Thursday, July 16, 2020

What if we include the work of “Breastmilk Production” in the GDP?

Toddler son feeds me while I feed the baby. 

Recently I read an economic analysis report which argues that breastfeeding isn’t free and that work should be included in the GDP (gross domestic product). 

“What we measure reflects what we value and shapes what we do,” economists Nancy Folbre and Julie P. Smith wrote in the report. “International systems for measuring the economy have institutionalized the devaluing of women’s unpaid productive and reproductive work, distorting the allocation of resources, and entrenching gender inequality.” 

Thinking carefully about that, this argument actually makes a lot of sense to me! Of the nearly four million babies born in the United States every year, four out of five are breastfed at some point, according to the CDC.

Almost half babies consume nothing but breast milk for three months. One quarter consumes only breast milk for six months. Breast milk is a vital part of the nation’s infant food supply—and it isn’t free.

American Academy of Pediatrics recommends six months of exclusive breastfeeding. The work, according to an Australian research, would cost a mother an average of 17 to 20 hours a week, plenty of discomfort, and a lot of sleep. 

Yet unlike infant formula, breast milk production is not included in the GDP. Folbre and Smith believe it’s not a small omission, and the exclusion of breastfeeding from the GDP is part of a broader problem with international systems for measuring economic activity. It largely ignored the contributions of unpaid work historically undertaken by women and has real consequences. 

What is GDP, anyway? It is a primary measure of economy adopted after World War II in an effort to regulate the international monetary order. To this day, the GDP remains the dominant indicator used to assess a nation’s economic strength and the efficacy of its public policies. 

Folbre and Smith aren’t the first economists to point out that the framework underpinning the GDP formula leaves a lot out. For decades, feminist scholars such as former New Zealand member of Parliament Marilyn Waring have noted that as it being calculated, the GDP skewed our understanding of economic growth by failing to account for shifts between market activities—such as the creation of physical capital including factories, buildings and machines—and non-market ones— such as the creation of a human, an essential of economy.  

Waring explained in her book "If Women Counted" that because the child care provided by a stay-at-home parent, traditionally the mother, counts for nothing in our national accounts, the increase in the GDP that results if that care is outsourced and the mom returns to the “normal” labor force will be exaggerated. 

This kind of mismeasurement inevitably distorts policy making: If the government’s just looking at the market sector, they’re being misled about trends in the economy, and they’re going to make wrong decisions about what’s important and what’s worth investing.

This explains a lot why breastfeeding and other unpaid housework that the majority shouldered by women are not being valued as they should be. With decades of hard work of pioneering feminist scholars and advocates, now we finally have a little better understanding of child care’s role in the economy. As their successor, let’s keep up the good work and be hopeful that we could get some progress. 

**This post was originally published on San Diego County Breastfeeding Coalition's newsletter on July 15, 2020. Photo credit to the writer. 

Thursday, July 2, 2020

CDPH visitation guidelines now recommends two visitors at one time for NICU patients

Photo credit to Shutterstock.

The California Department of Public Health (CDPH) recently changed its visitor limitation guidance: it is now  recommended that two designated support persons can visit a NICU patient at the same time. Before this update, the guidance suggested only one visitor be allowed in the NICU.

It is a major win for California postpartum families. Recognizing and supporting the role of parents when a baby in NICU is a fairly recent phenomenon.

Since the early 1960s, dramatic improvement in the care of preterm infants and/or infants with certain medical conditions has taken place in NICU across our country.  Knowledge has advanced along with the technical equipment to care for these babies: incubators to help babies stay warm, oxygen delivery to help with respiratory distress, supplemental forms of intravenous intrusion to nourish them.

But the role of the parent was not an important topic before the 1970s. At that time, in most hospitals and nurseries, dads were often excluded and maternal-infant bonding was often not the priority. Strict visitation hours and policies were the norm and a sterile “do not touch” culture was routine. It wasn’t until the late 1980 that family-centered care expanded along with visitation policies and support groups.

Still, the one visitor at a time limitation gave an impression that not all parents were essential by forcing families to choose which parent could visit baby at any given time.  It also posed a huge burden for families by preventing parents—usually the mother, if she can go to the NICU—from having the benefit of a partner in the NICU with them. 

