Monday, 21 July 2014

Parenting – It’s Not All About You

You see the world from your own perspective – of course you do. What can be harder to recognise is that not everyone else does. When you’re a child, most of the people in your world are focused on you most of the time. When you’re two, for example, you can scream when you’re hungry and someone will produce food for you. But that’s not going to work when you’re 20. Okay, so you’re thinking “No shit Sherlock”. But there are other ways in which we can all too easily assume that the world is focused on us when in fact no one is giving us a thought. Parenting is the mother of all imagined theatrical stages. We picture ourselves centre-stage, with all eyes on *our* performance.

Either we think people are “breastfeeding at us”, or a scientific study is a conspiracy to make us feel bad, or someone pointing out the risks of circumcision is spoiling for a fight with us. Such self-centrism is an easy trap to fall into. Yet part of growing up is recognising that other people might not have us in mind at all, and that is normal. After all, we aren’t thinking of everyone who may possibly be affected every time we make a decision or comment.

So who is causing all the butthurt? Answer: Those people who passionately advocate a certain breed of parenting (be them attachment parents, lactivists, intactivists, babywearers). Those bastards with their statistics, their science, their comments and their critiques. How very DARE they! I’m not talking about the folk who simply make parenting choices, be them breastfeeding or whatever, in the quiet of their own homes. Rather, I’m referring to those people who passionately advocate a particular style of parenting. They extensively research the topic, engage in debate, network to a standard that would shame Mark Zuckerberg, even stage protests. They have a zest that rivals feminism. Yet their behaviour angers and upsets many. You may ponder: if they aren’t aiming this behaviour at you personally, then what are they doing?

I’ll tell you what they’re doing, being one of them I am in a stellar position to explain. The majority of advocates I have had the pleasure to liaise with have a thinking outside the box mentality. They are problem-centered rather than ego-centered. They see the issue of parenting on a macro level rather than a micro level. These people feel inclined to inform themselves so that they can ask educated questions. They recognise a pertinent truth: no other 'authority' - be it commercial companies, friends, health professionals, even the government - will be remotely as committed or as motivated to protect children's well-being as parents are. It's as if parental thinking creates a distinct worldview, and a set of values, arising from the daily work of caregiving. As a parent, they bring these little people into the world, and they deeply feel that they must make it a good place for them to live.

This attitude is nothing new, anyone who's attended elementary school will know that modern history is littered with examples of women who have channelled energies arising from their own domestic sense of responsibility into a much broader commitment for social reform. Did you know, for example, since women got the vote, mothers have became more reliable voters, registering and turning out in greater proportions than childless women (Deprez 2012). We need to carry on this long and honoured tradition whereby mothers are making the personal political and, in doing so, extending a commitment to their own families' welfare to the world at large. 

For advocates, parenting is a topic they conceptualise as going far beyond themselves. Many are dismayed at the all-too-common suggestion that they should only care about what happens to their own children. They think the welfare of children is everyone’s business. They feel kinship and connection, as if all people were members of a single family. They are interested in social reform. In concepts like social responsibility.

Indeed, contrary to the knackered stereotype that women narrow their world view and passively retreat into the home once they have babies, motherhood has been known to energize and even radicalise women. Forgive me folks, as I patronise you with some science for a moment: In 1998, at the ripe old age of eighty-six, pioneering neuroscientist Paul MacLean wrote an essay titled "Women: A More Balanced Brain?" In it, he described this phenomenon in evolutionary terms. After decades of research he believed that human maternal behaviour has evolved to enlist the relatively newer part of the brain (the prefrontal cortex) allowing "a concern for the future welfare of the immediate family to generalize to other members of the species, a psychological development that amounts to an evolution from a sense of responsibility to what we call conscience". In other words: as a species, we're just not designed to mind our own business. Motherhood comes with, (or should come with), a heightened sense of empathy with the defenceless, an ability to see dangers from the point of view of a potential victim (infants).

Tongue-in-cheek, but you get my point.

On the whole, advocates see the topic – be it breastfeeding, circumcision, birth rights, vaccination, whatever - as nonpersonal, concerned rather with the good of humanity in general, rather than the feelings of a select few. This is progressive thinking. Philosophical and ethical questions are at the forefront of their minds. These people live in the widest possible frame of reference. They prefer never to get so close to the trees that they fail to see the forest. For instance, rather than focusing their energies on the minute percentage of women who are physically incapable of breastfeeding, they focus on the majority who can. They work within a framework of values that are broad and not petty, universal and not local, and in terms of the century rather than the moment. To them, anecdotes are worthless red herrings.

To sum it up: If you get into the groove of looking for the personal, you can always find it. But parenting is political - it’s not all about *you*.

Tuesday, 8 July 2014

Is your state the best or the worst for breastfeeding? Find out.

Did you know that your geographical location can contribute to your likelihood of breastfeeding success? Okay, well just pretend you didn't. Feign shock or something. The good folks over at The Centers For Disease Control and Prevention have gone all Santa and written a list detailing which states are naughty and which are nice. Rather than bore you with it, I thought I'd show you this nifty interactive map, created by Rani Molla for The Wall Street Journal. It showcases all the info for you lucky people:

The first few days..

We all know how important those first few hours and days of a baby’s life are for establishing breastfeeding. Nursing your baby right away increases the likelihood that he will continue to breastfeed, and gives him colostrum which is uber rich in antibodies and essential nutrients. Moms also benefit from early breastfeeding through improved lactation and less loss of blood. What's not to like, people? Suffice to say, babies and moms should be rooming-in from birth, spending those important first few days together, without interruption.

