A shift in ‘Our Milky Way’

Did you see one of our most recent pieces on lactation and menopause? I both love and hate the topic, because it connects how the risk of not breastfeeding carries through our lives. As someone who tends to live life like there may be no tomorrow, this is powerful and important for me to remember: Breastfeeding sets us up for life-long health. Behavior we engage in today, ripples. That’s why I love the topic. I hate it for essentially the same reason. Mostly, dyads’ ability to breastfeed is sabotaged, and that has not only life-long, but generational and planetary implications.

In the piece, I recall an interaction with a friend enduring menopause. Lately, I’ve been witnessing and learning about several friends’ experiences as they move into their post-reproductive lives. One of these women just became a first-time grandma. Another is about to become a great aunt. Pregnancy, birth… events anticipated, expected, following the “normal” trajectory of life; yet, it’s extraordinary and sacred every time.

New grandmothers and aunties, new mothers, new babies, growing families, new chapters. As a few of my mentors have told me: Life is Change.

I became a first-time mom over 13 years ago. It was then I discovered my passion for maternal child health, fascinated by what my body could achieve, enraged by the forces attempting to stifle its majesty.

It was also 13 years ago that I was invited into my work with Healthy Children Project, Inc. We launched the Our Milky Way weekly blog, a place for musings and reflections, celebrations and criticisms, news and discoveries. The blog has documented fledgling projects, growing movements, insidious phenomena, inspiring insight from newbies, and rich wisdom from well-established mentors. Our Milky Way houses the stories of hundreds of brilliant, passionate people. A place of paradox, each of us mere flecks of stardust, and each of us entire universes.

For a while now, I have felt different parts of myself expanding. Once it was my guts shifting and my body expanding to physically accommodate pregnancies; now, this expansion and movement less graspable. To articulate what this evolution is exactly is a bit like me attempting to comprehend the origin of our galaxy. Mind-bending. Nevertheless, I feel my work on Our Milky Way gently pushed into periphery.

As readers, you can continue to expect publications on Our Milky Way. Many of you won’t need an introduction to Healthy Children Project’s Kristin Stewart who will be authoring the blog going forward. For those of you who are unacquainted, you can read an early Our Milky Way piece about Stewart’s fascinating history, inspiration, and passion here. Somewhat serendipitously, Stewart’s interest and expertise in communication in health care echos that of a recent message by Dr. Elaine Meyer On Being Present, Not Perfect.

On my way out, I’d like to extend a massive thank you to all of our immensely generous Our Milky Way participants for sharing their time, energy, passion, and wisdom, and the same gratitude goes to our curious readers. Finally, thank you to my colleagues who have led by example, who have connected me with so many of our wonderful blog features, and to many of whom have become deeply admired mentors.

Onward and beyond!

‘Breastfeeding myths and why they can cause difficulties’ guest piece by Donna Walls with intro by Jess Fedenia

Jacopo Tintoretto
The Origin of the Milky Way
about 1575
Oil on canvas, 149.4 x 168 cm
Bought, 1890
NG1313
https://www.nationalgallery.org.uk/paintings/NG1313

Our blog’s namesake is steeped in mythology.

While researching classical breastfeeding images for their Icons of Breastfeeding presentation, Cindy Turner-Maffei and Karin Cadwell came across art like Tintoretto’s The Origin of the Milky Way and Rubens’s Birth of the Milky Way.

“We were thrilled to find that the milk of a Goddess was thought by ancient peoples to be the source of our Galaxy,” Turner-Maffei shares. “This concurs with our view that breastfeeding is a core experience of human life.”

She and Cadwell retold the classic Milky Way story in their book Case Studies in Breastfeeding: Problem-Solving Skills & Strategies:

​[Jacopo Tintoretto’s beautiful painting, The Origin of the Milky Way, depicts] “the Greek God Zeus (Roman name Jupiter) bringing baby Herakles (Hercules) to suckle at the breast of the sleeping Goddess Hera (Juno), Zeus’s wife. Zeus wants Herakles to receive the milk of a goddess, because it bestows immortal life, and will make Herakles into a god. Zeus anticipates that Hera will not willingly provide her milk to his love child [born to mortal woman Alcmena]. Therefore, he tries to sneak up on her while she is sleeping. However, foreshadowing his adult strength, the baby Herakles attaches forceably to Hera’s breast, awakening her. Hera reacts by pushing the baby off her breast. Her milk spurts forth into the heavens, and creates the stars of what becomes our galaxy, the Milky Way.” (Cadwell & Turner-Maffei, 2004, p. xi)

Source Healthy Children Project Inc.

