's milk in the top freezers of three different, very generous families, all located close to where my brother lives in Toronto. The day that we fly to Halifax, we'll buy the dry ice and pack up our cooler. We need to add a layer of cardboard in between the dry ice and the milk because the dry ice is so extremely cold that it could burn the milk bags.

Many thanks again to everyone who asked friends, relatives and friends of friends about freezer space! We'll let you know how it all turns out.

Traveling With Our Stash

We've flown a few times with donated breast milk in order to visit our relatives in Vancouver. Next week, we'll be attempting something rather more challenging. A mission in the Apollo Program comes to mind - we need to pack necessities to support life far from home and we'll be depending on technology to make it all work out. I can see the worried look on Tom Hanks' face: "The freezer appears to be... offline."

Joking aside, we haven't yet figured out what to do to secure baby Jacob's milk. We will stay in Toronto for four days with my brother while Ian, my partner, does a bit of work in town. Then it is on to Halifax. Our flight is late in the evening, and we'll stay in a hotel near the airport upon our arrival. The next day, Ian's birth mother will pick us up and drive us to her home near Lunenberg, a two-hour trip.

All this is to say that we need to pack our cooler of human milk so that it will stay completely frozen on a potentially very hot summer's evening, overnight, and well into the following day. We will take our most densely-stored milk and try to have as little air space around it as possible. We'll carefully tape the seams of the cooler. Best of all would be to ensure that at the beginning of our trip to Halifax, the milk is as cold as possible. Unfortunately, my brother in Toronto has a small freezer on top of his refrigerator, not a deep freezer capable of going down to a lower temperature.

Thus we find ourselves using the internet and Facebook not just for finding donated milk, but also for helping us store it during our stay in Toronto. Someone in Toronto must have space in a deep freezer they'd be willing to share! I've put out a call on my personal Facebook page as well as Emma Kwasnica's worldwide group, Informed Choice: Birth and Beyond. Hopefully, someone will come to our rescue - Kevin Bacon, maybe?

Google Bomb: "Breastfeeding Is..."

Motherwise pointed out on Facebook this week that when you Google "Breastfeeding is", the search engine comes up with some very disappointing suggestions:

- child abuse

- gross

- creepy

- exhausting

- agony

- a nightmare

- offensive

This is absolutely NOT what somebody looking for information about breastfeeding needs to see. Those who are new to breastfeeding or who are struggling to breastfeed deserve to find encouragement, good information, and positive attitudes.

A few weeks ago at a La Leche League meeting I attended, participants were asked to say in one word what breastfeeding meant to them. Admittedly, the word "hard" did come up a few times, but people also said "convenient," "easy," "natural," "amazing," "beautiful," "bonding." Now, this is more like it!

If you have a couple of minutes to spare, type in a few of your favourite positive descriptors. Let's Google bomb breastfeeding!

Guest Post: My Doula's Story

The midwives unwittingly hung my IV from our Medicine Buddha.

The following is the written story of my baby's birth, presented to me by my incredible doula. I have edited minimally for clarity and length, but these are her words. To me, this story feels like a most wonderful gift of a unique perspective. I was especially amazed to see the words "without consent" in my doula's telling of events. At the time, I had a sense that I did not want certain procedures to be performed and I have ever since blamed myself for "allowing" them and "not being clear enough." I would like to thank my doula for being a powerful witness.


​Trevor felt the first rushes of labour on Sunday evening before heading with Ian to dinner at their friends' house. They kept the excitement a secret for the time being. On arrival home later that night, relieved to be able to labour openly, they continued to witness transformation as the magic of birth took flight.


Trevor rushed frequently throughout the night and attempted to sleep but felt restless. Cleaning the kitchen satisfied an early labour ritual for a few hours with baby as an active participant. The rushes started to come closer together and Trevor found comfort in a hot shower and his loving partner Ian. Together they recited the sacred incantation Om as they moved deeper into their birth journey and ultimately the path to becoming parents.

​Trevor slept for an hour and then had breakfast. He and Ian watched Grey’s Anatomy, pausing for each rush – the show proved to be a great distraction. At this point Trevor felt labour was manageable. Rushes were short in length, however Trevor could no longer talk through them. The labouring family went to the Forks for river gazing and stopped in at a pet store for a few rushes.

On April 12th, 2011 at midnight, I was honoured with an invitation to join the sacred birth nest. Ian began to set up the birth pool and gather supplies. Trevor’s rushes came more frequently and were more intense. I arrived to their safe and loving birth space and watched as Trevor focused inward, using deep slow yoga breath to move through each rush.

