This year’s National Breastfeeding Month (NBM) celebration has come to an end, but our momentum as maternal child health advocates– striving for equitable care for all– powers on.
The 2020 NBM theme, Many Voices United, called on us to come together to identify and implement the policy and system changes that are needed to ensure that all families have the support and resources they need in order to feed their babies healthily.
Achieving this shared goal requires daily self-work and individual introspection so that our collective can be as effective as ever. No matter how socially-conscious, open-minded, anti-racist, (insert adjective), we think we may be, we still have learned biases and prejudices that require near constant attention. Much like I remind my children to brush their teeth every morning and every night, as a white, binary woman, I must remind myself to examine my biases and my privilege daily.
With NBM’s theme of unity in mind, this Upworthy video features an art installation that demonstrates our society’s interconnectedness. With a piece of string, the installation shows an intricate, densely-woven web created by individuals wrapping thread around 32 poles with identifiers arranged in a circle.
“You can see that even though we all have different experiences and we all identify in different ways…We are really one,” the project’s creator says in the video.
The sentiment and the product are truly beautiful and fascinating. While appreciating the beauty of unity, it’s important to keep our critical thinking and progressive attitude sharp, refraining from slipping into too comfortable a space where change cannot happen.
Recently, I’ve seen a few statements on unity circulating social media that I’d like to embrace with a “Yes!” Instead, I find myself reacting, “Yes! But…”
My worry is that these well-intentioned mantras we live by– much like some might argue certain microaggressions are well-intentioned– are also dismissive.
We all bleed the same blood.
Children are not born racist.
I will teach my child to love your child. Period.
Let’s break those down starting with “We all bleed the same blood.” Some things to consider:
“Black breasts do not exist separate from Black bodies and the situated existence we navigate in this world northe racialized experience of motherhood. Racism and classism intertwine to act as a containment, working to make some of us feel as if we are walking in quicksand. Add to this the complexities of new motherhood and the needs of the postpartum body and now we have a cocktail for failure. Literal milk plugs. So, although her precious body may be able to produce milk, her situation prevents her and her baby from receiving it. Even the intention to breastfeed cannot save the milk of the mother who cannot find time for pump breaks as she works the night shift as a security guard. Or, perhaps she cannot figure out why pumping is not working, but she doesn’t have the time to seek the educational or financial resources to help her problem solve.” (underline added by OMW)
Racism affects People of Color (POC) at a cellular level. Studies show that the experience of racial discrimination accelerates the shortening of telomeres (the repetitive sequences of DNA at the ends of chromosomes that protect the cell) and ultimately contributes to an increase in people’s risks of developing diseases.
What’s more, Black children are three times more likely to die when cared for by white doctors, while the mortality rate for white babies is largely unaffected by the doctor’s race, a recent study found.
White children are born into being part of the problem and just the same, can be part of equitable solutions.
I will teach my child to love your child. Period.
Love is action, and even if it’s easier said than done, there are so many ways to teach our children about race, inequities and injustice. Afterall, “If Black children are ‘old enough’ to experience racism then white children are ‘old enough’ to learn about it.” – Blair Amadeus Imani
Be careful what you say. As a young girl on my way to ballet class one day, my mom, while locking the car doors, pointed out the barred doors and boarded windows in the neighborhood we rolled through.
“That’s how you know this is not a safe neighborhood,” my mom warned me.
No questions asked, I noted the building facades, and then I noted the Black people. Because there wasn’t any further conversation, I made the connection that Black people must be “not safe” and ultimately, that there must be something wrong with Black people if they’re confined to neighborhoods “like this.”
As a nation we are apathetic, made apparent by a recent poll. The survey shows that only 30 percent of white people have taken concrete action to better understand racial issues after George Floyd’s killing.
The poll also shows that White Americans are also the least likely to support the Black Lives Matter movement, with 47 percent expressing support.
Is it because we don’t claim it as our problem? Is it because we misunderstand the problem? Is it because it’s easier to point fingers at others than ourselves?
I’d like to leave you with this video of writer Kimberly Jones where she provides a brief history of the American economy told through an analogy using the board game Monopoly. I urge you to watch it, and then watch it again, and again, and again.