In a recent piece, we shared an excerpt from Radical Mom Union’s Natasha VC’s Let us Admire the Lactating Fountains of Italy: The most powerful representation of nature in art is a lactating woman. 

“The Fontana della Spinacorona is a marble representation of the mythological founder of Naples, the winged siren Parthenope. Legend has it that the siren shot her breast milk onto the flames of the volcano Vesuvius to extinguish the fire. The work bears the Latin inscription Dum Vesevi Syrena Incendia Mulcet: ‘while the siren of Vesuvius calms the flames’…I must point out how absolutely METAL that is!!??? BREASTMILK TO EXTINGUISH THE VOLCANIC FLAMES OF VESUVIUS!!!!…”

She goes on, urging, “Think about that for a minute. We typically think of a postpartum woman as weak, drained, struggling. Here, the nursing mother with fountains of milk shooting from her ample breasts, puts her on par with the gods of the sky and sea. PURE, RAW POWER, que bella!” 

Grabosky, Tom. Mothers. 01 Oct 1991. Web. 2024. <https://ark.digitalcommonwealth.org/ark:/50959/8s45wt479>.

Mythology offers powerful and inspiring pieces of lore, but myths as we have come to know them in modern times, can be powerfully harmful. 

The visionary Linda Smith covered breastfeeding myths on Our Milky Way over a decade ago. Many persist in our culture today.

Praeclarus Press recently released Breastfeeding Myths: Busting the Misinformation Harming You, Your Baby, and Society by Lucy Ruddle. Unicef offers a page to dispel breastfeeding myths.  Lactation care providers and maternal child health advocates address breastfeeding myths ad nauseam, and sometimes, we’re tasked with unlearning of our own. 

This week, Donna Walls RN, BSN, ANLC takes the opportunity to dispel some myths she often encounters in her guest piece titled Breastfeeding Myths and Why They Can Cause Difficulties. 

Donna is a frequent contributor to Our Milky Way. You can read her other pieces here. 

——

Some breastfeeding myths seem to continue unchecked for decades. It seems no matter how much we teach, preach, beg, educate, cajole and insist, they persist. So, I guess I’m going to take one more swing at setting the record straight and hope we can dispel some of the more common ones. 

Myth #1
Some women are just too stressed or ‘high-strung’ to breastfeed. Successful breastfeeding requires relaxation. 

Nothing could be further from the truth. We know women have been successfully nursing their babies in highly stressful situations for eons. During times of war, weather disasters, personal crises, physical illness, financial distress, and so on and so on,  they continue to make the quantity and quality of milk needed for their babies to thrive.

It would be very difficult for our species to survive if a stressful, anxious situation was all it took for our milk supply to shut down. This applies to widespread situations such as wars as well as individuals’ situations. When a new baby is brought into the family, whether it’s the first or fourth, it’s an adjustment. Changes in lifestyle, activities of daily living , sleep patterns and emotional adjustments…no one escapes without some moments of anxiety.  It’s a good thing our bodies are designed to do everything it can to nourish and nurture the next generation.

Truly, prolactin is a wonderful hormone! We know it is responsible for milk production, but it is also actually involved in moderating stress responses in males, females, lactating and non-lactating mammals. In simple terms, it has a stress-reducing, calming effect. Even more amazing is our ability to actually increase our prolactin production in times of acute stress. In one NIH study, the levels of prolactin were significantly increased in women who reported long-term stress and resulting depression. So busting this myth should be easy; not only does stress not reduce milk supply, it can actually increase our levels of milk-producing prolactin and help to calm frayed nerves in the process.

Myth #2
Your milk will “come in” about day 3 or 4 postpartum.

This one could be one of the most harmful, because it’s an all-too-common phrase repeated continuously, everywhere. Unfortunately, new mothers, already worried about not having enough milk, are told this as a routine part of breastfeeding education and can result in mothers becoming discouraged in the first hours and days of breastfeeding. We commonly hear them express their fear of “starving” their newborn. Mothers have milk for the first feeds. We call it colostrum, but it’s milk! They have heard about  breasts being so full it hurts, but they don’t see or feel that yet. The perpetuated message is clear but untrue: ‘You  really don’t have milk now, but in 3-4 days, your milk will “come in” so don’t worry!’ This confirms moms’  number one concern about not having enough milk.

Truth is, colostrum is produced beginning about halfway through the pregnancy and is present, and designed for, the first feedings. Could it be that because we label it colostrum it is not perceived as milk?

It would be great if we could completely ditch the term “milk coming in”, reassure prenatal and new moms that they DO have milk (albeit called colostrum) available for the first feedings. Could we change our terminology from “milk coming in” to milk changing over to mature milk? Could we change the name of colostrum to “newborn milk” which sends the message that this is indeed milk?

