Why is it so hard for mot­hers to breast­feed in Ca­na­da? ...

Mem­bers of the pu­blic can help by sup­por­ting wo­men’s right to breast­feed in pu­blic and de­man­ding baby-friendly stan­dards in health-ca­re set­tings

La Jornada (Canada) - - PORTADA -

An Ice­lan­dic MP breast­fed her baby whi­le de­li­ve­ring a speech in par­lia­ment re­cently. No one reac­ted to her breast­fee­ding, be­cau­se in Ice­land, breast­fee­ding is the cul­tu­ral norm. The mot­her sta­ted this was the most na­tu­ral thing in the world.

If only that we­re the ca­se in Ca­na­da.

Ac­cor­ding to Sta­tis­tics Ca­na­da, whi­le Ca­na­da has ma­de sig­ni­fi­cant stri­des to­ward breast­fee­ding as a cul­tu­ral norm - 89 per cent of wo­men initia­ted breast­fee­ding in 2012, com­pa­red to 69 per cent in 1982 - we still ha­ve a long way to go.

Why is breast fee­ding so im­por­tant?

Overw­hel­ming evi­den­ce shows breast­fee­ding is good for ba­bies’ brains and for so­cial de­ve­lop­ment. Breast­fed ba­bies are thought to th­ri­ve be­cau­se of the health qua­li­ties of breast­milk in com­bi­na­tion with the healthy re­la­tions­hips pro­mo­ted by clo­se con­tact bet­ween mom and baby.

Breast­fee­ding is al­so con­ve­nient - just ask any breast­fee­ding mom. Breast milk is al­ways avai­la­ble, the right tem­pe­ra­tu­re, clean and per­fectly ti­med to an in­fant’s fee­ding needs, as the baby grows and even over the cour­se of a sin­gle fee­ding. It’s al­so free.

What could be mo­re na­tu­ral?

The­re are al­so risks for not breast­fee­ding - for mot­hers and ba­bies. Mot­hers who don’t breast­feed ha­ve an in­crea­sed risk of car­dio­vas­cu­lar di­sea­se, ty­pe 2 dia­be­tes, breast and ova­rian can­cers, and de­la­yed re­turn to healthy weight. In­fants who are not breast­fed ha­ve a hig­her risk of sud­den in­fant death syn­dro­me, com­mon child­hood ill­nes­ses, child­hood obe­sity, can­cer and dia­be­tes.

So what’s the ba­rrier?

In coun­tries li­ke Ice­land, peo­ple grow up seeing breast­fee­ding in pu­blic. By con­trast, in Ca­na­da baby for­mu­la as an al­ter­na­ti­ve to breast milk is pro­mo­ted wi­dely to pa­rents in many ways: th­rough free sam­ples and coupons, th­rough dis­gui­sed “edu­ca­tio­nal” ma­te­rials on baby fee­ding with an emp­ha­sis on for­mu­la, and show­ca­sed in pa­ren­ting books and ma­ga­zi­nes.

The Ca­na­dian health-ca­re sys­tem con­tri­bu­tes to a for­mu­la fee­ding cul­tu­re when so­me hos­pi­tals and ot­her health fa­ci­li­ties con­tract with for­mu­la com­pa­nies, who­se pro­duct is then pro­mo­ted in the ins­ti­tu­tion, thus pro­vi­ding cre­di­bi­lity. Evi­den­ce shows that mot­hers are mo­re li­kely to initia­te breast­fee­ding and breast­feed lon­ger when their baby is not of­fe­red or sup­ple­men­ted with for­mu­la in the hos­pi­tal un­less me­di­cally in­di­ca­ted.

With such an emp­ha­sis on for­mu­la, it’s dif­fi­cult for breast­fee­ding to be­co­me the cul­tu­ral norm in Ca­na­da - or for fa­mi­lies to ma­ke an in­for­med de­ci­sion about fee­ding ba­bies, free from com­mer­cial in­fluen­ce.

Not sur­pri­singly, even amongst tho­se who de­ci­de to breast­feed, da­ta from the Al­ber­ta Preg­nancy Out­co­mes and Nu­tri­tion study sho­wed that only 54 per cent of mot­hers are ex­clu­si­vely breast­fee­ding by the ti­me their ba­bies are th­ree months of age and only 15 per cent by six months of age.