Now, take a gander at this map. As your eyes drift from left to right, the rate of rooming-in actually decreases! But don't freak, you haven't discovered an innate ability to curse others with your eyes (your mother in law is breathing a sigh of relief). Nope, it would seem hospitals and birth centres are more baby-friendly in the West, with over 55% of babies rooming-in at least 23 hours per day. Lucky babas!

If you're of the Pinterest persuasion, I've put together this list showing how each state is performing in the breastfeeding trenches. Pin away, my friends!

Now time to show your breastfeeding pride on Facebook, with these lovelies..

The Top 5

1. California 

2. Idaho 

3. Alaska 

4. South Dakota

5. Vermont

The Bottom 5

1. Arkansas 

2. West Virginia

3. Georgia 

4. Mississippi 

5. Tennessee 

Monday, 7 July 2014

Is Formula Feeding Worse Than Smoking?

When you read the title you probably thought, ‘But formula is nothing like smoking, jeeeeez!’ On the contrary, there are numerous parallels. In this post I’m going to set out, not only why formula feeding is like smoking, but why it may even be considered worse.

Firstly, a common thread between formula feeding and smoking is consumption patterns. They both follow the addiction model: It’s easy to get hooked, and then you’ve gotta have it (see what I mean, here). During World War II, soldiers were issued with free cigarettes, courtesy of the tobacco companies, whereas today formula companies gatecrash maternity wards, doctors’ surgeries, and parenting magazines proselytizing with free formula:

Health cover-up

Mark my word friends, in the not so distant future, lawsuits will be filed against formula companies claiming that they are responsible for the ill-health of the obese, diabetics, crohn’s sufferers, allergy sufferers, arthritis sufferers and asthmatics, to name but a few of the possible plaintiffs, who fed for a considerable period of their infancy on their products. No, this isn’t some kind of joke. I liken such a legal challenge to the fight against ‘big tobacco’ in the nineties. People ridiculed those attempts too, but in 1998, the Master Settlement Agreement saw the major US tobacco companies agree to pay $246 billion over twenty-five years to settle lawsuits filed by US states. 

From a legal point of view, there are certainly precedents set by the tobacco suits which those pursuing formula companies can utilise. One legitimate way we can draw an analogy is to identify a common logical structure. For example, it can be maintained that the arguments against the tobacco and formula industries have the same form, namely:

1. If a manufacturer covers up the harm its products can cause, it is responsible for any such harm its products do cause.
2. X has covered up the harm its products cause.
3. Therefore X is responsible for any such harm its products have caused.

Organic ill-health HAS to be better than regular ill-health, right?

Bogus compari.

"30 years research" makes it all right, allegedly.

"Protection". Nuff said.

However, the fact that arguments against big tobacco and the formula industry have the same structure is not in itself very interesting. What’s really important is whether the content of the arguments is analogous, not just the forms. Has the formula industry engaged in a health cover-up comparable to that of the tobacco industry? I would argue that they have. In the UK for example, according to a survey undertaken by the UK government, 34% of mothers incorrectly believe that infant formula is the same or almost the same as breastfeeding. Another survey conducted by Unicef found more than a third of mothers thought formula was 'as good' or 'better than' breastmilk. Let me present one more fact for you stats fans: a massive 9 out of 10 mothers questioned in a British Heart Foundation (BHF) survey misunderstood marketing information when feeding their child. The study found that mothers believe claims such as “a source of calcium, iron and six vitamins” mean a product is likely to be healthy.

By asserting that their products are safe for babies, and even, advantageous, formula companies have orchestrated a cover-up on a monumental scale. The analogy with the past antics of the tobacco industry is glaring. As the Drug Policy Foundation maintains, “Tobacco products have had a long and inglorious history of largely unfettered marketing built around pseudoscience, false and misleading claims, and appeals to medical authority.” Sound familiar? This is the current under-regulated marketing arena that formula companies enjoy today. Take these two ads for example:

Notice at the bottom of the cigarette advertisement, it features a doctor with a speech bubble containing his advice on cigarettes: "I advise my patients to switch to Viceroy cigarettes, because Viceroy filters your smoke!" The ad claims that filtered cigarettes, especially those with Viceroy filters, are "better for your health" than cigarettes without filters. In a similar vein, the formula ad claims that babies fed that brand of formula have fewer infections than babies given other formulas. The underlying message behind both ads is the same: our product causes health problems, but not as many health problems as our competitors. The consumer focuses on the latter part of that sentence when what they really ought to be focusing on is the initial confession.

As I have explained in depth elsewhere, just as loaded words try to manipulate parents emotionally, pseudo-scientific jargon tries to induce an unearned respect for what is said. To bolster their claims, the ads above use 'authorities': the formula company quotes 'research', the tobacco ad quotes a 'physician'.

There's one physician however, who isn't taken in by such strategies. Jack Newman MD works with thousands of mothers and babies every year in his clinic at the International Breastfeeding Center, Toronto. He's argued that all pregnant women and their families need to know the risks of formula feeding:

"If mothers get the information about the risks of formula feeding and decide to formula feed, they will have made an informed decision. This information must not come from the formula companies themselves, as it often does. Their pamphlets give some advantages of breastfeeding and then go on to imply that their formula is almost, actually just as good."

Patti Rundall, policy director at charity Baby Milk Action agrees. She contends that mothers “should know the risks of formula feeding, which include higher incidence of ear infections, arthritis and many other conditions. Often just pointing out these risks is seen as aggressive promotion of breastfeeding, but people should know the dangers. And we should not have the sort of promotion of bottle- feeding in the UK, which encourages mothers to think it is the norm and carries no risks.”