Myth #3
You will need to give up the foods you like while breastfeeding.

While false, the lists of no-no foods can be quite extensive. No spicy foods are usually at the top of the list. It makes you wonder about all those babies in cultures that have curry, garlic, and chili peppers as a staple of their diets. Babies in Italy or Mexico aren’t fussier babies than in America or Sweden. Many years of work by Julie Mennella clearly demonstrates that newborns accommodate to the smells and tastes of their culture through exposure to those smells and tastes in the amniotic fluid. Infants learn to like the foods that are normal in their mother’s diet before they are born!

While we are on the subject of foods,  another persistent and incorrect myth is that of the need for the “perfect diet” with extra calories to be able to breastfeed. It doesn’t take a lot of research to look at nursing mothers around the world and realize that successful breastfeeding and healthy infants are not reliant on the perfect diet. Women have breastfed in the most dire of circumstances without negative consequences to their babies. The misinformation stating that lactation requires a significant addition of calories, sometimes as many as 1,500/day, to successfully nourish her infant still persists. This can be discouraging to a new mother, anxious to lose pregnancy weight. I think we have all heard concerns expressed that maybe breastfeeding is not the right choice for those wanting or needing to lose postpartum weight. Again, not true. In reality the current CDC recommendation for calories during lactation are an additional 330-400 calories for maternal health, not for milk production. And remember, it’s not just calories but what foods are recommended. Eating a bag of processed chips gives you calories but does not contribute to better maternal health!

Myth #4  
Your breasts are too big…too small. Your nipples are flat…too big…too small.

Oh how we love to judge nipples and of course, make sure the mother understands she does not have breasts or nipples that are perfect for breastfeeding. Then we wonder why women struggle in this culture to breastfeed. Maybe because we work so hard to destroy their confidence even before the newborn goes to breast for the very first time. 

Care providers take one look and diagnose flat nipples, rarely considering how they actually function. Anatomy 101 reminder! Nipples are erectile, they stretch when stimulated. So when the baby touches the nipple either with their hands or mouth the nipple erects, some a little, some a lot. Sadly, many women compare their nipples to an artificial teat and worry that theirs is not the same, not quite right. Let’s set the record straight, we have the gold standard nipples, the rubber ones are a pathetic imitation! 

And consider human infant feeding compared to other mammals. Many other mammals have long, exaggerated teats designed for the offspring to slurp it in and suckle the teat. Human infants breast feed- not nipple feed. Our offspring open their mouths wide and attach to the breast, not just the nipple. Correct latch involves the baby taking in lots of breast tissue. If they are sucking on just the nipple it will cause discomfort and result in inadequate milk transfer. It  makes you wonder why we get so “judgy” about nipples! Let me take a moment to reassure you that babies don’t have a pre-set idea of measurements they want in a nipple. No, they want the one attached to their mother.

Nipples too big? I have seen small premies open wide and attach to nipples deemed “too big”. Did we forget to tell the infant that their mouth was not the right size to nurse? Asymmetric latch, with the baby starting nose to nipple, coming to the breast chin and bottom lip first, then bringing their head forward in an “up and over” motion can work like magic for little ones.

So before we start judging nipples and breasts, branding them not quite right, let’s first remember our number one job is to build the mother’s confidence and support their breastfeeding journey.

Myth #5
Drinking a lot of water will help you make more milk.

Another persistent one and untrue. I still read it in books and see it on well-meaning how-to websites which state that if you’re concerned about your milk supply the answer is easy: drink more water. Sometimes the amount can be more than a gallon a day with frustrating results. These results are spending more time in the bathroom and less time with your baby. Sadly, this shortcut skips asking pertinent questions like: 

  1. How often are you nursing? The answer should be 10-12 times/24 hours.
  2. What is the baby’s output? The answer should be at least 4 urinations and 4 stools, with the stools changing color to a golden yellow and the urine a pale yellow, by the fourth postpartum day.
  3. What is the baby’s weight gain pattern?  It should be no greater weight loss than 7% in the hospital, no further weight loss by day 5 and regaining to birth weight by 14 days.
  4. Have there been changes in the mother’s breasts?  Ideally noticing fuller breasts in late pregnancy and breast becoming rounder, fuller, firmer and heavier as the milk composition changes over to mature milk. 
  5. Is the baby latching comfortably? Correct latch facilitates optimum milk transfer. 

Shortcut answers like “just drink more water, eat oatmeal cookies, or drink lactation tea” bypass the need for assessment and can ultimately lead to poor outcomes for the newborn. Rather than setting arbitrary amounts of water, encourage mothers to drink enough to quench her thirst. Some research even shows drinking too much water can actually decrease milk production.