Having a baby in the NICU can be stressful for parents. Any parent with a baby in NICU can use all the support from the partner. This is especially true for a mom who wishes to breastfeed her baby in the NICU.

Breastmilk is the best for food for babies, and its antibodies is even better for babies in the NICU. When the baby is not ready to be breastfeed, a mom wishes to provide breastmilk has to pump her milk. Pumping on schedule is a lot of work itself. In the mean time, a partner can help the mom provide breast milk for the baby: Help get bottles ready, make sure the milk is stored correctly and take it to the hospital so it’s ready when the baby needs it.  
In addition to breastfeeding support, a partner can play important roles reassuring the mother and encouraging her to take care of herself.

We applaud the CDPH for making this update, which is in the best interest of the infanta and their families. The NICU has skilled staff and so much technology, but the baby has Mom and Dad.

**The post originally published on San Diego County Breastfeeding Coalition's newsletter on July 1, 2020.

Tuesday, June 16, 2020

WHO: Countries failed to implement the Code of Marketing of Infant Formula

The global COVID-19 pandemic highlights the importance of protecting breastfeeding—the optimal nutrition for infants—to improve child health and survival. “I am seeing way too many emails from formula reps to hospital administrators who are trying to use the pandemic to sidestep state, industry or Baby Friendly guidelines on their in-hospital marketing practices,” tweeted Kimberly Seals Allers, author of The Big Letdown. “No mention of what is being done to resolve supply chain issues.”

I’ve personally seen evidence of this kind of predator practice. Even before the pandemic, it is no secret that Nestlé and other infant formula companies have been offering doctors and health workers in some countries—like Philippines— free trips to lavish conferences, earning their loyalty.

Then in May, WHO and UNICEF launched the 2020 status report on the national implementation of the code of marketing of breastmilk substitutes, stating that formula manufacturers are exploiting the panic and fears of contagion to intensify their aggressive marketing practices.

WHO and UNICEF said that promotion of breastmilk substitutes is especially harming Pacific Islander families, stating that despite efforts to stop the harmful promotion of infant formula, only two countries in the region—Fiji and Paula—had strong laws and regulations to protect families from false claims about the safety and role of formula.

Again, I’ve personally seen how this kind of practice hurts PI families. Being born and raised and still writing for magazines in Taiwan, I received so many social media messages from the island calling moms to “make sure you stock up enough formula for babies” at the beginning of coronavirus outbreak. It is also reported many hospitals stopped the practice of rooming-in. On top of that, the editor from one of the magazines I’ve been working with told me “not to quote WHO about it encourages women to continue to breastfeed during the pandemic,” referring to the spat between Taiwanese authority and WHO back in March.

It is unfortunate. UNICEF and WHO strongly encourage women to continue to breastfeed even if they have confirmed or suspected COVID-19 based on science evidence: Breastfeeding reduces death from acute respiratory infection.

Here in America, we would imagine what’s happening in PI countries has nothing to do with us. The truth is, I’ve seen so many mothers in PI communities stop breastfeeding since the outbreak, especially those first generation moms who rely on information from home countries to make parenting decisions. Promoting and supporting breastfeeding is a work with no borders. Pandemic or not, now is the time to protect families from misleading information. 

**The post originally appeared on San Diego County Breastfeeding Coalition's Newsletter on June 15, 2020. Photo credit to Elisabeth Millay/BreastfeedLA.

Monday, June 1, 2020

From One New Mom to Another: Keep Calm and Breastfeed On

My first child was born right before Mother’s Day. I’ve always said that he is my Mother’s Day present. This year that “Mother’s Day present” turned seven years old. I took him to the pediatrician for his annual wellness check. At the door of the clinic, I saw a very little baby, probably two or three weeks old, crying just like…a baby. I saw the young parents taking turns to hold and try to calm the baby. I saw their faces. Due to the pandemic, the clinic set a rule that each child can only be accompanied by one adult. And it was obvious that neither one of them was confident to take the baby through the clinic door alone.

I remember when I was a new mom. Every time I had to take the baby out by myself, I felt like a Hobbit leaving the Shire to fight the Battle of Helm’s Deep. I imagine it must be even harder to become a new parent during a pandemic.