Another leading charity, aptly named: Save the Children, is also in agreement and has recommended that formula should have tobacco-style health warnings informing parents of the risks associated with formula feeding, not in wimpy small-print. They want the messages to be big enough to cover at least a third of the packaging. Reckon they'll succeed? Not without a bitch-fight. Any attempt to quash the free-reign free-market predatory behaviour of formula companies is sure to be met with staunch defiance. Economic power is a force only the brave dare challenge. For instance, in 2007, when the Philippines tried to limit formula advertising, several formula companies took the issue to court. The court sadly ruled against a ban on baby formula advertisements. However, on the plus side, the court stood firm on restricting potentially misleading health claims and also increased regulation of such ads. Not unlike the FDA Tobacco Regulation Bill, which compelled tobacco companies to eliminate potentially misleading labels like “light” and “mild,” regulate a product’s ingredients and increase the size of the warning labels on cigarette packs. One blogger pondered: “The high court decision about the tobacco advertising got me thinking, in fifty years time, will the idea that formula was marketed as a health product seem unbelievable? I hope so.”

I hope so too. Like smoking, the risk of using formula cannot be negated. Even properly-prepared formula carries numerous health risks. Warnings such as those now placed in advertisements by the alcohol industry – ‘use our product responsibly’ – would not be out of place on formula cans. At present, the best we have is teeny tiny small-print the size of two postage stamps tucked into the ingredients list:

"Use as directed by your baby's doctor". How many parents
actually consult a physician before using formula?

Defensive Users

Recall previously, I wrote about formula feeders and denialism. It’s interesting to note the parallels in rhetoric used by the defenders of formula and the defenders of tobacco. It should be obvious that no facts about the risks of either can ever be proved beyond all doubt whatsoever. What some defenders latch onto however, is that despite the facts of formula and tobacco's risks having overwhelming evidence, they do not have quite as much as most well-established scientific truths (the existence gravity for instance). So, although there is very strong evidence that smoking is a major cause of lung cancer, there is wiggle-room available for defenders to demand a higher standard of proof and claim science has not met it. As illustration, take a look at this quote direct from Imperial Tobacco legal documents:

"Cigarette smoking has not been scientifically established as a cause of lung cancer. The cause or causes of lung cancer are unknown" (The Observer 2003).

Yup, they actually said that. Does this rhetoric sound familiar? That's because it's the same strategy formula defenders use when referring to the risks of formula:

"Formula feeding has not been scientifically established as a cause of SIDS. The cause or causes of SIDS are unknown".

Science is by its nature fallible and to demand infallibility from it is to disobey Aristotle's wise injunction to expect only as much precision as the subject matter allows. Like the connoisseur of good vodka, the truth seeker should not demand 100 per cent proof. We have to live with a small measure of uncertainty. 

Many formula feeders have the same illogical understanding of the health issues with formula feeding as they did of smoking in the 1940's: "If I can't SEE how this lifestyle choice makes a difference to health then there can't BE a difference." Yet if the impact of lifestyle choices on health was so obvious, women wouldn't have been positively encouraged to smoke and eat liver in pregnancy for decades. Can you look at a group of adults and tell whose mother smoked when they were in utero? Not all damage is visible to the naked eye, my friends.

Failed duty of care

Like smoking, formula feeding is a personal decision and an expression of one’s freedom. Yet the consequences of that decision and their impact reflect an important dichotomy. Here, we are getting to the crux of the ethical implications: unlike the smoker, the end-user of formula is not the decision-maker. Whilst a smoker can chose to endanger their health, a baby has no choice. This victimisation, this betrayal, is what makes formula feeding trump smoking in unethical terms. Infants are a vulnerable group. They rely on their caregivers to protect their best interests. Like the parent who fails to protect their child from second-hand smoke, the mother who abandons breastfeeding without a fight has failed in her duty of care. Given that formula feeding is involuntary on the child's part, and given that the health risks are well documented, it is not a stretch to argue that formula feeders are playing the same ethical ball game as smokers. With regards to smoking, the majority of passive smoking occurs in the home and children are the prime victim, and whaddya' know, with regards to formula feeding, children are the prime victims. Yet surely in an ethical society, child health should be prioritised over adult convenience?

Consider also that the staggering healthcare costs of treating diseases caused by both smoking and formula feeding. According to the Centers for Disease Control and Prevention smokers costs $96 billion a year healthcare costs and $97 billion a year in lost productivity. Likewise If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year (Pediatrics 2010). Like smoking, formula feeding puts an unfair economic burden on non-users, a legitimate public health concern.

In closing, there needs to be public debate focusing on issues such as the regulation of formula marketing and the disincentivization of formula feeding (Both of which I have discussed here). The ethical issue, I believe is one of freedom versus responsibility. Where does a mother's right to exercise a lifestyle choice end and where does her responsibility to her infant and to society begin? Mull that one over for me.

Dare you pin it?

Monday, 30 June 2014

“ONE BOTTLE WON’T HURT” - How Mothers Lose Their Moral Compass

We’ve all heard the mantra “one bottle won’t hurt”. It’s the mating call of the disengaged health professional or well-meaning but ultimately misinformed relative. A study published last year even suggested that giving formula to babies can help relax mothers and increase the length of time they end up breastfeeding (The Telegraph 2013). This was a huge pat on the back for supplementing mommas - and there are plenty of them about. According to the U.S. Centers for Disease Control and Prevention, one-quarter of the babies born in America in 2009 were supplemented with infant formula by two days of age, and by three months, this had increased to nearly two-thirds. With this bottle-centric backdrop it should come as no surprise that when I posted the following meme on Facebook, there was a lot of panties taking residence in buttcracksville:

However, as I have explained previously (here), one bottle does in fact hurt. It can cause irrevocable damage to your baby’s immature digestive system. Even with this pertinent truth aside, one bottle is the starting klaxon of bona fide formula feeding. It is akin to putting yourself in a giant hamster ball, standing atop a steep hill, and leaning forward. The La Leche League has issued warnings detailing how small amounts of formula can lead to such entrapment. They say:

“Unnecessary supplements sabotage milk production by reducing milk removal and stretching out feeding intervals. Problems usually start with "just one bottle a day" or "just a few bottles a week," but the more supplements that are given, the more are needed because milk isn't made when it isn't removed. It becomes a slippery slope and bottle feeding eventually seems more convenient or the baby appears to like it better.”