The­re is a way that our si­tua­tion can be tur­ned around. Ca­na­dian hos­pi­tals should adopt the World Health’s Or­ga­ni­za­tion’s Baby-Friendly Ini­tia­ti­ve (BFI). Hos­pi­tals must ta­ke 10 steps to achie­ve BFI stan­ding.

One of the steps re­qui­res hos­pi­tals to re­ject con­tracts for free or re­du­ced cost for­mu­la, and they are not per­mit­ted to mar­ket for­mu­la to their pa­tients. In BFI hos­pi­tals, for­mu­la is only used if me­di­cally in­di­ca­ted and, when gi­ven, the for­mu­la la­bel is re­mo­ved. A few Ca­na­dian hos­pi­tals (about fi­ve per cent) ha­ve achie­ved BFI de­sig­na­tion.

Of cour­se, not all moms are able to breast­feed, or choo­se not to. All the mo­re reason to sup­port all mot­hers in fin­ding the best way to nou­rish their baby. We can do this by pro­vi­ding sup­port for wo­men who want to breast­feed and are strug­gling, as well as pro­mo­ting healthy al­ter­na­ti­ves.

Pre­na­tal edu­ca­tion should in­clu­de in­for­ma­tion on how to ac­cess lac­ta­tion con­sul­tants - ex­perts trai­ned in the art of breast­fee­ding - as well as breast­fee­ding sup­port call cen­tres and healthy al­ter­na­ti­ves to breast milk. In se­ve­ral lo­ca­tions across Ca­na­da, La Le­che Lea­gue pro­vi­des a free mot­her-to-mot­her sup­port call li­ne.

Pro­mo­ting a breast­fee­ding cul­tu­re should not be seen as an af­front to wo­men who, for wha­te­ver reason, choo­se to for­mu­la feed their ba­bies. We li­ve in a so­ciety whe­re mul­ti­ple ap­proa­ches are res­pec­ted. BFI doesn’t ad­vo­ca­te one si­ze fits all. Rat­her, it ad­vo­ca­tes pro­mo­ting the best evi­den­ce so ever­yo­ne can ma­ke the most in­for­med de­ci­sions about baby fee­ding.

As fun­ders, pro­vin­cial go­vern­ments should di­rect hos­pi­tals and ot­her health fa­ci­li­ties to ta­ke con­cre­te steps to crea­te a baby-friendly en­vi­ron­ment, which in­clu­des pro­mo­ting breast­fee­ding and cea­sing con­trac­tual arran­ge­ments that may pro­vi­de a mo­dest ad­van­ta­ge to the hos­pi­tal bud­get but di­sad­van­ta­ge ba­bies.

Mem­bers of the pu­blic can help by sup­por­ting wo­men’s right to breast­feed in pu­blic and lead the way to­wards de­man­ding baby-friendly stan­dards in health-ca­re set­tings. -TROYMEDIA

Nicole Le­tour­neau eau is an ex­pert ad­vi­ser with Evi­den­ceNet­work.ca ork.ca and the aut­hor of Scien­ti­fic Pa­ren­ting: ng: What Scien­ce Re­veals about Pa­ren­tal l In­fluen­ce. She is a pro­fes­sor in the Fa­cul­ties cul­ties of Nur­sing and Me­di­ci­ne. She al­sol­so holds the Nor­lien/Al­ber­ta Chil­dren’sn’s Hos­pi­tal Foun­da­tion Chair in Pa­rent-In­fant ent-In­fant Men­tal

Health at the Uni­ver­sity ver­sity of Cal­gary.

Mary Loug­heed is a cer­ti­fied Lac­ta­tion Con­sul­tant (IBCLC) with the BFI Re­search Group of the Cal­gar­yary Breast­fee­ding Mat­ters Group Foun­da­tion, and has wor­ked as an IBCLC for over 20 years.s. She is a board mem­ber of the Cal­gary Coun­se­llinglling Cen­tre, and a past board mem­ber of the he Cal­gary Uni­ted Way, the Cal­gary Wo­men’s n’s Emer­gency Cen­tre, and past mem­ber of f the Cal­gary Po­verty Re­duc­tion Coa­li­tion. n.

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