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3/22/2017

Breastfeeding
as a Public
Health Issue:

Do we Have the
Right
Approach?

DrAmyBrown 1

Disclosures
There are no conflict of interests for this activity for
planners, presenters, faculty, authors, nor content reviewers
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Objectives

Describetheimportanceofresponsivebreastfeeding
Describe the importance of responsive breastfeeding

Analyzethecomplexityofhumandecisionmakingaround
health

Describetheinfluenceofpsychological,cultural,andsocietal
barriersto

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Icouldnt
breastfeed

IIdidn
didntt have
have
enoughmilk

Hefedtoomuch

Hewasjustreally
unsettled
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6 weeks
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6 months
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12 months
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Idletmybabydown
thegoodstartIhad
promisedhimhe
wasntgoingtoget.I
felt like Id
feltlikeI dfailedhim.
failed him
Rightatthestart.
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86.3%agreedthatitisimportant
topromotebreastfeeding

78.9%believedbreastfeeding
promotionaffectsdecisionto
breastfeed.

Howeveronly...

14.6%agreedmethodsofbreastfeedingpromotionwereexcellent

8.2%believedthatthebreastisbestsloganwasagoodwayto
increasebreastfeedingrates.

10.4%believedbreastfeedingpromotionmessagesprepared
mothersforwhatitwouldbeliketobreastfeedababy. 15

Breastisnotbest;itisthe
normalwaytofeedababy

Dontfocussolelyonhealth
impactofbreastfeeding

Recognisethateveryfeed
makesadifference

TTellusthetruth
ll h h itcanbe
i b
difficult

Targetawideraudience
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Breastisnotbest,itisthenormalwaytofeedababy...

Breastisbestbutthisputsbreastfeedingonan
unobtainable pedestal for some people This
unobtainablepedestalforsomepeople.This
thenmakesinfantformulaseemtobe
reachable,normalandsomethingthathasall
thestuffneededforbabies.Instead
breastfeedingshouldbemarketedasnormal
andperfect.

Breastispromotedasbeingbest.Soifyou
breastfeedyouarethebestmotherand
doingthebestforyourbabyandmakingthe
bestchoices.Ifyoucantbreastfeedwhere
doesthatleaveyou?Anotgoodenough
mother?Abadmother?
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Dontjustfocusonthehealthreasons...

Althoughtherearehealthdifferences
betweenbreastandformulafedbabiesthey
arenotguarantees.Breastfedbabiescanstill
f d b bi ill
getillsoifmothersaresoldtheideaof
breastfeedingonhealthbenefitsaloneand
thentheirbabygetssickitcanmakethemfeel
liketheydiditwrongorthatitwasntactually
thatgoodandtheymightaswellformulafeed
astheirfriendwhodidhavereallyhealthy
kids .
kids.

Breastfeedingisaboutsomuchmorethan
health.Itisaboutcuddles,andclosenessand
bonding.Itsavestime,costsnothingandyou
canneverforgettotakeitoutwithyou.Why
dontweemphasisethesethingsmore? 18

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Tellusthetruth itcanbedifficult...

Itwouldhavehelpedtohavebeenhonestly
toldthatit'snotapieceofcakeandthatyou
havetolearnitandthatit'snormaltohurt/feel
uncomfortableforthefirstfewweeks;that"it's
natural"doesn'tmean"it'seasyandwilljust
happen.

Itwasallsopositive.Breastisbestforyourbaby.
B
Breastfeedingwillhelpyouloseweight.
tf di ill h l l i ht
Breastfeedingisawonderfulexperience.Perhapsall
truebutinnowaythewholepicture.WhenIthen
founditdifficult,attimesdemandingandmybaby
appearedtowanttoscreamratherthanfeed
serenelyIfeltlikeacompletefailureand
embarrassedandguiltythatIfeltthatwaytoboot.
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Recognisethateveryfeedmakesadifference...

Ifyoureallywanttoboostbreastfeeding,you
havetoabandonthisblackorwhitestance.I
know exclusive breastfeeding is best but there are
knowexclusivebreastfeedingisbestbutthereare
somanyrulesnow.Nobottlesbefore6weeks,no
formulaever nowonderpeoplegiveup.It'sa
spectrum,withexclusivebreastatoneend,and
exclusiveformulaattheother.Mostendup
failingtokeepalltherulesandgivingupthe
wholething

Althoughwedoneedtotellmumsthatits
Alth h d d t t ll th t it
important,givethemsomecredibility.Tellthem
theguidelinesbutexplainhowallbreastfeeding
counts.Youmighthaveamumwhobaulksatthe
ideaof6months,but6weeksoreven6days
seemsachievableforher.Thatisbetterthannot
atall. 20

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Target a wider
audience
Youcantellwomenthatbreastisbesttil
You can tell women that breast is best til the
the
cowscomehome.Butiftheirpartner
believesdifferentlyandthemotherinlawis
tryingtogivethebabyabottle,whodoyou
thinkisgoingtowin?Tellmumsbyallmeans
butalsotelltheirwiderfamily

Iknowwhybreastfeedingisimportant.My
partnerknowswhybreastfeedingis
important.Butitsverydifficulttoputup
withothersignorantviews.Educatethe
generalpublicanditwouldbealoteasier.
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Wedefinitelyneedto
betellingnewmums
aboutwhy
breastfeedingissogood
b
butIthinkthisshould
hi k hi h ld
alsobeextendedto
everyoneelse.
Everyoneneedsto
knowwhy
breastfeedingisso
importantformumsto
standachanceof
makingthiswork 22

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Thesuccessorfailureof
breastfeedingshouldnotbe
seensolelyasthe
responsibilityofthe
woman.Herabilityto
breastfeed is very much
breastfeedisverymuch
shapedbythesupportand
theenvironmentinwhich
shelives.Thereisabroader
responsibilityof
governmentsandsocietyto
supportwomenthrough
policiesandprogrammesin
thecommunity.