There is no time for complacency within these truly abhorrent systems. When we start to lose sight of that, envision the tangle of yarn from the aforementioned unity art installation and remember that vastly different experiences are networked together.
Inform people about the links between breastfeeding and the environment/climate change
Anchor breastfeeding as a climate-smart decision
Engage people and organizations for greater impact
Galvanize action on improving the health of the planet and people through breastfeeding
Can breastfeeding really affect climate change and create a cleaner, healthier environment?
Our planet’s health is closely tied to human health, and so there is a growing interest in learning how to protect the health of the environment.
Among the many things humans can do to protect the environment, breastfeeding is one of the most important. Breastfeeding is the best example of a clean, eco-friendly action to protect and improve the health of planet Earth.
Breastfeeding is the ultimate natural, sustainable resource. It requires no raw materials needed for processing and no energy consumption in production or transportation. It does not produce any material waste or by-products, does not require any packaging materials, water resources or electricity, and creates no pollution of the air or water. Lactation is a perfect partner for environmental health and the ultimate example of “eating local”.
Parents who express their milk and feed from bottles or other methods also provide a more planet-friendly feeding method than artificial feeding. Formula manufacturing requires energy, material and transportation.
The carbon footprint of breastfeeding gives us another glimpse into the environmental impact of breastfeeding. Wikipedia defines carbon footprint as “the total greenhouse gas emissions caused by an individual, event, organization, service, or product, expressed as carbon dioxide equivalent.” In simple terms, it’s a measurement that shows us something’s impact on the health of the environment.
The carbon footprint of breastfeeding is based on the production and transportation of food for the mother based on the RDA of an additional 500 kcal/day recommended during breastfeeding. According to research from the United Kingdom, the carbon footprint of breastfeeding is estimated at 5.9 (this varies between countries).
In comparison, the carbon footprint of formula feeding— which is based on the use of resources, animal and factory production emissions and transportation of the formula as well as supplies, preparation and storage of formula at home— is estimated at 11.0 (again varying between countries). On average, feeding breast milk substitutes had a higher impact on the climate than breastfeeding in all countries studied. This certainly demonstrates the positive impact on the environment when the infant feeding choice is breastfeeding.(Bodkin, 2019 Meade, 2008)
The International Baby Food Action Network (IBFAN) supports optimal infant feeding practices and advocates for universal implementation of the International Code of Marketing of Breastmilk Substitutes, an international health strategy recommending restrictions on the marketing of all formulas and supplies intended to discourage breastfeeding. In 2015 IBFAN developed their statement on breastfeeding and the environment:
“Breastfeeding protects our health and our planet – right from the start, breastfeeding is the first step towards protecting human health, short- and long-term. It is also the first step towards protecting the health of our environment and conserving our planet’s scarce natural resources. We need to start at the beginning, with infants and young children. Our babies and children are in no way responsible for climate change and environmental degradation, but instead they suffer the disastrous consequences.” (IBFAN, 2015)
It’s clear that breastfeeding is the most climate-friendly option for infant feeding, but does the environment have an impact on breastfeeding? The answer is yes.
For decades scientists around the world have studied the impact of environmental contaminants on the mammary gland, and on mothering behaviors. For instance, a study from the Journal of Health Science demonstrated that rats exposed to dietary bisphenol A (BPA) in early pregnancy showed cellular injury to the mammary glands as well as lower prolactin levels. (Miyaura, 2004).
What’s more, Rochester Medical Center studies reported in Science Daily demonstrated damage to rat mammary glands to the extent that some mother rats were unable to nourish their pups after exposure to dioxins. Researchers noted that some rats were able to recover mammary function by late pregnancy. (Lawrence, 2009).
In 2013, a study in the Journal of Neurotoxicology and Teratology showed a decrease in maternal behaviors in Wistar rats (less grooming, protection and nuzzling), a concerning finding but not yet demonstrated in humans. (Boudalia, 2013}.
Studies like these are the basis for ongoing research looking into possible negative impacts on human lactation. The studies are also the basis of much education related to how to create a safer environment while protecting lactation.