Myth #6  
Breastfeeding is hard and difficult to learn. 

Perhaps the saddest of the myths is that breastfeeding is so hard that your chances of success are really quite low. Breastfeeding is NOT difficult nor is it hard to do. Let me clarify: There can be difficult situations that arise but the vast majority of “problems” are generated by a hospital system or other systemic issues that are not designed to foster successful breastfeeding. Systems that separate mothers and their newborns might be the biggest reason for difficulties. When the newborn is immediately removed for the “experts” to tend to the baby, the message is that we can do a better job of caring for your newborn than you can, not the confidence- building care that supports breastfeeding. When newborns are housed in nurseries and brought out for scheduled feedings, the innate communication between mother and baby is interrupted. This exquisite communication is the foundation of breastfeeding as the newborn signals their needs and the mother’s body responds to provide the nutrition, nurturing and protection all newborns need and deserve. 

Other practices that can reduce the chances of successful breastfeeding are:

-not encouraging skin to skin in the first hours and days after birth

-promoting a strict feeding schedule rather than teaching responsive feeding

-covering the newborn’s hands with mittens, denying them the use of their hand-to-mouth activities

-swaddling tightly and restricting their movements

– nursery housing so the mother “can get her rest” rather than talking with her about how to rest and sleep in the first days and weeks after birth

-allowing a brightly lit, noisy environment in the patient room rather than a calming, quiet environment for rest

-not honoring the magical connection between mother and baby

There are many other myths, of course but hopefully, with time, research and education, we can continue to support breastfeeding families with sound, evidence-based information and early and continued support for all families. 

Sources 

Agata Faron-Górecka. et al. The Involvement of Prolactin in Stress-Related Disorders. Int J Environ Res Public Health. Feb. 2023. doi: 10.3390/ijerph20043257. PMCID: PMC9959798  PMID: 36833950

Cadwell, K. et al. The Pocket Guide to Lactation Management. Jones and Bartlett Publishers,Inc. Fourth Edition. June, 2021. 

CDCAP. CDC.gov. Breastfeeding. Maternal Diet. National Agricultural Library. NAI.USDA.gov

Kent, J. et al. Int. J. Environ. Res. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and TreatmentsPublic Health 2015, 12, 12247-12263; doi:10.3390/ijerph121012247

Mennella,J. Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults. 2019 Apr 2.J Vis Exp. 2016 Jul 16; (113): 10.3791/54163. Published online 2016 Jul 16. doi: 10.3791/54163.PMCID: PMC6445264

On being present, not perfect: compassionate communication in healthcare

It was over a decade ago that Elaine C. Meyer, PhD, RN, MBE, FSSH presented her TEDx Talk On being present, not perfect. Her message remains crucial, relevant, universal especially within maternal child health.

Image source. Used with permission.

Dr. Meyer’s powerful piece incorporates personal and professional examples which bring life to the importance of holding space for compassionate communication and difficult conversations in healthcare.

She notes the essential ingredients of these conversations: Courage, Brains, and Heart, a clever Wizard of Oz mnemonic, and she emphasizes that “Practice makes better”, not perfect, as alluded to in her title. 

Reflecting back, Dr. Meyer reports that we’ve accrued more awareness about these conversations. Compassionate communication is no longer a nice-to-have-it item; it has become an essential part of healthcare. Overall, Dr. Meyer has noticed that patients are more empowered, expecting this connection and level of care. Online rating tools have allowed for patients to evaluate providers specifically on their bedside manner.

Across the globe, On being present, not perfect has been incorporated into nursing and medical school curricula placing value on providers’ relational capacity early on in their careers. 

In a culture where health care providers are often massively stressed and burnout can be of real concern, Dr. Meyer makes clear that honoring conversation is not only of benefit to the patient. 

“… Being in relationship with the patient can be very fulfilling,” she begins. “This matters. At the end of day, a healthcare provider can say What I did matters. It can be the words that we speak, just being present, and showing up in all of your humanity. This doesn’t necessarily require extra time.” 

Take for instance the personal vignettes she shares in On being present, not perfect: a nurse who held her hand, squeezing back in reciprocity, an anesthesiologist who told her “I will be with you the whole time. I will watch over you. We’ll get you through this.” Simple yet profound, words and actions that sustained her during harrowing procedures. “Gestures of humanity,” Dr. Meyer calls them.    

What’s more, when this kind of respect and communication are established, patients have significantly better health outcomes and provider job fulfillment and retention increases. 

“If a clinician feels like I did a good job today, I connected, that buoys the clinician. The clinician feels more efficacious,” she explains. 