To explain the skinny, it's time for a patronising mini science lesson: breastmilk contains something called the Feedback Inhibitor of Lactation (FIL). Its function is to reduce production when it seems the milk isn’t needed. The amount of FIL is dependent on the amount of milk in the breast. So, when you give your baby a bottle your milk-making cells will respond by slowing down. And it is surprisingly easy to fall into this trap.

Imagine, if you will, that you are exclusively breastfeeding and visit your family doctor for a routine check-up. Your doctor recommends that you switch completely to formula feeding immediately. His rationale is that you deserve a break, and formula feeding would provide this by enabling others to feed the baby, and besides, you've breastfed long enough in his opinion. There is no medical justification for having a break but with modern formula being ‘so safe and advanced’ the doctor declares, you’d be foolish not to. Chances are you would refuse. A break would be lovely but it’s not worth surrendering your breastfeeding relationship over. Of course, a few mothers would do it with persuasion, heck, some would even do it without persuasion, but most would tell the doctor where to stick his formula.

Now suppose the doctor lures you along more gradually. Suppose he recommends a minuscule amount, say 2 ounces of formula per day, just to take the edge off your sole feeding responsibility. Two measly ounces can’t hurt and you really could do with an extra 10 minutes to blow dry your hair every morning (plus, seeing your hubby tenderly nourishing your little one would be just soooooo keyyyyyute, a message brought to you by those oh so thoughtful formula companies). So you agree.

A few days later, the doctor tells you that as your baby is growing steadily she needs 4 ounces of formula per day to maintain her steady weight gain. Again, he argues that this is such a small and harmless amount. You’ve already given your baby 2 ounces each day and she’s fine. You see no reason why you shouldn’t give her 4 ounces. Then, you say to yourself, 5 ounces isn’t that much more than 4, and for that amount I could even have a shower in peace. A few days later, the doctor informs you that he is thrilled with your baby’s weight gain and instructs you to increase the feed to 6 ounces.

Where do you draw the line? When do you decide enough is enough? Will you keep going to a full bottle a day, two bottles, or even beyond that to complete formula feeding? When mothers are asked in advance how far they imagine they would go, almost no one would say they would go to complete formula feeding. But when they are actually in the situation, the vast majority of mothers go all the way, ditching the breast forever. In my book, aptly titled, 'Breast Intentions', I explore how women turn to formula to satisfy internal intentions even moreso than external pressures. If you glance back at the doctor scenario above, you can see how mothers' expectations and beliefs about what formula will do for them influences the rewards and behaviors associated with its use - thus giving formula an addictive potential. Mothers opt into formula feeding and thus opt out of breastfeeding by justifying each step as they go along. 2 ounces won’t harm; 4 isn’t much worse than 2; if I’ve given 4, why not 6? As they justify each step, they commit themselves further to formula. By the time they are administering a bottle or two, most mothers find it difficult to justify a sudden decision to surrender the bottle.

The easiest time to quit formula is before you start

It’s easy for a mother to tell herself that she’s not going to make a habit of using formula. But the easiest time to quit any bad habit is before you start. If you can’t give up the first ounce, you’ll never have it so easy again. Mothers who resist early on, questioning the validity of the doctor’s recommendation, are much less likely to become entrapped (Tavris and Aronson 2007).

Look, I’m telling you this because I’ve learnt the hard way, not because I’m one of those infallible sorts who wouldn’t know a bad habit if it bitchslapped them in the face. I fell into the formula trap with my first child (story here) and clawed myself back out of it. I’ve spoken to countless mothers who dabbled with the bottle only to fight with nipple confusion, diminished supply and the health issues inherent with formula use. And every time, every fricken time people!, they wished they’d never picked up that darn bottle in the first place.

Not all mothers are able to claw themselves out of the formula trap. Through a chain reaction of behaviour and subsequent self-justification they find themselves at a markedly different infant feeding destination to their original aspirations. This is what leads to the dramatic feelings of guilt and despair which choke their mothering experience. In one study for example, the most common reason for weaning at any age was a "perceived lack of supply". But it was revealed that these early weaners consistently introduced supplemental feedings in the first 2 weeks, whereas those mothers still nursing at 6 weeks gave no supplements at all. If that isn’t enough to convince you to step away from the bottle, I will leave you with some statistical truths:

  • “The highest level of breastfeeding problems is experienced by mothers using a combination of breast and formula feeding” (National Childbirth Trust).

  • “Infants still breastfeeding at 4 or 9 weeks were far more likely to have been unsupplemented than those no longer being breastfed” (Journal of Paediatrics).

  • “Supplementing with formula before 2 weeks is significantly likely to lead to termination of breastfeeding by 8 weeks” (Journal of Paediatrics).

  • “At four to six months most mothers who had given their baby milk other than breastmilk were mainly giving infant formula” (National Childbirth Trust).

  • “Mothers who supplement before 3 months are significantly more likely to discontinue breastfeeding before the first 12 months” (Journal of Public Health and Nutrition).

  • “Mothers who believed that the baby prefers formula were more likely to stop breastfeeding within the first 2 weeks postpartum” (Journal of Paediatrics).

  • “Combination feeding is associated with shorter overall breast-feeding duration” (Journal of Paediatrics).