At 1:45 am Trevor entered the birth pool for the first time with Ian cocooned in the hammock next to him. Trevor leaned over the tub to work through each rush, supported with loving touch and kisses from Ian. Hot water and frozen grapes brought much joy to this hard working man.

At 3 am Trevor’s labour became deeper and birth sounds grew louder. Ian held Trevor over the tub and they kissed deeply during each rush. Trevor and Ian shared the story with me of how they first met and soon after Trevor began to sleep deeply between rushes. The word OPEN made its way into Trevor’s birth ritual, followed by a deep enjoyment of sorbet. The rushes became more intense, at times overlapping.

At 5am Trevor and Ian were ready to welcome another doula, Krystal, into their birth nest. “How will I be able to do this?” Trevor asked. The birth circle attempted to add more hot water to the pool and instead sprayed the entire room as well as each other. Laughter, water and tea revived us and reminded Trevor that he could continue. Trevor began to make louder, deeper birth sounds and felt intense sensations in his pelvis. Trevor and Ian discussed whether it was time to invite the midwives. With careful consideration it was decided that Ian would made the call.

The first midwife Leslie arrived at 8 am. Trevor and baby passed all the vital tests and Trevor vomited. The birth circle headed upstairs to settle back into the birth nest. Trevor squatted on the floor during rushes and rested on the birth ball in between. Rushes started to feel different, shorter with longer rest time. Trevor shared his concern of a stalled labour and questioned whether it was caused by the arrival of the midwife? The daylight? Trevor and Ian had a shower together to refocus and reconnect. Krystal took Quinoa for a walk and Alexa the second midwife arrived.

At 10:30 am Trevor decided it was time to return to his happy place (the birth pool). Ian attempted to rest and snored in sequence with Trevor’s labour mantra, which induced healing laughter but unfortunately woke Ian. Trevor breathed deeply and squatted in the pool during rushes. He could feel his pelvis opening. At this point Leslie found the fetal heart tones to be a bit high and asked that Trevor be helped out of the pool quickly to bring his body temperature down.

Trevor was open to trying every suggestion offered. Hot tea, hip opening yoga poses, leg massages, more Sorbet, lunges, stair walking and finally a shower. Back in the birth nest Ian assisted Trevor into a hanging position between rushes. Trevor started to feel more pressure and baby movements and decided finally to return to the comforting waters of the birth pool. Once again, Leslie found the fetal heart tones to be slightly above normal (164). Hydration, cool cloths and removal from the tub were requested to help bring his temperature down. Trevor squatted with Ian during rushes. Half an hour later, fetal heart tones lowered to 150 and Trevor returned to the tub, tête-à-tête with Ian, breathing deeply as one.

At this point the midwives took me aside to discuss their concerns: Group B Strep, length of labour, Trevor’s energy level, Trevor’s request for no internal exams and ultimately how they could communicate these concerns with Trevor. After an attempt to calm their concerns and bring trust to their practice, I returned to the birth room and asked Ian to give it a shot. Frustration was building, fueled by the midwives' lack of trust in birth and respect for informed choice.

Trevor and Ian decided to go for a walk to process how to move forward with their midwives present. They called a supportive friend and had a good cry. They returned to their home to request of their guests rest and privacy. Krystal and I served dinner in bed to the labouring couple. Despite the request for privacy, the midwives continued to interrupt to monitor.

At 9pm Trevor decided to consent to an internal exam in order to satisfy the midwives. They confessed they wanted to know how far along Trevor’s labour had progressed so that they could decide to stay or leave. Trevor’s cervix had dilated 6-7 cm and so they would stay. The midwives suggested baby’s position was preventing descent and further dilation. Once again Trevor tried everything to move things along. Aromatherapy, stair walking, acupressure, yoga poses and finally an epic head stand.

​“I welcome these sensations and I’m opening. I’m opening. I’m opening.” Smells of clary sage and peppermint filled the air as Trevor recited his birth mantra.

At 1 am on April 13th Trevor requested sterile water injections to relieve his back discomfort and they worked. Ian took the opportunity for rest. A few hours later Leslie suggested a second internal exam and artificial rupture of membranes to move things along. A discussion took place in the birth room regarding the pro’s and con’s of AROM at this point. Trevor requested a discussion with Ian before proceeding. I went to wake Ian to bring him into the conversation.

While waking Ian, Leslie found the fetal heart tones to be a bit high. Trevor was removed from the pool promptly and Leslie named dehydration as a possible cause. Leslie and Trevor entered the bedroom and an internal exam began without consent. The intended discussion between Trevor and Ian had not yet taken place. Leslie ruptured Trevor’s membranes during the internal exam without consent. Trevor’s cervix had dilated 8 cm, his fluids were clear, baby was positioned at -2 station with an asynclitic head tilt. Trevor felt the intensity of his membranes rupturing, started to feel pushing sensations and headed back to the safety and comfort of the water.