An unpublished study from Wright State University looked at mothers with self-described low milk supply and the relationship between environmental contaminants. The 78 mothers in the study were four weeks to eight months postpartum and were all given education on reducing exposures to environmental estrogens (personal care products, food hormones and plasticizers).
Results were seen in one to five weeks and ranged from the mothers stating her “breasts were fuller,” the “babies seemed more satisfied,” and fewer needed supplementation. Some found a doubling of supply (noted with pumping during work hours). Seven had no noticeable increase in milk supply, and of those only two weaned from breastfeeding. The rest continued supplementation. (Walls, presented 2009).
In a Mexican study of young Yaqui tribe women, those who moved from native land to new chemical based agriculture, had less alveolar tissue compared to the young women who remained with the tribe and practiced traditional, non-chemical farming techniques.
Many of the agri-chemical exposed young women were found to have larger than normal breasts, but less glandular tissue (referred to as “empty breast” syndrome) and many were unable to breastfeed their infants which is viewed as an integral part of mothering in their culture. (Hansen, 2010).
On the surface, these studies can seem discouraging until we really weigh the risks and benefits of breastfeeding in a polluted world.
First, human milk contains properties that have been shown to mitigate some negative, environmental effects. (Williams, Florence, NYT)
For instance, human milk contains bio-active components which specifically control and resolve inflammation, promote a thick, healthy gut lining to support an optimum functioning immune system and provide the most nutritious food for optimum general health for infants and children.
Emeritus Director of the Carolina Global Breastfeeding Institute Miriam Labbok, MD, MPH, IBCLC stated “The fact that studies of child [health] outcomes in highly polluted areas are still better for the breastfed infant . . . would seem to indicate that certain factors in the production of human milk and in the milk itself, immunological and other, may mediate the potential harm of the ambient pollution.”
She went on to say, “… No environmental contaminant, except in situations of acute poisoning, has been found to cause more harm to infants than does lack of breast-feeding. I have seen no data that would argue against breastfeeding, even in the presence of today’s levels of environmental toxicants.”
Sandra Steingraber, biologist and author of Living Downstream and Having Faith: An Ecologist’s Journey to Motherhood agrees: ”We haven’t yet compromised breast milk to such an extent that it’s a worse food than infant formula…..”
The American Academy of Family Physicians (AAFP) has also published that certain components of human milk act to increase the infant’s elimination of some toxins and to protect the infant’s developing brain, central nervous system, and body as a whole.
WABA’s statement on breastfeeding and environmental contaminants echoes this sentiment and encourages breastfeeding as the safest feeding choice despite maternal exposure to contaminants.
Their statement reads: “Is the presence of these chemical residues in breastmilk a reason not to breastfeed? No. Exposure before and during pregnancy is a greater risk to the fetus. The existence of chemical residues in breastmilk is not a reason for limiting breastfeeding. In fact, it is a reason to breastfeed because breastmilk contains substances that help the child develop a stronger immune system and gives protection against environmental pollutants and pathogens. Breastfeeding can help limit the damage caused by fetal exposure.” (WABA, 2005.)
The World Health Organization’s (WHO) review on contaminants and human milk states definitively, “The benefits of breastfeeding far outweigh the toxicological disadvantages that are associated with certain POPs” (persistent organic pollutants).
To reiterate, considering the safety of human milk even when contaminants have been detected, neonatal intensive care researcher Fani Anatolitou (2012) states, “the detection of any environmental chemical in breast milk does not necessarily mean that there is a serious health risk for breastfed infants. No adverse effect has been clinically or epidemiologically demonstrated as being associated solely with consumption of human milk containing background levels of environmental chemicals”.
It is important to understand that many of the measurements of POPs in human milk are not clinically meaningful, hence are not a cause for alarm. Even more importantly, as mentioned earlier, a number of components of human milk act to counter potential risks of contaminant exposure (Anitolitou, 2012). The Centers for Disease Control and Prevention (CDC) points out that effects of exposure have only been detected in a breastfeeding infant when the mother was extremely ill.