  • “Use of supplementary formula has a negative influence on breastfeeding duration” (World Health Organization;Centers for Disease Control and Prevention).

  • “In infants given formula, as soon as regular formula feeds started, the breastfeeding frequency and suckling duration declined swiftly” (Journal of Paediatrics).

  • The list goes on...

In a nutshell: the trick of avoiding the formula trap is to be fully aware of it - recognize the potential habit before it has a chance to become established. That way you can take avoiding action, abstaining from buying formula “just in case” and staying clear of those who may attempt to sway you.

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Monday, 23 June 2014

First Facebook, Now Apple – Sexualizing Breastfeeding

Earlier this month, Mark Zuckerberg hoist his white boxers onto a pole and waved them in defeat. He, and his fratboy team at Facebook HQ, finally conceded that breastfeeding wasn’t sexual. Good. Glad we sorted that out lads.

Technology had, at last, given breastfeeding moms a high five. This was great timing, as I was about to launch a new breastfeeding cellphone app: an interactive version of The Timeline of a Breastfed Baby! A dynamic on-the-go breastfeeding resource for busy moms who needed accessible support at their fingertips. The dudes at Google swiftly approved the app for their Android market. Thanks guys. Next stop – Apple.

Now, Apple are notorious for being elitist pearl-clutching brand-guardians. Any company can create and submit an app to appear in their app store, but Apple has the ultimate say on which apps make it. The basics of the their vetting process boil down to a technical pre-application check of your binary, a review by an Apple employee along with revisions to the app if necessary, followed by acceptance or an appeal of a rejection, and the summons of a pound of flesh.

A lot of hoops to jump through, but, if I say so myself. I’m quite good at hoop jumping, so confidently, I submitted my app and waited. Apple's response?

Apple need to 'free the nipple' already.

Snootypants Apple - makers of ipads, iphones and iattutude problems - didn’t like the app. Turns out, they just don’t like boobs being associated with kids. Presumably, these guys would only know a breast if it poked them in the eye at a strip joint. In their rejection email, they linked to their resolution center with the following spiel:

3.6: Apps with app icons and screenshots that do not adhere to the 4+ age rating will be rejected

We found that your app icons, screenshots, and/or Application Description includes content that is not appropriate for all age groups, as required by the App Store Review Guidelines.


They included the following screenshot...

Brace yourself, the offensiveness will put your retina into shock:

Consider my wrists slapped. Back to the drawing board.

In an attempt to discover what would pull the bothersome wedgie from Apple's ass-crack I searched for other breastfeeding apps available via Apple. Here I noticed something piss-boilingly sad: most had a 12+ rating that warned of, and I quote, “Mild Sexual Content”. It appears, the boys at Apple don’t think anyone below the age of 12 can cope with viewing a nursing mother (yet strangely, I know plenty folk under the age of 1 that have no issue with it).

Well, Apple could swiffle on an ipod shuffle if they thought I was going to label my breastfeeding app as sexual. This would feed right into the warped perception of breasts as pornographic by default. So, instead, I chose the only other category that seemed remotely relevant: “Infrequent/Mild Medical/Treatment Information” which automatically lifted the age limit of my app to 12+. Hoop well and truly jumped, pole-vaulted and Zumba'd around.

I submitted my application again, and waited. And waited. And whatya’ know, this time Apple rejected the app again! They told me they were not happy that the images featured breastfeeding and that people would *OMFG* see them when they browsed the app store. So, let's recap: breatsfeeding images would be permitted ONLY if their viewing was restricted to people over 12 years old, and ONLY if they were inside the app and not darkening the app store shelves like porno on the top shelf of a dodgy service station. After all, some poor DFF or male widower could clamp their eyes on the flesh of a young woman nursing her child, and throw a wobbler. Seems the boys at Apple don’t think anyone above the age of 12 can cope with inadvertently viewing breastfeeding, and such people should be protected from this obscenity (a view only adopted in Technology-Land; for those of you living IRL, the law does not recognise a need for protection from breastfeeding, just, you know, FYI).

Back to the proverbial drawing board again.

Finally, I replaced the main menu with a different background, not showing breastfeeding. And finally, Apple begrudgingly placed the app in their app store, where it is now free to offend anybody, as long as they have two dollars and have been on the planet no shorter than 12 rotations around the sun:


Would this offend you?

The App details:

  1. The (Entire) Timeline of a Breastfeed Baby, PLUS:
  2. Stunning pro-breastfeeding images on every page.
  3. Notifications: I can send news, messages, and links directly to your phone. It’s like having your very own pocket Alpha Parent harassing you.
  4. The app is designed to work on cellphones and ipads. The blog is not. Thus the app is smoother and more effective to navigate.
  5. Has a direct one-click connection to The Alpha Parent facebook page, for all your bitching needs.
  6. Updated in line with the latest lactation research.
  7. Works on every device there is. So for Apple, it works on the iphone 3, 4, 5 and all ipads.
  8. Functions globally.
  9. Rock bottom cost to you: $1.99 in Apple or $2.00 in Google Play (I don’t believe in milking my Alpha mammas – that’s your babies’ domain!)

Not offended? Get your ass over here then! 

Want this bad boy for yourself? Support the app!

Monday, 16 June 2014

How Breastfeeding Changes Your Brain

‘Motherhood changes you forever’ - the cliché your own mother forewarned you. And she was right. Motherhood, and specifically breastfeeding - the most central physiological act of mothering during infancy, changes you because it literally alters your brain - structurally, functionally, and in many ways, irreversibly. I am about to explain how the act of nursing sets apart mothers who breastfeed from those who don’t – on a neurological scale.

