Tuesday, October 16, 2018

Infant Feeding Inequities and How Does It Affect All of Us

My little one also have something to say.

This week I had the pleasure to serve as a panelist at BreastfeedLA’s 2018 summit. In a 90-minute panel, my fellow panelists explored how race, ethnicity, geographic location, place of birth and other factors have a direct correlation to breastfeeding.

Infant feeding inequities do exist and play a much bigger role in health equity than most of us would imagine. You only need to think about this: if you were born tomorrow in California, what are your chances of growing up healthy?

Let me tell you. You have a 22.8% chance to be born in a family living in poverty and a 0.6% chance to die before turning one year old. Breastfeeding is one of the most powerful tool to increase your chance to survive beyond one year old but it’s hard for your mother to breastfeed you.

For starters, breastfeeding can be physically difficult. Your mother may struggle with getting you to latch. She can be dealing with milk supply issues, sour nipples, or tongue tie. And because you’re in from a low-income family, your mother may not be able to afford a lactation consultant.

And also because you are from a low-income community, there is less education about breastfeeding, and hospital nurses are more likely to encourage low-income and/or black mothers to use formula. There is also a negative perception of breastfeeding in the colored community.

If your mother receives breastfeeding education from the hospital and is encouraged by the nurses to breastfeed, it’s still hard for her to breastfeed you after leaving the hospital. Because the lack of mandatory paid parental leave complicates the breastfeeding relationship. It’s likely that your mother can’t afford to take six weeks off after giving birth to you, but establishing a nursing relationship really requires round-the-clock nursing for the first few weeks.

Even if your mother manages to take six weeks off and establishes breastfeeding, it’s still hard for her to continue breastfeeding after return to work. It’s very likely she doesn’t have access to a clean place to pump at work. Although California law requires employers to provide accommodations for workers to pump, employers regularly break the law and fail to provide employees with a clean place to pump.

So even if your mother desperately wants to breastfeed, she might not be able to, for numerous reasons. The lack of social support and resources for low-income families or families from marginalized communities is a big one.

Breastfeeding is incredibly difficult for less-advantaged families. When we talk about which women are able to breastfeed and why, it’s important to note that there are a ton of societal issues at play. Breastfeeding is a privilege, while it really should be a right.

At the end of the panel discussion, the facilitator asked me what’s my one solution to increase the availability of lactation support in low-income and colored community. To answer that, I think everyone can contribute whatever one can. One thing I can do is continue writing to raise awareness on infant feeding inequities. What would you do? Please comment below.

*This post originally appeared on San Diego County Breastfeeding Coalition's Newsletter on Oct 15, 2018. Photo credit to Dawn Bower, IBCLC.

Thursday, October 4, 2018

Making a Point to Breastfeeding Openly

Breastfeeding while waiting for boarding in Ontario International Airport.
Earlier this month, when traveling to Taiwan for my new book tour, I saw an interesting poster in the breastfeeding room in Taoyuan International Airport. It said “Hold and Breastfeed your baby anytime, anywhere.”

To me, the poster basically said “you don’t need a breastfeeding room to breastfeed. You can breastfeed anywhere.”

The "Hold and breastfeed your baby anytime, anywhere" poster.
Well said. But still, during my 30 days in Taiwan, I didn’t see any nursing mom in public. There were breastfeeding rooms everywhere. They were in airports, shopping centers, government buildings, metro stations, even on the train. And there was often a line in front of the precious breastfeeding room. I once waited for 20 minutes for the breastfeeding room on a high speed rail train. While 20 minutes sounds acceptable, it felt like forever when you were holding a hungry, crying baby. I would totally breastfeed on my seat, if only the young gentleman sitting next to me seem to be not so uncomfortable.

Things are a little bit better back in America. We don’t have that many breastfeeding rooms, yet we have more breastfeeding moms in public. I think it’s a good thing.

My experience in Taiwan remind me how important exposure is when it comes to normalize breastfeeding. While we applaud the availability of nursing rooms for moms who feel most comfortable with some privacy, breastfeeding in public should be encouraged. In order for breastfeeding to be truly normalized, it must be seen and incorporated into daily life. Only the kids growing up in places where breastfeeding is openly practiced will internalize breastfeeding as being normal way to feed and nurture a baby.

Plus, we don’t want a society where people think the *only* place for breastfeeding is hidden away in a private room. Really, I don’t want to stand in line for 20 minutes again just for a breastfeeding room.

In a 2016 CDC survey of over 4,000 male and female adult respondents, 64% of people believe that women should have the right to breastfeed in public places. That number should be 100%. Luckily these attitudes are continuing to shift. Here, I want to invite all my fellow nursing mothers to make a point to breastfeed openly and support other nursing moms. For the moms who are not used to breastfeeding in public, let me provide a few tips for stress-free experience for you and your baby.