DrNigelRollins,
WorldHealthOrganisation 2016
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When you have a new baby,


people ask you 3 questions
Isitaboyoragirl?
Is it a boy or a girl?
Howmuchdidsheweigh?
Isshe

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YOUREJUST
Youneedto
Areyousureyouvegot
Mybaby
IsHeshim
Ishefeeding
showhe feeding
showhim
Rod
Rodforyourown
h forilk?
your own
DOING
DOINGITALL IT ALL
enoughmilk?
sleepsall
Youllstillbefeeding
Heneedsaroutine!!
again?!
manipulating
back!
night
himwhenhesoffto
whosboss!!
WRONG!!!!!
university!!
you!!!

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Theycometorealisethattheydont
needthelatenightfeedingandmostof
themgiveitupat1,2or3monthsofage.

Ifbabiesreachtheageof1monthand
weigh9poundsandstillwakefora2am
weigh 9 pounds and still wake for a 2 am
feeding,Ithinkitssensibleforthe
parentstotrytoinfluencethemtogiveit
up

Beconsciousthatsomebabiesthinkyour
solepurposeinlifeistohelphimfall
sole purpose in life is to help him fall
asleep

Duringnightfeedstrynottotalktoyour
baby
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Tizzy Hall
OneaspectIconsiderediswhetherthequalityofthe
motherssmilkchangeswhensheputsherbabyona
mother milk changes when she puts her baby on a
routine.Becausecowsmilkisclosetohumanmilk,
whichiswhywedrinkitandfeedittoourchildren I
decidedtodiscussitwithvariousdairyfarmers.

Dairyfarmerssticktostrictroutinesinrelationtotheir
milking Most will milk their cows at 5 am and 3pm
milking.Mostwillmilktheircowsat5amand3pm
everyday.WhenIenquiredwhyitwasexplainedtome
thatmilkingthecowsatasettimeeverydaymeant
theirmetabolismknewexactlywhenandhowmuch
milktoproduce.
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Thefarmerssaidthatiftheymilkedtheircows
earlierorlaterthanscheduled,themilkwouldnot
beofthehighestqualityofquantity.Itsnotsucha
leaptocometotheconclusionthatthismightbe
thesameforabreastfeedingmothersmilksupply

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Weneedtochangethe
conversationaround
breastfeedingbystopping
layingtheresponsibilityfor
thismajorpublichealth
issueinthelapsof
individualwomenand
acknowledgingtherole
thatpoliticsandsociety
p y
hastoplayateverylevel.

UnicefBabyFriendly,Call
toAction2016 42

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Theonlythingyoucandoismakeitmore
normalandaccepted.Ifeveryonegrowsup
seeingpicturesofit,seeingitontv etcand
seeingpeopledoingit,itwillbeanormal
naturalthingtodo

Formulacompaniesadvertisebyshowing
bouncy,happybabiesratherthanjustthem
suckingonabottle.Maybeweneedtoseehow
wecanpromotebreastfeedinginotherways
thanthemoretraditional.

Wevelostsightofwhatitsliketobreastfeed
andneedtogetbacktounderstandingcaringfor
andfeedingbabies.Peoplelabelnormal
behaviourassomethingthatiswong andwe
needtogetbetterunderstandingandacceptance
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References
Ball,H.L.(2003).Breastfeeding,bedsharing,andinfantsleep.Birth,30(3),181188.

Brown,A.(2016)BreastfeedingUncovered:Whoreallydecideshowwefeedourbabies?Pinter&Martin:London

Brown A (2015) Milk supply and breastfeeding decisions: the effects of new mothersexperiences.NCTPerspectives
Brown,A.(2015).Milksupplyandbreastfeedingdecisions:theeffectsofnewmothers experiences NCT Perspectives 29

Brown,A.(2015)Breastisbestbutnotinmybackyard:Societalinfluencesonbreastfeedingpractice.Invitedreview:Trends
inMolecularMedicine21(2),5759.doi:10.1016/j.molmed.2014.11.006

Brown,A.(2016).WhatDoWomenReallyWant?LessonsforBreastfeedingPromotionandEducation.Breastfeeding
Medicine,11(3),102110.

Maushart,S.(2000).Themaskofmotherhood:Howbecomingamotherchangeseverythingandwhywepretenditdoesn't.
PenguinGroupUSA.

Palmer G (2009) The politics of breastfeeding: when breasts are bad for business Pinter & Martin Publishers
Palmer,G.(2009).Thepoliticsofbreastfeeding:whenbreastsarebadforbusiness.Pinter&MartinPublishers.

KendallTackett,K.,Cong,Z.,&Hale,T.W.(2011).Theeffectoffeedingmethodonsleepduration,maternalwellbeing,and
postpartumdepression.ClinicalLactation,2(2),2226.

Thulier,D.,&Mercer,J.(2009).Variablesassociatedwithbreastfeedingduration.JournalofObstetric,Gynecologic,&
NeonatalNursing,38(3),259268.

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