As lactation care providers we are in a unique position to not only support the optimum health of infants and children, but also be a part of creating a healthier environment for the children to grow and thrive.
American Academy of Family Physicians (AAFP). (2018). Breastfeeding, Family Physicians Supporting (Position Paper). Downloaded 17. Jan. 2018 from https://www.aafp.org/about/policies/all/breastfeeding-support.html
American Academy of Pediatrics (AAP), Section on Breastfeeding. (2012). Breastfeeding and the use of human milk (Policy Statement). Pediatrics 129(3), e827-e841. DOI: 10.1542/peds.2011-3552.
AMERICAN ACADEMY OF PEDIATRICS The Transfer of Drugs and Other Chemicals Into Human Milk Committee on Drugs https://pediatrics.aappublications.org/content/108/3/776/T7
Anadón, A., Martínez-Larrañaga, M. R., Ares, I., Castellano, V., Martínez, M. A. (2017). Drugs and chemical contaminants in human breast milk. In R. C. Gupta (Ed.), Reproductive and Developmental Toxicology (2nd Ed., pp. 67-98). London, UK: Academic Press.
Anatolitou, F. (2012). Human milk benefits and breastfeeding. Journal of Pediatric and Neonatal Individualized Medicine 1(1), 11-18. DOI: 10.7363/010113.
Arnardottir,H. et al. Human milk proresolving mediators stimulate resolution of acute inflammation. Mucosal Immunology, October 2015 DOI: 10.1038/mi.2015.99
Bodkin, H. Breastfeed to save the planet, scientists say as study exposes infant formula damage to environment https://www.telegraph.co.uk/science/2019/10/02/breastfeed-save-planet-scientists-say-study-exposes-infant-formula/
Boudalia, S. et al. A multi-generational study on low-dose BPA exposure in Wistar rats: Effects on maternal behavior, flavor intake and development. Neurotoxicol Teratol 2013 Nov 20. pii: S08920362(13)00217-1. doi:10.1016/j.ntt.2013
Climate Change and Health June 2015 https://ibfan.org/docs/climate-change-2015-English.pdf
Dadhich, J, Lellamo, A. Report on Carbon Footprints Due to Milk Formula: a Study from Selected Countries of the Asia-Pacific Region
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Goldman, A. Anti‐inflammatory Properties of Human Milk. September 1986. https://doi.org/10.1111/j.1651-2227.1986.tb10275.x
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Terri Hansen, Today correspondent. Pesticide exposure deprives Yaqui girls of breastfeeding – ever, Feb 28, 2010. https://www.sej.org/headlines/pesticide-exposure- deprives-yaqui-girls-breastfeeding-ever
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WABA Towards Healthy Environments for Children Q. Frequently asked questions (FAQ) about breastfeeding in a contaminated environment https://www.waba.org.my/whatwedo/environment/pdf/faq2005_eng.pdf
“…In a world as complex and interconnected as the one we live in, the idea that one person has the answer is ludicrous. It’s not only ineffective, it’s dangerous because it leads us to believe that it’s been solved by that hero, and we have no role. We don’t need heroes. We need radical interdependence, which is just another way of saying we need each other.”
In reference to the despicable maternal child health outcomes for birthing and lactating Black Indigenous People of Color (BIPOC), Seals Allers implores us to stop having “this very individualized conversation about what is happening to Black women.”
“There is so much involved,” she says. “There is no single solution, and there never was a single source of the problem.”
It’s a tangle that calls for more than reduction, reusing and recycling.
Through an equity lens, Seals Allers uses Bruce Bekkar’s, MD, et al research to ask questions like “Why are there factories mostly in Black and Brown neighborhoods? Why were Black and Brown people driven to heavily populated urban areas?”
The association between air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the U.S., demonstrated in Bekkar’s research, is heavily influenced by systemic racism.
Flavelle goes on, “Adrienne Hollis, senior climate justice and health scientist for the Union of Concerned Scientists, said the problems could not be tackled in isolation. ‘We need to look at policies that provide equitable opportunities for communities of color,’ Dr. Hollis said. ‘If you address structural racism, I think you’re going to start getting at some of these issues.’”