If you’re feeling anxious about breastfeeding in public, try practicing at home in front of a mirror so you can see what you look like while nursing. I promise that you’ll notice you’re not exposing as much of your breast as you imagined, because your baby’s head is covering it.

What you wear when breastfeeding in public makes a difference. Personally I found it’s worth it investing in a few items of nursing wear to make life easier. It’s not necessary to buy specific breastfeeding clothing—you can simply layer up two of your normal tops.

In one of my favorite nursing dresses.
Know your breastfeeding rights also helps. Read more about your legal rights in my previous post here. Happy openly breastfeeding!

*This is originally a post for San Diego County Breastfeeding Coalition's newsletter by To-wen Tseng. Photo Credit to Mu-huan Chiang.*

Thursday, August 16, 2018

What Happens in Baby’s First Hour, According to the Neuroscience of Birth

ZERO SEPARATION on screen and a packed room.

Birth, defined by Merriam-Webster Dictionary, is the emergence of a new individual from the body of its parent. It is a magical moment, when a mother and a baby first meet. After nine months of waiting, a new mother gets her first chance to hold her baby in her arms, to kiss the tiny forehead and nowadays, to snap a shot of the the newborn and post it on social media.

While everyone knows infants need to bond with their mothers early on, Dr. Nils Bergman told us that what happens during the first hour of a baby’s life can maximize that bonding experience between a mother and a child.

Calling himself a Public Health Physician, Dr. Bergman launched a mother-baby skin-to-skin revolution. He said at a recent SDCBC seminar, “Skin to skin unlocks the neuroscience.”

Raised in Zimbabwe, Dr. Bergman enjoys the wildlife in Africa, the layered, interconnecting jungle where everything functions in relation to everything else. Dr. Bergman told us, “The brain is a jungle, not a computer. There are more synapses at birth than stars in the universe.”

What happens in the first hour after birth matters to what goes on in the baby’s brain. Early experiences fire and wire the brain, activate the genetic inheritance, lay the foundation on which higher circuits will be built later on.

Early experience depends on the baby’s environment. The environment can tell a baby’s DNA,
“The world is safe. Eat, rest, grow, connect. Oxytocin flows through the circuitry.” 
“The world is not safe. Be on guard, vigilance is needed. Cortisol courses through circuits.” 
So what is the environment a human baby expects at birth?

Seminar attendees practice "skin-to-skin" with one another.

At the time when I was born, mother-child bonding took a back seat to medical procedures immediately following a baby’s birth. My mom watched me be handed to a nurse who examined and weighed me, cleaned me up, put on a diaper and swaddled me in a blanket. After all of that, my mom finally got to hold me. But she didn’t hold me for long before I was moved to the nursery. (Not I remember all of these, but according to my mom.)

When my son was born, health care providers already knew that skin-to-skin contact within the first hour is the best way for a newborn and mother to bond. My baby was placed in skin-to-skin contact with me after weighing and measuring. The medical caregiver and the nurses conducted the first physical assessment of him while he was on my chest. Bathing, injections and blood test waited until the first round of breastfeeding was established. We remained together throughout the recovery period.

Now, Dr. Bergman recommends “ZERO SEPARATION.”

Yes, zero separation! Weighing and measuring should also wait after the first feeding. Dr. Bergman told us, “In the nursery the baby is helpless. But when we leave the baby where nature intended, the baby is totally competent.”

Where the nature intended for the baby is the mother’s body. The case of zero separation simply reduces the toxic stress that disrupts brain architecture and leads to life-long consequence. “When a baby is on the mother’s body, everything makes sense.” Dr. Bergman said, “And raising a healthy baby is much easier than fixing a broken man.”

The youngest attendee of the seminar.

*This is an original post for San Diego County Breastfeeding Coalition's newsletter.

Thursday, August 2, 2018

Recognizing "the Foundation of Life" in Early Education

It is World Breastfeeding Week! The slogan of WBWeek 2018 is "Foundation of Life". And just recently, my 7-month-old and I had an exciting opportunity that reflects the #WBW2018 slogan: to participate in the production of a series of Breastfeeding-Friendly Child Care Training videos. The series of videos is to help train child care facilities on how to be breastfeeding friendly.

I was so grateful for this opportunity. As a nursing mother, I am not only open and willing to, but do consider it’s absolutely important to support this kind of projects. Because they recognize the value of normalizing breastfeeding for families who choose this first food for their babies and help removing barriers in different workplace arenas.

The project we participated in was part of the Breastfeeding-Friendly San Diego (BFSD) program. UC San Diego Center for Community Health, a partner of San Diego County Breastfeeding Coalition (SDCBC), produced four professionally filmed training videos on how childcare providers can support breastfeeding families.

So why should home care or day care center support breastfeeding?

