Saturday, June 24, 2006

The Breastfeeding Campaign

Last week I mentioned a new breastfeeding campaign from the Department of Health and Human Services. There are currently two television spots, one featuring pregnant women in a logrolling competition, and the other featuring a pregnant woman riding a mechanical bull. The main messages of the ads are "breastfeed exclusively for 6 months," and "you wouldn't take risks before your baby is born, why start after?" Click the links above to view the ads; you can also read the transcripts for each ad. The complete set of print, television, and radio materials for the campaign is available here.

The ads have generated a fair bit of controversy, because of the intended feeling of guilt many women think the ads are designed to generate if a woman does not or cannot breastfeed for 6 months. This seems to be a fair criticism, given that many women know breastfeeding is best, but may not have the support they need, particularly in the workplace, to breastfeed exclusively. There are some good comments over at Feminsting describing the difficulties some women had when trying to breastfeed. A Chicago Tribune editorial, "The Breast Police", also addresses reasons why women can't meet this goal, and says the HHS tactics are unnecessary, given that 70% of mothers at least attempt to breastfeed. NBC Nightly News also covered the ad campaign, and has accompanying video.

The National Women's Health Information Center has a ton of breastfeeding information up, including coverage of the HHS campaign, but some of the information provided suggests the challenges that women will have. Among the recommendations:
  • "Breastfeed on demand" - in the section on Coping with Breastfeeding Challenges - how are women supposed to do that at work, where babies aren't welcome?

  • One section of the "Challenges" addresses going back to work, and says,
    "After you have your baby, try to take as much time off as possible"
    "Don't be afraid to request a clean and private area where you can pump your milk. If you don't have your own office space, you can ask to use a supervisor's office during certain times. Or you can ask to have a clean, clutter free corner of a storage room."

    In the Frequently Asked Questions:
    "Will breastfeeding tie me to my home?: Not at all! Breastfeeding can be convenient no matter where you are because you don't have to bring along feeding equipment like bottles, water, or formula. Your baby is all you need. Even if you want to breastfeed in private, you usually can find a woman's lounge or fitting room. If you want to go out without your baby, you can pump your milk beforehand, and leave it for someone else to give your baby while you are gone."
    Doesn't this assume 1) you can always take baby with you (like to work); 2) there actually is always a "women's lounge or fitting room" available (are women with babies only going out to shop?); 3) you have the resources to have someone to help who can feed the baby pumped milk if you do have to go out? The website does say, "Breastfeeding is more than a way to feed a baby, it becomes a lifestyle." How many women can afford to let that become their lifestyle, when money is needed to provide for the whole family?

    I can imagine that many, many women do not have the option to "take as much time off as possible," and don't have supervisors who are going to respond kindly to requests for accomodation. Are these recommendations completely out of touch with the situations of most working women? They seem to presume an office-type, professional environment. What of women who work at McDonald's, in factories, on farms? Are these employers going to allow women to take extra time off or take extra breaks to pump? Their babies might be most in need of the health benefits of breastfeeding, and they may be least able to provide them.

    La Leche League provides a nice rundown of breastfeeding-related legislation, so women can at least know their rights. Let's look at Tennessee's law:
    Tenn. Code Ann. ยง 50-1-305
    1999 Tn. ALS 161; 1999 Tenn. Pub. Acts 161; 1999 Tn. Pub. Ch. 161; 1999 Tn. SB 1856

    (a) An employer shall provide reasonable unpaid break time each day to an employee who needs to express breast milk for her infant child. The break time shall, if possible, run concurrently with any break time already provided to the employee. An employer shall not be required to provide break time under this section if to do so would unduly disrupt the operations of the employer.
    (b) The employer shall make reasonable efforts to provide a room or other location in close proximity to the work area, other than a toilet stall, where the employee can express her breast milk in privacy. The employer shall be held harmless if reasonable effort has been made to comply with this subsection.
    (c) For the purposes of this section, "employer" means a person or entity that employs one (1) or more employees and includes the state and its political subdivisions.
    Do you see the wiggle room in there? An employer is only required to try, not to actually provide necessary break time or appropriate areas. You just don't have the extra space? Extra break time would disrupt operations (such as in low-wage workplaces)? You're all set - don't worry about it.