These conversations matter across the lifespan in any specialty, of course; however, the perinatal period is of special importance, because perinatal experiences have generational physiological and psychological implications. This time period influences the mother-child relationship for a lifetime.   

Having endured multiple pregnancy losses and IVF, Dr. Meyer shares that when her son was born, her initial focus on breastfeeding was primarily nutritional. 

“The connection and attachment that breastfeeding can foster wasn’t as much on my radar,” she says. “But after rising from the ashes of infertility, being able to nurse my baby boy was restorative and healing.” 

Though she and her son were not up against monumental feeding challenges, she consulted a lactation professional as a support person. She says this was immensely helpful to have someone who believed in her, someone joining her in the journey, someone to fortify what was important to her. 

As a provider, Dr. Meyer recalls a few highly distressing stories related to birth and infant feeding when she needed to show up with Courage, Brains, and Heart. She shares one in particular:  

There was a preterm newborn who was admitted to the Intensive care unit with severe birth complications and prolonged anoxia. The baby’s mother was determined and dedicated to breastfeeding her baby. The baby was unable to nurse because she was sustained on life support with a ventilator. Dutifully and with great care, the mother pumped her breastmilk and the baby received the milk through a small nasogastric tube. As a psychologist, I had the great privilege of meeting with the parents to listen to their story, to bear witness to their fledgling parenthood, and to offer support….Those were tender and difficult conversations. We held several family meetings with the team to help determine the baby’s treatment. Given the infant’s devastating brain injury, and poor prognosis, the parents and team agreed with the difficult decision to withdraw life support treatment. After the ventilator was withdrawn, the baby passed away peacefully in her mother’s arms with the father at their side. In a final act of love and dignity, as the parents left the hospital for the last time, the mother left a little bottle of breastmilk at the nurses’ station counter. Testament to a mother’s love, it was a most precious parting gift. The parent-child relationship transcends death. The lactation consultant offered ongoing education and support to the mother who went home without her baby- to pump for comfort and to stand in a warm shower with her back toward the shower head, so as to ease any discomfort. Courage, brains and heart….

As she concludes her Tedx Talk, Dr. Meyer offers some final inspiration: “Once upon a time you wanted to change the world. You still can, one conversation at a time.” 


Learn more about Dr. Meyer’s efforts here.  

 

Lactation and menopause

*This piece contains curse words. 

Conjunctivitis? Eczema? Diaper rash? Just put some breast milk on it. [Witkowska-Zimny, et al  2019]

[Source]
Breastfeeding is more than nutrition. Read our Breastfeeding is series to learn more about how breastfeeding is beyond what most people assume. Basically, breastfeeding and human milk are miracle elixirs, cure-alls!

Of course this isn’t entirely true. Read more about what we mean in A different angle and Still watching our language. Also check out Parts One and Two of Potential consequences of invoking ‘natural’ in health promotion. 

[Source]
Like Nikki Lee once analogized: “Human milk is not magic fairy dust. Human milk is nature’s seatbelt. A seatbelt does not guarantee survival in a car crash. We wear seatbelts because they increase our chances of survival…” 

Thanks to breastfeeding, my family and I survived infancy, toddlerhood, and beyond. 

Thinking back, my coffee dates were once accompanied by my nursing toddlers, their chubby little fingers cupping mini hot chocolates, scribbling with crayons, and chit-chatting with the elderly patrons; now, I spend more one-on-one time with friends at the coffee shop. With many of them quite a bit older than me, I am learning about their experiences going through menopause. It’s a new chapter.  One morning, I observed a dear friend breathe through hot flashes, her face flush, as she shed her vest and scarf, then bundled up again, then squirmed out of them, over and over throughout our visit. I sat there entirely helpless, but not entirely speechless. 

Breastfeeding. The magic elixir. The cure-all. 

Her eyebrow raised. 

I quoted Wenda Trevathan: 

“Why is menopause stressful? The short answer to this question is that it is not stressful for most women in the world, as far as can be ascertained by social scientists… Anthropologists Jane Lancaster and Barbara King propose that modern women may experience the end of ovulation under a different hormonal milieu from that of our ancestors and women in ‘natural fertility’ populations today. For example, !Kung women reportedly breastfeed their last infant for a longer time than for previous infants and when they terminate breastfeeding, perhaps in their mid-40s, they simply do not resume ovulation. Thus, the hormonal milieu of menopause includes the hormones of lactation (especially prolactin and oxytocin), which may modulate the effects of other changes…”  [Ancient Bodies, Modern Lives, 2010, p 168-169] 

Her brow remained raised. 