Breastfeeding mothers and their babies are attuned to each other on a deep biological level. In fact, a breastfeeding mother and her baby are sometimes referred to as a ‘dyad’ – two individuals so closely linked they are considered one unit. Her body nourishes him; his feeding determines her milk production. Scientists call this ‘limbic regulation’. It’s a remarkable natural phenomenon whereby the mother is neurologically and chemically in sync with her baby, and her baby to her. Michael Merzenich, the San Francisco University brain plasticity expert, has described breastfeeding as a kind of temporary breakdown of identity for both mother and child that powerfully affects both their brains. “At that point, the baby and the mother are unified” (Merzenich 1994). Glassy eyed, who, me?

New Pathways

When you breastfeed, you are relating to this little person in a way you have never related to anyone else in your life. The process of a baby suckling at the breast actually forges new neurochemical pathways in the mother’s brain that create and reinforce maternal behaviour. This process is aided by chemical imprinting and huge increases in oxytocin. These changes result in a motivated, highly attentive, and aggressively protective brain that compels the breastfeeding mother to alter her responses and priorities in life (Hahn-Holbrook 2011). This hormonal cascade makes mom want to respond to her baby and helps her to interpret his needs effectively (Rapley and Murkett 2012).

When a mother nurses, not only do her blood oxytocin levels increase, but her body makes more receptors, permanently increasing her feelings of love - and her ability to feel loved. Mom's sensitivity to oxytocin’s power is one of the most fundamental ways she changes as a new mother. In humans, we have oxytocin receptors snuggled within our breast tissue. As Sweden’s Karolinska Institute, Kerstin Uvnas-Mobery, the global authority on oxytocin, found in a series of experiments, breastfeeding women tend to be less reactive to stress hormones, less physically tense, less suspicious, and less bored. They are also calmer and more sociable when tested for these traits than mothers of comparable ages who are not breastfeeding (Uvnäs-Moberg & Petersson 2005).

But the accolades don't stop there! In another study, this time conducted by Margaret Altemus, a psychology professor at Cornell University, 10 lactating and 10 non-lactating women were stressed by being forced to engage in one of my favourite past times – pounding a treadmill for no particular reason. The research team found the lactating women released only HALF the amount of stress hormones, compared to those not nursing (Altemus 2010). Other studies back this up. It appears that oxytocin not only lowers blood pressure but also inhibits the release of the stress hormone glucocorticoid. Glucocorticoids are one reason why prolonged stress can damage the hippocampus. Meanwhile, prolactin, dubbed ‘the parenting hormone’, dampens fear and anxiety by inhibiting the amygdala (the part of the brain responsible for fear responses) (Kirsch 2005). Zen! The two hormones are elevated each time baby suckles at the breast reaching blood levels of eight times the norm (Ellison 2006). In other words: breastfeeding moms’ antistress systems are frequently activated and they are buffered. Oxytocin is Mother Nature’s weapon against stress, an innate mechanism that mammal mothers enjoy so that stress doesn’t interfere – and least not too much – with mental function. As Stanford biologist Robert Sapolsky, an international expert in stress (would you want his job?) has remarked: “Somehow mammals have worked this out, because cognition is a good thing to have when you have small dependents” (Sapolsky 2014).

Breastfeeding mothers respond to stress less with the banal ‘fight-or-flight’ model (commonly seen in men) and more with an alternative one that has been named ‘tend-and-befriend’ - with friendliness rather than anger. This ‘female model of the stress response’ is again, thanks to lactation’s triggering of oxytocin (Taylor 2000; McCarthy 1995). Throughout most of human history, women have had to watch out not just for themselves but for the sprogs they most likely had in tow. Their bodies knew they had little people to care for purely because of the signals produced through sustained lactation. A consequence of this biology is that each gender has evolved differently in the matter of psychological responses to stress. Formula feeding mothers respond to stress like men, in a more ‘fight or flight’ manner, due to their low exposure to oxytocin relative to lactating mothers. This in part explains why breastfeeding mothers are significantly less likely to abuse their babies (Strathearn 2009; On this touchy topic, see also: 'Why the Way You Feed Your Baby is MY Business').

Dr Kerstin Uvnas-Moberg, a world authority on oxytocin, has studied the changes between these two defence mechanisms, where she refers to the 'tend and befriend' approach as 'calm and connection'. In her book 'The Oxytocin Factor' she compiled two striking lists:

For breastfeeding moms, it's an upward spiral. The longer and more often their baby suckles, the more it triggers the prolactin-oxytocin response in the mother’s brain, forging more connections. Pretty soon, the mother forges enough receptors that she can feel her breasts tingling and leaking at the sight, sound, or merely passing thought of nursing her baby. As one Warwick University study discovered:

“Breastfeeding causes a massive increase in communication between the neurons, co-ordinating a ‘swarm’ of oxytocin factories producing intense bursts of the hormone”. To illustrate, take a gander at the virtuous circle depicted in the diagram below:

When a baby grasps its mother’s breast with tiny hands and sucks on her areola, it triggers explosive bursts of oxytocin and prolactin, prompting bursts of dopamine, in the mother’s brain. Prolactin is detected by a sensitive area on each milk-making cell and has the effect of priming them, or switching them on. Breast milk then begins to flow. These ‘receptors’ are much, MUCH stronger in lactating mammals than non-lactating mammals (Tzanou et al 2007). When these receptors are stimulated they make the mother want to protect her baby and hold him close.