  • Because breastfeeding helps kids by providing protection from infection, obesity and SIDS. 
  • Because breastfed babies are easier to care for. They are less prone to spitting up, are sick less often, and are less likely to have constipation or diarrhea. In addition, their diapers have less odor. 
  • Because breastfeeding helps the day care financially. Meals containing breastmilk are reimbursed by Child and Adult Care Food Program(CACFP)
  • Because Breastfeeding helps marketing the day care. The Breastfeeding Friendly recognition can be used in advertisements of the program. 
And what investments that childcare providers can make to become breastfeeding-friendly?

  • Created a breastfeeding-friendly environment where mothers are encouraged to breastfeed onsite, and where families and employees are provided a non-restroom space to breastfeed or pump. 
  • Provided individual or employee training to support breastfeeding such that all providers and employees are trained on breastfeeding-friendly practices that include: benefits of breastfeeding, handling/storing/feeding breast milk, creating a breastfeeding supportive environment, policy/procedure development and implementation, and parent engagement and support. 
  • Implemented proper storage, handling and feeding of breast milk by providing refrigerator and freezer space for storage of breast milk, instructing breastfeeding families on how to properly label and store breast milk, and creating individualized feeding plans for every infant under 18 months. 
  • Adopted written policies supporting breastfeeding families and employees by explicitly communicating support in written form for breastfeeding families and employees, and by giving breastfeeding employees the appropriate break time to breastfeed or pump. 
  • Offered breastfeeding resources for families and employees by sharing breastfeeding information from local and online resources. 
One thing I love about breastfeeding friendly day care is that they normalize breastfeeding in front of our youngest learners. It makes perfect sense that California Infant Feeding Guide encourages promotion of breastfeeding in the child care setting. This week, please join me and thank your child care center or family day care home if they've been supporting breastfeeding families.

Read more: Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs; 3rd Edition (2011) 

*This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. A slightly edited version was published on MomsRising.org. Photo credit to Melissa Cabral.

Tuesday, July 17, 2018

US Opposition to UN Breastfeeding Resolution Puts Profits Before Babies

My husband gives our 2-month-old a bottle of breastmilk when I'm at work.
 Our 4-year-old also gets a share of mama's milk.
Every time a baby goes to breast, the $70 billion baby food industry loses a sale.
The U.S. Delegation to the United Nations-affiliated World Health Assembly (WHA) undermined a global resolution aimed at supporting breastfeeding, threatening trade sanctions against Ecuador before yielding to a proposal put forth by Russia, reported by the New York Times.

The draft resolution was to reaffirm that breastfeeding is critical for child development and maternal health, to express concern over low rates of breastfeeding worldwide, and to call on WHO Member States to increase investment and implementation in breastfeeding policies, systems, and environmental supports.

According to the New York Times, the Resolution was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the WHA. But the U.S. delegation specifically called for the removal of passages that called on Member States to restrict the promotion of artificial infant milk. The strong opposition to the Resolution by the U.S. stunned world health officials.

My colleagues at San Diego County Breastfeeding Coalition (SDCBC) has joined breastfeeding organizations and advocates across the country and raised concerns about the role of industry in international policies and the aggressive tactics used by the U.S. delegation. We stand strongly for all families and fights for their well-being and believes that policies should always put babies before profits.

“SDCBC would be in agreement that the latest efforts to undermine the global resolution to promote, protect and support breastfeeding by U.S. Delegates at the World Health Alliance are unacceptable,” said Kim Speckhahn, the president of SDCBC. “The corporate interests should never supersede the protective benefits of breastfeeding for both mothers and infants.”

Breastfeeding is the nutritional standard for infant and young child feeding as recognized by scientific evidence and health organizations worldwide. Decades of research on infant feeding has consistently proved critical short- and long-term health risks of not breastfeeding, as well as significant costs of artificial milk feeding. Breastfeeding builds a foundation for life-long health and wellness for mothers, babies, and all of society. It is considered a global maternal and child health imperative. 

Countries should strive to limit the inaccurate or misleading marketing of breastmilk substitutes. It is critical that international, national, and state policies work to protect, promote, and support breastfeeding so that every family who chooses to breastfeed has the opportunity to succeed. It is unfortunate that in the U.S. and World wide, barriers to breastfeeding success are widespread.

The U.S. Breastfeeding Committee (USBC) is calling organizations to sign a letter and ask Department of Health and Human Services and Department of Commerce to support WHA Resolution on Infant and Child Feeding. Meanwhile, MomsRising is calling individuals to sign a petition and ask the formula companies to put the health and well-being of moms and babies above corporate profits.

It's always the right time to put babies before profits. Please join the movement and call upon our government to ensure that policy decisions and actions are based on current scientific evidence, free from industry influence, and carried out in accordance to global trade agreements and international law.

Read more: USBC Statement on WHA Resolution on Infant and and Young Child Feeding

*This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. A slightly edited version originally appeared on MomsRising.org.