I offered: Christine R. Langton, MSW, MPH, et al, in Association of Parity and Breastfeeding With Risk of Early Natural Menopause, discovered an increase in parity decreased the risk of early menopause. What’s more, the authors note, “Breastfeeding was associated with significantly lower risk, even after accounting for parity. Breastfeeding at levels consistent with current recommendations may confer an additional benefit of lower risk of early menopause.” 

And then, Natalie V. Scime, et al found that “In a dose-response manner, longer lactation was associated with reduced risk of natural menopause before age 50 (for ≥ 13 months of lactation, adjusted hazard ratio at age 45: 0.68, 95% CI 0.59–0.78), surgical menopause before age 55 (age 45: 0.56, 0.50–0.63), and indeterminate menopause before age 50 (age 45: 0.75, 0.69–0.82). Longer lactation was associated with lower odds of surgical (adjusted odds ratio 0.54, 95% CI 0.45–0.66) and indeterminate menopause (0.63, 0.55–0.73), compared to natural menopause.” [2024]

So you see, it’s breastfeeding, breastfeeding is the answer. 

My friend was now not only struggling to regulate her body temperature, she was struggling to regulate her patience with me, because of course, this was all very interesting, but not relevant to her current challenges. 

And that’s when all of the rage we’ve both learned to suppress and breathe through and gratitude-journal and downward dog away came boiling out into a frothy fuck you to the medical-industrial complex, to the patriarchy, to anything that’s gotten in the way of women enjoying healthy, fulfilled existences.  

I was pissed because I know what the infant feeding landscape looks like in America and what this means for the future health of our offspring, ourselves, and our planet. She was pissed because she knows what it looks and feels like to get “care” during menopause (but really her entire lifespan) in America. So, basically, we were pissed, some might say hysterical, about the same thing.

We’re not the only ones. 

Brené Brown spoke with Dr. Mary Claire Haver, a board-certified OB/GYN, on the Unlocking Us podcast, and they too, are fired up about women’s health care. 

During all phases of our lives, we are considered emotional, dramatic, attention-seeking, imaginative (not in a good way), fragile, crazy over things that have major and long-lasting implications like family planning, birth, infant feeding, menopause. We are laughed at, dismissed, lied to, pitied… 

In Unlocking Us, Dr. Haver says: “There’s a reason why hysterical is a word and we don’t have testerical. And that has got to stop…” 

She goes on to explain: “I was taught that there’s a significant percentage of hyperemesis, now, this was in the ’90s, that is psychological. We were putting people on antipsychotics for hyperemesis. That has been completely debunked. We have found the receptor in the brain that is causing this. And I have to shout out to Shannon Clark, right in Galveston, who presented to the FDA, she’s done the most research on this.”

Dr. Haver compares this to current menopause care: “One of the most popular treatments for hot flashes that is being touted as, this is the route we should go, especially in Europe, is cognitive behavioral therapy. Which I love, for a multitude of things…

And Brown interjects: “I mean, I love too, but shut up and sit down.”

Dr. Haver continues sarcastically: “…cognitive behavioral therapy, if you just out think your hot flash, if you change your perception of your menopause…”

Dr. Trevathan wonders in Ancient Bodies, Modern Lives, “…does menopause have to be a ‘bad’ thing? This question derives from a fairly Western perspective that has pathologized the period of time when a woman is experiencing the physical and emotional transitions to a post reproductive state… It is often likened to diabetes as a disorder characterized by hormonal deficiency. In fact, menopause has been called an ‘estrogen deficiency disease.’” (p 161) 

Laurel Wilson has looked extensively at estrogen and its interplay with lactation and [peri]menopause. Find her work here. 

Trevathan goes on to offer  “Whether perceived as a medical ‘problem’ or not, the menopause transition is associated with a number of physiological changes that are experienced by women at this time and are usually explained by changes taking place in ovarian function. (p 163)   

Finally, she suggests: “The perspective of evolutionary medicine would argue that ‘returning’ to the lifestyles under which human reproduction evolved would alleviate some of the problems that women face today with menopause. Without taking the recommendations to extremes (no birth control, self-imposed undernutrition), it seems possible that by increasing exercise, reducing fat intake, and minimizing exposure to industrial biochemicals, women would experience fewer problems at menopause. In this way, adopting the behaviors and diets of our ancestors may go a long way toward not only reducing the stresses of menopause but prolonging healthy lives as well.” (p 169-70) 

So, like I said, breastfeeding is (at least part of) the answer.

Mom blame festers in isolation

Mom guilt, mom blaming, mom shaming. These things are perpetually on my mind. I am a mom. I am guilty of blaming and shaming other moms. I often think about what kind of therapy my children might need because of my quirks, my parenting… my existence.