These hormonal interactions create the notorious ‘breastfeeding bond’, switching off negative emotions and switching on pleasure circuits that produce feelings of exhilaration and attachment (Domes et al 2007; Hurlemann et al 2010). The hormonal exchange works as follows: The nursing response of the oxytoxin circuits is reinforced by the feeling of pleasure created by bursts of dopamine - the pleasure and reward chemical. Dopamine is jacked up in the mother’s brain by estrogen and oxytocin. The mother’s blood pressure drops, she feels peaceful and relaxed, and she basks in waves of oxytocin-inspired loving feelings for her baby. This neurological mechanism explains one of the ways that breastfeeding reduces the risk of a mom developing postpartum depression (Figueiredo et al 2013;  Figueiredo et al b 2013; Hahn-Holbrook et al 2013). Think of it like walking through a forest the same way again and again, each time making a clearer trail – this is what’s happening in mom’s brain. Circuits that activate as she breastfeeds, become stronger and respond more readily.

More Powerful Than Cocaine

Let’s explore this feel-good mechanism in even more detail. In one study, mother rats were given the opportunity to press a bar and get a squirt of cocaine or press a bar and get a rat pup to suck their nipples. Which do you think they preferred? Those oxytocin squirts in the brain outscored a snort of cocaine every time.

To give you another example of oxytocin's potency, male prairie voles given a shot of the stuff are converted from roving-eyed bachelors into nurturing husbands and fathers (Ellison 2006).

Enhanced Empathy

In one Yale University study, a team of researchers examined new mothers – half who were breastfeeding, and half who were formula feeding. Two to four weeks after giving birth, the mothers had their brains scanned using a swanky ‘functional magnetic resonance’ (fMRI) machine while they listened to recordings of their babies' cries. Why their cries? I can think of better stuff to put on my ipod. Why not their cute baby gurgles? Or their babbles? Well, the focus on crying was strategic: as I have discussed elsewhere, responding promptly and lovingly to a baby’s cry is an important part of helping that baby develop trust, a feeling of safety, of worthiness, and of mental well-being. The results of this Yale experiment revealed that the brains of the breastfeeding mothers showed a significantly stronger response to the sound of their babies' cries than did the brains of the formula feeding mothers. Greater activity was revealed in several brain regions, including the superior frontal gyrus, striatum and amygdala. The researchers hypothesised that high activity in these regions contributes to breastfeeding mothers’ ability to understand how their babies are feeling and respond in an appropriate way (Kim et al 2011). In other words: breastfeeding mothers are more attentive than their formula feeding peers. Mammaries: 1. Man-Made Powder: 0. 

The amazing hormonal cascade induced by lactation doesn’t end there. Lactation also facilitates learning and memory specifically for social information. Breastfeeding mothers show improved memory for human faces, in particular happy faces (Rimmele et al 2009; Guastella 2008). They also show improved recognition for positive social cues (Unkelbach 2008; Marsh 2010) and improved recognition of fear in others (Shofty 2010).

Not breastfeeding stunts
maternal brain circuits
To examine how important this process is, let’s take a look at rats again. Female rats inhibited from producing oxytocin after giving birth do not exhibit typical maternal behaviour (Van-Leengoed 1987). They show a marked delay, and in some instances avoidance, of pup carrying, pup manipulation, nest building, autogrooming, and time spent on the nest with the pups. At the end of 1 hour, two out of the six mothers had not yet picked up a single infant. Consider that human mothers who formula feed are literally inhibiting their oxytocin production, lack of lactation is literally stunting their maternal brain circuits. Contrast this with mothers who breastfeed, they have been found to exhibit more behaviors that create a close relationship to their baby, such as singing a special song to them, bathing and feeding them in a special way, or thinking about them more (Odent 2011). Quite simply, the more oxytocin you have, the more loving and attentive you are to your baby. The reserve is equally true.

The breastfeeding mother has a brain that is literally marinating in oxytocin and dopamine making her feel loved, deeply bonded, and physically and emotionally satisfied. Just check out the smorgasboard of other psychological and physiological changes that oxytocin brings about in breastfeeding moms:

Enhanced Smarts

In the same way that lactation gives breastfeeding mothers the edge over formula feeding mothers on the attentiveness front, it also makes them smarter than their bottle wielding peers. By ‘smart’ I’m not talking about Hawkingesc quantum physics – nope - the smarts of a breastfeeding mother mean much more than that. I’m talking about the kinds of smarts that translate into enhanced perception, efficiency, resiliency, motivation and social skills. This is a topic I explore in depth in my book when I speak of breastfeeding mothers as ‘positive deviants’. Breastfeeding is nature’s academic plan for mothers. Harvard psychiatrist Dr John Ratey explains: 

“When a mother gives birth, you want her to be really smart, as smart as she can be. You want her to know about the territory around her and remember things about her kids, and be in a prime state to function” (Ratey 2003).

When Dr Ratey examined the brains of mothers in late pregnancy, he found that their normal rate of cell replacement had slowed down and brain size had shrank - an event which may explain the oh-so-dopey ‘mommy brain’ fog of the third trimester. However, once mom has given birth and breastfeeding begins, cell replacement resumes and increases. Compared to those not breastfeeding, Dr Ratey found that lactating moms had more glial cells, which support the neurons by importing energy and exporting waste products.

Let me give you an example of these cells in action: breastfeeding mothers are more sensitive to the sounds of their own babies, and more skilled in interpreting what they mean. A breastfeeding mom’s pricked-up ears (as discussed in that crying experiment we spoke of earlier) make her more perceptive and aware – in a word, smarter – about her child. This perceptional ability becomes part of her general feeling of extraordinary attachment to this new being. Strong attachment itself can help make her smarter about the rest of the world, in part by keeping her brain elevated.

