It's Artificial, Naturally!
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It’s artificial, naturally! Shielding the breast in an era of climate change Janelle Lamoreaux, August '16 World Breastfeeding Week (WBW) is upon us once again, celebrated annually from 1st -7th August. This is a week during which event founder and organizer, the World Alliance for Breastfeeding Action, hopes to mobilize institutions and individuals around the world to promote feeding babies from the breast. Each year WBW has a theme. Last year’s theme was Breastfeeding and Work: Let’s make it work! This year’s theme is Breastfeeding: a key to sustainable development and it is being explored in five different ways, one of which focuses on the relationship between breastfeeding and the environment. A flyer on the World Breastfeeding Week website (image 1) reads “Breastfeeding is the first practical step we can take to protect not only the health of babies and mothers but also the health of our planet – right from the start, by providing green and sustainable nourishment to babies.” With bold word choice, the flyer continues: “Artificial feeding contributes to global warming which is causing climate change, with catastrophic results.” This literature’s simple delineation of the artificial from natural, as well as the attribution of the climate change catastrophe to the “artificial feeding” of babies is especially interesting to me in light of ReproSoc’s Reproducing the Environment project, in which Katie Dow and I have been exploring how reproductive and environmental activisms and sciences often implicate one another. It is also interesting to me as a mom who straddles the artificial/natural boundary each time I breastfeed my child. Image 1. Page from World Breastfeeding Week leaflet. Though an event that has been occurring since 1991, I admit I had never heard of World Breastfeeding Week prior to my baby’s birth this January. Since then, and usually while pinned under the weight of a sleeping infant who has just fed, I’ve been reading all things breastfeeding – blogs that offer tips, advice and encouragement; critical academic articles about both cultural imperatives and social deterrents to breastfeeding; reports on rates and benefits of breastfeeding to certain durations. Given this intellectual intake during my own expression sessions, I’ve been thinking a lot about how to make sense of my sustained desire to breastfeed, despite the difficulties I’ve encountered along the way. This blogpost situates my personal feeding experience in the context of what appears to be the UK’s breastfeeding conundrum: while women in the UK face higher breastfeeding expectations than ever before, rates of breastfeeding here are some of the lowest, if not the lowest, in the world. The following is an exploration of this tension as I experienced it in the weeks after giving birth. On January 29 of this year, when my new baby was just 15 days old, the BBC published an article calling UK mothers the “world’s worst breastfeeders”. As a new mom struggling to feed her child from the breast, the dramatic headline hit home. The news article followed from a study in the Lancet, also published in January, which highlights the United Kingdom as the country with the lowest rates worldwide, with only <1% of mothers still breastfeeding at 12 months. While the article points out that all “high income countries” have low breastfeeding rates compared to their middle and low income counterparts, the newspapers were quick to point out that U.K. rates were low even among higher income countries. As shown below (Image 2), all European countries have higher breastfeeding rates than the U.K. Even the United States, which does not have government mandated maternity leave, paid or unpaid, has a 27% 12-month breastfeeding rate. The article does not state why UK breastfeeding rates are so low, but states that not enough breastfeeding support is given. Based on my experience, and the experiences of a few other UK moms I’ve spoken with, I’d like to suggest that it is not a lack of support that results in low UK breastfeeding rates, but the type of support that is given. Image 2. Percentage of children who receive any breastmilk at 12 months of age. From the article: “Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.” Victora, Cesar G et al. The Lancet , Volume 387 , Issue 10017 , 475 – 490. Mothers in the U.K. face an amazing amount of pressure to breastfeed “naturally” – from the breast exclusively and without technological assistance or supplementation. (This has been discussed and studied by Dr. Charlotte Faircloth and others, who refer to the contemporary moment as one of “intensive mothering.”) In my experience, much of this pressure unintentionally comes from well-intentioned systems of maternity support, which over-emphasize “natural” birth and breastfeeding in an effort to avoid the unnecessary medicalization of pregnant women. Upon falling pregnant in the UK I was excited to experience midwife led maternity care. I was eager to be a part of a medical system that encouraged home births, birthing pools, and gas and air as pain relief in an effort to avoid epidurals and c-sections. In the end, however, I came to see some drawbacks to the intense focus of this community on “the natural,” and to understand the strict delineation of natural from artificial as impacting my own early breastfeeding practices and likely that of others. More importantly, I believe this over-emphasis on the natural impacted my child’s health in his earliest days. I did not read the article calling UK mothers the worlds worst breastfeeders when it was published. As you might imagine, I was rather busy, figuring out how to care for the 15-day-old life I had so recently birthed into a pool of water that sat in a birthing centre suite at a hospital within a city and country that still, especially at times like this, felt foreign to me. I was an American living in England. and as I sat in my rocking chair, looking out on our green grass garden spotted with apple trees while feeding my son a bottle of expressed milk that I had pumped from my breast an hour or so before, I felt very far away from home. My parents, who had been visiting for the birth, were now in London and would soon be making their way back to the states. My partner had popped out to the grocery store to stock up on milk and more prepared meals to get us through the next few days. It was the first time I was at home alone with my baby, and in this moment, even when I stared into the face of my baby contently suckling away on a bottle’s nipple, not only did I feel like a foreigner, I also felt like a failure. I felt only part of the mom (or should I say mum) that I was meant to be. It should be my breast, my skin, that provides him his food, not a plastic bottle. These are the thoughts that went through my mind, even as I fed my baby milk I had expressed from my own breast. Sick of this feeling, I said fuck it. I’m sure I said it out loud, as brazen cursing always made me feel like I was properly standing out as an American in the U.K. I sat down the bottle of expressed milk and with baby in hand walked out of the room to find the box of feeding supplies stacked on a bench that had been converted into a baby zone in the hallway. I stirred through the contents and found the nipple shield: a small, transparent nipple-shaped silicone sheath that I had eventually been given by a community midwife who visited after we got home from the hospital the second time. I returned to my rocking chair and sat down with my baby, affixing the silicone shield to my breast like a decal onto a curved window. The “nipple” part, a rounded cone with five small holes in the end, stuck out where my own nipple did not. I was haphazardly diagnosed with flat nipples shortly after giving birth when a midwife told me why my baby was having trouble latching: my nipples were “a bit flat.” Immediately after I gave birth I was able to feed my child; he latched on to the breast just a few minutes after being scooped out of the water and into my arms by an amazing midwife who, alongside an amazing partner, helped me through the last nine (of nineteen) hours in labour. We sat on the suite’s double bed, my baby attached to my nipple and staying on my breast, suckling just long enough to bring on a burst of meconium. Covered in this dark sticky poo, I gave my partner the baby in order to quickly shower while the midwives changed the sheets. It was, despite its messiness, such a happy moment. I had just given birth to a healthy baby the way I imagined I would – in the water with the help of only gas and air. The pain and tiredness that I had felt for the last 24 hours had left; I was giddy with adrenaline and love. Soon after this first feed however, my breasts began swelling up and my already small nipples protruding less and less. Per midwife instruction, I was to demonstrate that I could feed him for at least five minutes three times before I could be discharged. But things were no longer going smoothly. When near the breast my poor babe repeatedly opened his mouth wide and closed it again, trying to find the nipple that would let him know he was in the right place, that he should clamp on and suck.