So, Rachel Yoder’s Nightbitch has spoken to me the way that the author character Wanda White speaks to the mother in the book as she navigates her own shame and purpose. I dog-earred this passage in particular (among many): 

“If he gets sick, it’s on you, the husband whispered sharply. If other kids think he’s weird, that’s you.

Of course it is, Nightbitch said. It’s all on me. Every part of it.” (page 127) 

Photo property of Healthy Children Project, Inc.

A popular show’s character recites a punchy line: “Boy, I love meeting people’s moms. It’s like reading an instruction manual as to why they’re nuts.”

In a long-running sitcom episode, the patriarch makes a remark in response to one of his children’s perceived downfalls. It goes something along the lines of “Don’t look at me, I was hardly ever around,” insinuating it was the mother who damaged their children, his absence with no consequence. I hope most viewers giggle at the absurdity.  

Some claim that we’re moving away from mother-blame.   

For instance, Marianne Littlejohn writes in How Emotions Shape Your Baby’s Brain,  “Luckily… many of these 20th–century mother-blaming theories were taught as mere artifacts of history, and contemporary psychological theories had left these ideas in the dust. The focus on the development of mental health problems had shifted to the interplay of biological, psychological, and environmental factors. The impact of parenting is included in these environmental factors, but the focus is not specifically on mothers per se.” 

I’m hopeful and encouraged that some find this the case. Still, the allegory remains embedded in popular culture suggesting that it is indeed pervasive. In fact, in my circle of mother friends, we all feel the immense weight of mom-blame, -guilt, and -shame throughout our waking (and sleeping) hours. Actually, I don’t think it’s an exaggeration to state that it dominates many of our lives.  

Victoria Bailey wrote an extraordinary poem titled All The Ways, Always – An Ode to Mother Blame in which she shares:

“…for me it started well 

before 

it began really

before i was a mother

when a boy 

once said to me 

i know your kind

you’ll be a single mum 

by the time you’re sixteen

this was said to me 

by an eighteen year old 

who carried a skateboard 

to look cool

but i never saw him 

ride it

so i was blamed 

and shamed 

as a potential probable possible 

but not promising mother

long before i ever stepped foot 

into the land of motherhood…” 

Myself, thirteen years into motherhood, I find myself reminding my teen, who often recoils in disgust when I try to hug or kiss her,  that there was a time in her life when all she wanted and needed was me.

Photo by Jonathan Borba on Unsplash

In fact, when I was pregnant, this is the reason why I decided I would breastfeed. No one else could do this for her, produce milk tailored exactly to her needs, provide a space that offered security and regulation. That seemed incredibly empowering and important. I’d watched new moms handing off their babies to well-meaning, loving friends and family with a tinge of reluctance and anxiety in their faces. I wasn’t interested in sharing my baby quite as much. Selfish mother! 

In practice, exclusive breastfeeding proved rewarding, convenient, exhausting, irritating, fulfilling, daunting, etc., etc. I could simply offer a boob to my baby on cue, to nourish her, to settle and soothe her. It was a blessing and a massive responsibility. I sometimes daydreamed that my husband had lactating breasts. 

I attribute my decision to breastfeed mostly guided by intuition; I wasn’t fully aware– Uneducated mother! — of all of the cool science-y stuff that was happening in skin-to-skin contact and during breastfeeding.  

For instance, Bigelow and Power write in Mother–Infant Skin-to-Skin Contact: Short‐ and Long-Term Effects for Mothers and Their Children Born Full-Term: “In infancy, oxytocin, stimulated by SSC, may help set the mother–child relationship on a positive trajectory. However, oxytocin may do more than stimulate a nurturing effect at the beginning of the relationship. Repeated exposure to oxytocin through tactile contact and breastfeeding may induce long-term changes in stress reactivity, as has been shown in animal studies (Holst et al., 2002). Early effects of oxytocin may be conditioned to shape sustained benefits at both physiological and behavioral levels (Uvnäs-Moberg et al., 2005; Uvnäs-Moberg and Prime, 2013).” 

Vidya Rajagopalan, et al found in Breastfeeding duration and brain-body development in 9–10-year-olds: modulating effect of socioeconomic levels that  “Longer breastfeeding duration showed long-term associations with brain and body development for offspring.”

And Anushree Modak, et al conclude that “Breastfeeding represents a transformative journey that encompasses more than just nutrition – it represents a complex array of interconnected benefits that resonate throughout our lives,” in The Psychological Benefits of Breastfeeding: Fostering Maternal Well-Being and Child Development. 

I always feel it necessary to note the language used, because breastfeeding doesn’t offer benefits, really. Instead, there are risks associated with not breastfeeding. Judgemental mother! 

Photo by bill wegener on Unsplash

Littlejohn’s piece describes the way mothers continue to shape their babies’ brains after pregnancy. 