Then there's the sensory aspect: a mother’s skin as she nurses her baby, is her most direct and loving means of communication, just as her suckling baby talks back with lips and hands, egging her on, before he knows a single word. Katherine Ellison, author of The Mommy Brain has extensively researched this area. She has noted that:

“Studies on animals strongly suggest that breastfeeding re-plots the map of the brain. When my baby son lay on my chest, he had direct impact on my sensory hormunculus. With repeated input from suckling and nestling, my chest, which used to be a purely aesthetic part of my personal repertoire, had acquired a leading role in the nurturing of another human being – and also in the way I was imagining myself, interpreting the world, and learning to behave”.

A decade ago, two neuroscientists, Judith Stern at Rutgers University and Michael Merzenich at the University of California, provided stunning evidence of this impact when they showed that in the cortex of a mother rat, the area devoted to the trunk, or chest, had actually doubled in size while that rat was breastfeeding. Both Stern and Merzenich have little doubt that the same kind of thing happens in humans:

“It is probable that human lactation results in substantial representational remodeling in most or all of more than 10 different somatosensory representational areas, as well as in a number of motor and 
premotor zones” (Stern and Merzenich 1994).

The brains of breastfeeding mothers are buffered against stress.
Another boffin known for his scientific brilliance, anatomist Vincenzo Malacarne, has noted that breastfeeding is an especially powerful cognitive experience because it involves, in his words, “learning under high stakes conditions, which is just the sort of learning that drives changes in the brain”. In his work he discovered how lactation increases synapses in the part of the brain’s cortex that deals with attention and complex tasks. This however, he did not find surprising: “In breastfeeding, you are relating to another person like you never related to anyone before. In a sense, you are one person, and it’s pretty educational to have another human being extending into the makeup of your own self” (Ellison 2006). Indeed, breastfeeding forces moms to use certain talents up-close, constantly and repetitively. And, unlike the mental challenges of studying or working at a job, it’s much harder to check out for any length of time when you’re on the spot for nourishing. Add to this the fact that breastfeeding reduces stress via oxytocin, and opportunities for learning are improved even further. Have you ever tried to learn something new when you're under stress? Breastfeeding strikes the perfect balance between keeping mom alert and yet also relaxed - an equalibrium which improves her overall comprehension skills.

Enhanced Efficiency

Does breastfeeding make a woman a more efficient mother? Formula apologetics would unsurprisingly argue – no. However suppose we did an experiment. Perhaps this experiment could involve depriving families of food and then watching to see which mothers were most efficient at obtaining it. Who would come up trumps, breastfeeders or formula feeders? This would, of course, be highly unethical, and so the hypothesis can never be tested on humans, but other mammals – bring it on. And that’s exactly what psychologist Dr Craig Kinsley did with our friends, the rats. He looked at the behaviour of age-matched rat moms, comparing those who were lactating and those who were not.  The rats were temporarily deprived of food and then given crickets. In order to feed, the rats had to capture and kill the crickets whilst Kinsley’s team observed.

In the animal world, a heightened ability to capture prey means a decreased amount of time the mother spends away from vulnerable offspring and this decreased window of vulnerability means a lower infant mortality rate. The results of Kinsley’s study showed that lactation gives mothers the edge, with the non-lactating rats taking around 290 seconds to catch the crickets, whilst the lactating group only took about 70 seconds. Speaking of his findings, Kinsley commented: “The lactating brain expresses a great deal of plasticity and creativity in service to, and in support of, reproduction. In other words, mothers are not born, they are made through breastfeeding” (Kinsley and Lambert 2006). And what’s more, the breastfeeding rats’ gains in learning and memory were lasting up to twenty-four months, a full eighteen months past their last litter, and the equivalent of about 80 years of age for a human! 80 years, people!

Another research team, this time from Okayama University in Japan, found more evidence to support the existence of permanent change. They discovered something called ‘long-lasting, long-term potentiation’, known as L-LTP, in the hippocampi part of the brain of lactating mammals. L-LTP is a psychological marker of long-term memory foundation, involving an actual increase in the efficiency of synapses – i.e. the structure that permits a neuron to pass a signal to another cell (Tomizawa et al 2003). Essentially: the changes to a mother’s brain do not subside once mom stops breastfeeding. Scientists have good evidence to believe that permanent changes occur. They base this partly on research showing that humans and other mammals respond more readily, and emotionally, to their second baby than to their first. This is much more than a matter of knowing what to expect: the differences appear to become hard-wired, even influencing mothers’ milk flow, which is generally freer second time around (Ellison 2006).

In short, breastfeeding mothers are more present, focused, and organized – changes which last for the entirety of a woman’s mothering AND grandmothering journey. Just as nursing rat mothers build a nest, protect their young from danger, and keep them clean, so nursing human mothers perform in comparable ways - and keep on performing. 

Adoptive mothers and formulas feeders can also lap up these benefits. How? Well, it's not easy. When virgin rats are injected with breastfeeding hormones (doing this to humans would be deemed 'unethical' so here we have the rats again), they go from their usual behaviour of rejecting rat pups, to nurturing them (Moberg 2011). Adoptive human mothers can induce lactation to produce the same effect. Formula feeders can relactate.

Wow. You've just sat through a neuroscience lecture. That's a lot of learning, and being a badass breastfeeder, you probably soaked it all up. Let's sum up this post: Breastfeeding is so much more than nutrition – it changes the architecture of the brain. The way neurons in a woman’s brain are restructured in response to lactation enables her to respond to her baby with a richer and more enhanced behavioural repertoire. In the blood, lactation hormones govern milk ejection, while in the brain they affect behaviour. And these changes are the most profound and permanent of a woman's life. Mother Nature knows her stuff.

Now, of course, since breastfeeding is the biological norm for humans, an accurate conclusion from the science is not "Breastfeeding makes mothers more empathic, more intelligent and more efficient" but rather: "Formula feeding makes mothers less empathic, less intelligent, and less efficient". Oh dear, sirens are going off at Formula Feeder HQ...

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