After an hour and a half of hard work, the midwives found fetal heart tones to be high and Trevor was once again removed from the pool to cool down. At 5 am Trevor and Ian moved to the bedroom to labour in bed together and Quinoa joined them. Trevor felt nauseous and the midwives suggested an IV to help with hydration and to regulate fetal heart tones. The IV was hooked up with a direct line to the medicine Buddha painting hanging on their wall.

At 7:45 am Trevor returned to the birth pool. Moments later fetal heart tones were found once again to be high and Trevor was removed from the tub to birth next to the pool.

Trevor pushed with strength and determination and at 8:23 am baby Jacob was born.

​Trevor and Ian immediately fell in love with Jacob and time stopped. Their house filled with midwives, cleaning, organizing and replacing the exhausted with the rested. Trevor's placenta took its time coming out and an alarm bell was set off. Thankfully a transfer was avoided due to the work of two new midwives. Trevor was finally given space to start his breastfeeding journey while being cared for by an intuitive and supportive midwife, Ian and Quinoa. And so begins another story...

​It is an honour to have been invited to witness this most amazing experience in the lives of Trevor and Ian. Trevor, you have reminded me of the courage and strength of body, mind and spirit that is required to give birth to a baby. Ian, you have reminded me of the importance of love, support and trust in this process. It was with humility and awe that I witnessed your birth. Thank you for this opportunity.

With love,

your doula and friend.

Petition to Ease Restrictions on Breast Milk in Carry-On Baggage

Last week we packed up yet again and got ready to make our trip out west to visit our relatives. We don't have any family in Winnipeg, but we believe it is very important for our child to have a strong relationship with his grandparents. So, as much as I hate it, we fly frequently.

We took along several bottles of donated breast milk in a cooler, as well as an ice pack. At security, they asked to open up our cooler as usual. All seemed normal. And then came the question, "But how old is your baby?"

"He's thirteen months."

"Oh, ok. This is fine. Go ahead."

The exchange seemed simple enough, but suddenly left me wondering, is there an age at which I won't be able to bring milk along for my baby? Is thirteen months ok, but say, eighteen months too old? Why did they ask my baby's age?

We rely upon donated breast milk to feed our baby. I nurse him using an at-breast supplementation system, and am able to enjoy a satisfying breastfeeding relationship as a result. I would like to keep breastfeeding my child as long as he needs it. Since the World Health Organization recommends breastfeeding for two years AND BEYOND, I am and will continue to be grateful for human milk donations. If and when we are no longer able to find donated human milk, we will probably move to using whole goat's milk in the supplementation system. Goat's milk is closer to human milk than cow's milk is, but it is probably not commonly available beyond airport security.

During our stay in Vancouver, I looked up the rules. In Canada, you may only bring extra liquid aboard a flight for a child UNDER the age of 2. So, I decided to start a petition on change.org. Please sign it and share widely!

http://www.change.org/petitions/canadian-air-transport-security-authority-ease-restrictions-on-breast-milk-in-carry-on-baggage#

"Canadian parents using expressed breast milk currently face greater restrictions when flying with their children than do their American counterparts. Only passengers traveling with infants UNDER the age of 24 months may bring aboard more than 100ml of liquid per container, inside a 1 litre plastic bag. Women traveling without their babies are not permitted to bring their expressed milk on board. Those traveling with children above age two are not exempt from restrictions on liquids.

"The World Health Organization recommends breastfeeding until age 2 AND BEYOND. For those parents who must express their milk and bottlefeed, or who use donated milk and an at-breast supplemental nursing system, carrying liquid on their persons is a must. Why should the Canadian Air Transport Security Authority decide at what age a child no longer needs breast milk, especially during potentially stressful travel?

"Passengers traveling without their babies should also be allowed to carry their precious breast milk rather than pump and dump. Breast milk, known in the birth world as "liquid gold" for its important health benefits, should be exempt from the usual restrictions on liquids.

"In the US, breast milk is treated as liquid medication and passengers may carry it on board in quantities greater than 3 ounces WITH OR WITHOUT A BABY OR TODDLER PRESENT. Sign this petition and tell the Canadian Air Transport Security Authority to start valuing breast milk as vitally important nutrition for babies and children!"

http://www.change.org/petitions/canadian-air-transport-security-authority-ease-restrictions-on-breast-milk-in-carry-on-baggage#