    So how many U.S. women do breastfeed? Are they all completely unaware of the benefits? According to CDC data for 2004:
  • 70.3% ever breastfeed; 36.2% at 6 months (14.1% breastfeed exclusively); 17.8% breastfeed at 12 months; 38.5% are breastfeeding exclusively at 3 months. So women are starting out strong, but fewer are breastfeeding as time passes. Maybe they're returning to work, eh? Because they have to?
  • Married mothers are more likely to ever breastfeed (76.5%) than unmarried mothers (57.2%). Because they don't have the support to stay home or just leave the baby with somebody who will feed the pumped milk? Same thing holds up for poverty - more money = more breastfeeding. So... think there might be some societal or economic barriers to exclusive breastfeeding?

    The point, after all this, is that educating women about breastfeeding does not seem to be the problem. Reducing the barriers to making that a reality is the problem, and the HHS ads address that not at all.

    Blogs covering it:
  • Mad Melancholic Feminista: The Politics of Breastfeeding
  • St George Blog: Driving While Pregnant
  • Angry Pregnant Lawyer: Get me a beer and a smoke while I hop on this bull
  • One Tired Ema: Late to the Party
  • Broadsheet: More on Breastfeeding from the Times
  • Huffington Post: Maia Szalavitz: Breast Feed or Else? NYT, HHS Boost Sketchy Science, Neglect PPD

    Technorati Tags: ; ;
    MeSH Tags: Breast Feeding; Infant Formula
  • 4 Comments:

    Blogger bridgett said...

    One of the rarely uttered things here (though raised mid-article in the Huffington post) is the reality of PPD. I breastfed exclusively and I (and the rest of my family) suffered through 6 months of a very deep, very scary post-partum depression. I did not take anti-depressants (though in retrospect, I suspect they would have helped) because of the breastfeeding. Moreover, while breastfeeding eventually turned out to be a sustainable, joyful and positive experience for all, it came with a miserable learning curve, painful infections, extreme fatigue, and poor support at the workplace and among my very progressive and otherwise tuned in feminist health care providers. The extra dish of guilt (Has to Be Breast! Formula is Like Cigarettes in a Bottle!) will be enough to make many first-time PPD mothers feel completely wacky, trapped, inadequate, and suicidal.

    8:35 PM  
    Blogger KathrynP said...

    Bridgett, I disagree with your statement. If a woman suffers from PPD they should ALWAYS seek treatment. Breastfeeding has been shown to help PPD and most medications used to treat it are quite safe to take while breastfeeding.

    These ads are no more aggressive than the ad campains put together to counter breastfeeding by the formula companies. I hope the ads stimulate more all around support from both men and women alike so more women can raise their expectations and take back their right to breastfeed.

    11:41 AM  
    Blogger Rachel said...

    Kathryn - I read bridgett's comment not as suggesting that women with PPD shouldn't seek treatment, but that women with PPD may feel additionally overwhelmed by the pressure to breastfeed if they're not getting proper support.

    What I would hope would result from the ads, perhaps not their intended purpose, is to raise awareness of the societal boundaries to extended/exclusive breastfeeding. I see that happening somewhat already, and I think that is a positive sign.

    12:06 PM  
    Blogger bridgett said...

    Women with PPD should always seek treatment. HOWEVER, they might not. Because they are depressed. Because they do not accurately perceive the chances that therapies will help. Because they do not know, are not told, do not inquire whether the drugs will transfer through breastmilk. Because they do not wish to admit that anything is wrong. Because they feel like failures as mothers. And when you are depressed, having a breastfeeding-or-else mentality is just one more isolating factor to struggle with that might be too damn much for women already depressed to bear.

    Thank you, Rachel for clarifying.

    8:29 PM  

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