I imagine there are many new parents out there, trying to take their beloved babies through this difficult time. I imagine they worry, they plan, they smile for their babies, even when they are falling apart inside.

I remember when I decided to become a mother. It’s not difficult to love. It’s not difficult to dedicate to my baby—these are almost instinctive things. The difficulty was that from now on I had to become the one who “holds everything together" for the baby. To feed the baby. To shelter the baby. Take him to the doctor and later to the school. Be patient, be kind. Always protect, always hope. And never fail. From the day I became a mother, I became a pragmatic person, always ready to answer all needs. This is quite a skill, unfortunately I can't write it on my resume.

Now that the pandemic continues, we are told to stay at home. I imagine all the moms and dads sheltering in place at home with their babies, trying to do everything right while staying calm and optimistic.

But how can we do all of these? I became a mother for the first time in the year when the country was prosperous and the people were at peace. Still the small storms in my small home sometimes made me feel stressful. That was my longest and hardest year.

Yet amazingly, that was also my easiest and shortest year. Baby cry? Breastfeed. Baby hungry? Breastfeed. Baby sleepy? Breastfeed. Baby waking up? Breastfeed. And the days passed.

Finally, one day, I discovered that the baby does not need me to “holds everything together.” He just needs me to be honest and do my best. Me and my baby are not the one protect and the one being protected. We are a team. The baby loves me and is willing to help me. I raise him, he raises me, and then we grow together.

Parenting is absolutely difficult yet amazingly simple. Just keep calm and breastfeed on, good things will happen.

From one mother to another, you can do it, too!

**This post originally published on San Diego County Breastfeeding Coalition's Newsletter on June 1, 2020. Photo credit to Mu-huan Chiang. 

Monday, May 4, 2020

A Quick COVID-19 Guide for Pregnant and Breastfeeding Mothers

***Information on COVID-19 is rapidly evolving, and this guide could become outdated by the time you read it. For the most up to date information, please visit CDC information page at

COVID-19 is a new strain of coronavirus identified as the cause of an outbreak of respiratory illness. The investigation to determine more about this outbreak is still going on. However, UNICEF, CDC and AAP have provided guidance for pregnant and breastfeeding moms.

For Pregnant Women
According to CDC, we do not currently know if pregnant people have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result. However, we do know that pregnant people have changes in their bodies that may increase their risk of some infections. Pregnant people have had a higher risk of severe illness when infected with viral respiratory infections, such as influenza. Pregnant people should always protect themselves from COVID-19 as well as other illness.

CDC recommends pregnant women:
Avoid people who are sick or who have been exposed to the virus. Clean your hands often using soap and water or alcohol-based hand sanitizer. Clean and disinfect frequently touched surfaces daily.

CDC also points out that mother to-child transmission of coronavirus during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread. A very small number of babies have tested positive for the virus shortly after birth. However, it is unknown if these babies got the virus before birth. The virus has not been detected in amniotic fluid, breastmilk, or other maternal samples.

For Breastfeeding Mom
Considering the protection that breastmilk provides against many illness, UNICEF, CDC, AAP all encourage mothers breastfeed as much as they can in the midst of the pandemic.

What if the mom has COVID-19? So far, COVID-19 has not been detected in breast milk, so the organizations listed above say that mothers can continue breastfeeding while applying all the necessary precautions.

According to AAP, If an infected mother decides to breastfeed, she should wear a face mask and wash her hands. If the mother is separated from their infants, she should express breastmilk but should wash their hands thoroughly and disinfect the pump and bottles. Someone who is healthy should feed the child.

Arthur I. Eidelman, MD, Editor-in-Chief of Breastfeeding Medicine, stated in a research published in early March: “Given the reality that mothers infected with coronavirus have probably already colonized their nursing infant, continued breastfeeding has the potential of transmitting protective maternal antibodies to the infant via the breast milk. Thus, breastfeeding should be continued with the mother carefully practicing hand-washing and wearing a mask while nursing, to minimize additional viral exposure to the infant.”

**The post originally appeared on San Diego County Breastfeeding Coalition's Newsletter on May 1, 2020. Photo credit to Mu-huan Chiang.