Seals Allers echoes: “Stop problematizing Black women; look at the systemic solutions.”
Unsurprisingly, the “solutions” we tend to generate include pouring millions of dollars into synthetic milk instead of investing in breastfeeding and lactating people themselves.
“It’s very disturbing,” Seals Allers comments in her Facebook stream. “The solution is not around empowering women, it’s not about getting women breastfeeding, it’s about finding synthetic solutions. [There’s ] such a disconnect.”
Equally concerning in this case, is that the investment into a proposed solution for poor health outcomes related to not breastfeeding, comes from a climate change investment fund. Human milk is arguably the most sustainable food on our planet; why are sub-optimal, artificial substitutes getting so much funding instead of promoting policies and programs that support direct breastfeeding or pasteurized donor human milk?
The conundrum goes beyond the years of milk feeding onto complementary foods which offer corporations new opportunities to target families with Ultraprocessed Foods (UPF). Like artificial milk substitutes, UPFs pose environmental threats: processing takes natural resources and generates waste. Moreover, UPFs are often heavily marketed in underserved communities, so poor health outcomes continue to be compounded.
Healthy Children Project’s Cindy Turner Maffei recently attended a webinar sponsored by the Breastfeeding Promotion Network of India (BPNI) and the Nutrition Advocacy in Public Interest (NAPI) on UPFs and their relation to obesity, diabetes, and other health dangers.
“Presenters from India, Brazil, and Australia shared insights on the health impacts of UPFs, about the market and social forces at play, and also what we can do to advocate reduction in use of these engineered foods,” Turner-Maffei reports. “Brazil in specific has incorporated decreasing UPFs into their dietary guidelines and restricted use of government funds to purchase these foods for school food programs.”
BPNI has also created a WBW action folder. The document contains information on the carbon footprint of breastmilk substitutes and offers interventions required to support breastfeeding at four levels: policy makers, civil society and breastfeeding advocates, hospitals and doctors and parents.
Nothing is relevant if we don’t have a hospitable planet. Breastfeeding and appropriate, unprocessed complementary feeding are the roots of a healthy ecosystem that all humans benefit from.
On one of my favorite walking routes, there is a beautiful oak tree that shades the street corner. Its sprawling roots heave through the sidewalk. One day, a dreamy song played through my earbuds, and as I walked toward the tree I felt the urge– almost like a spiritual calling– to touch its sturdy bark. Making contact with its trunk, a tickling, buzzing static traveled through my arm and zapped my ears like some energy had traveled through the cord on my earbuds. Stunned, I stepped back and gazed up at the oak’s gangly branches overhead, for a second believing that I’d connected with some otherworldly force. The sun shone down on the scene, casting a stark outline between the tree’s branches when I realized they were intertwined with telephone wires overhead.
Human innovation and nature entangled.
April 22, 2020 marked the 50th anniversary of Earth Day and as this video points out, while we breathe through masks, our planet breathes a sigh of relief.
“Around the world we are seeing the rebound of the earth when there is reduced human impact,” she says. “We see fish returning to the waters of Venice, kangaroos jumping in the streets of Sydney and comparison pictures of Los Angeles two months ago and now with clear, blue skies.”
For the first time in decades, air pollution has cleared enough to reveal mountaintops from over 100 miles away. (Find pictures here and here.)
Walls wonders if these spectacular phenomena will motivate humans to better care for our planet moving forward.
She explains: “Being a maternity nurse for many years I usually go directly to ‘how does this impact new families?’ Maybe this is the opportunity to educate families on a cleaner life for our children, grandchildren and the planet.”
“Anyone who says healthcare is not about cleaning up the environment is not well,” she laughs.
The Green Team worked to eliminate disposable diapers, formaldehyde-layden mattresses and unsafe, employee hand soaps, Walls reports. They found a clean, safe line of products and ultimately saved money.
Looking ahead, Walls poses: “At this time of renewal for the earth, can we make it the beginning of a new way of thinking, starting with the care and feeding of the newest members of the human race?”
The environmental cost of infant formula milk is well documented in some countries.