“Recent neuro-imaging studies show that when babies see a woman’s face, their right brain hemisphere ‘lights up’ and that a baby’s cry activates the right brain hemisphere of the mother. Most mothers tend to cradle their babies in their left arms (right brain hemisphere), possibly increasing reciprocal communication between mother and baby. The left ear and eye (right brain) of the mother are close to the baby, listening for sounds and watching the baby’s facial expressions. The mutual gaze between mother and baby also stimulates right-brain activity. More specifically, states Schore, the mutual gaze stimulates the opiate systems (pleasure) and the dopamine system (rewards), helping the relationship to be mutually gratifying, therefore setting the conditions for increasing neural connections in the baby’s brain. A mother’s warm and familiar facial expression and her soothing tone of voice help a baby regulate his own vagal nerve functions, laying the foundations for rich neural growth and development.

All of these findings are amazing, and the enormity of these effects might be a bit panic-inducing too. Could some of the science-y stuff be, in part, to blame for mother-blame and mother-guilt? These processes so influential, we should be making them easier for dyads  to accomplish.

Natasha VC of Radical Moms Union writes aptly, “…you shouldn’t blame your baby or motherhood for feeling lost after you have kids, blame all the systems that make being a mom so shitty.” 

What’s more, as Bonnie Zucker points out in  From A Psychologist: No, It’s Not All Mom’s Fault: 

“In heterosexual parenting relationships, studies have shown that mothers carry much more of the ‘emotional load’ or ‘mental labor’ of parenting. Even when the mother works full-time, she manages many aspects of the household that go beyond household chores. Often it is the mothers who are responsible for RSVP’ing to birthday parties and getting presents, arranging playdates, deciding what is for dinner on any given night, and scheduling their children’s doctors’ appointments. When a child has a disability or is in need of additional services, that burden also tends to fall on the mother. School room parent rosters are almost always composed of mothers, as are the memberships of PTAs and parent organizations. This is true even though 76.8% of mothers of children ages 6 to 17 are employed, and 80.3% of those are in full-time jobs, according to a 2019 Bureau of Labor Statistics report.” 

Bedraggled mother!

Photo by RDNE Stock Project

How do we battle mom-blame and shame? Free ourselves as individuals and as a culture? Surely, a complex and multifaceted problem will require a multifaceted solution, but I am inclined to share one with great potential. It’s summed up in an exchange on Elena Bridger’s instagram: 

… I don’t believe in advocating for extended maternity leave. Why? Because maternity leave is incredibly isolating and shoves the burden of care onto lone mothers. If we look to our evolutionary past as a model, maternity leave was short, but the return to work was gradual, flexible and child-friendly.  [Hyperlink added] 

I’ll never forget a book I read a few years ago. They asked women of a hunter gatherer group if breastfeeding on demand wasn’t too stressful because breastfeeding in industrialized societies often impacts mother’s mental health. They didn’t understand the question. Women answered, ‘What is breastfeeding keeping me from?’  And that’s when the researchers realized. Women in that culture were not kept apart from the rest of the group. They weren’t isolated. There was nothing breastfeeding kept them from doing. So breastfeeding so intensively for years was not a stress factor at all. 

Also check out Elena Bridgers’ thoughts on mom blame and communal care.

Another of Yoder’s passages fits well here. Though she writes in regard to the family unit, the ethos can be applied to all mothers, to all humanity just the same:

“This must be what it means to be an animal… Beneath the moon, we pile inside the warm cave, becoming one creature to save our warmth… This is how it has always been and how it will continue to be. We keep each other alive through an unbroken lineage of togetherness.” (p. 230-231)

In Bailey’s beautiful construction, she advises community too. 

“… and so what I hope you take away

from my poem

is testament to resistance

because here we all are

holding it together 

turning out whole

wonderful

amazing

compassionate

kind

loving

and, thank god, imperfect

humans all the same

and what a shame

what a crying

sighing

hands in the air throwing

foot stomping

spit on the ground

inside voice screaming

shame

all this fucking blame is

so don’t let it rob you of any joy any more

invest in lots of big fat fuck you’s

lots and lots and lots and lots of big loud spitting hot read-my-lips fuck you’s

share kudos with other moms

give them the props that you never got

make the space

reach out 

connect

isolation breeds contempt, not familiarity

familiarity generates 

relationships

sharing

acknowledgement

support

bonds

friendship

allies

community

in another word, love, for other mothers

which leads me to my last perhaps trite but just feels so right point

try to focus on and embrace the positive

that indescribable

thick

sticky

heart breaking

heart blooming

marvellously bloody messy

sloppy 

wonderful 

love

that being a mother can bring

easier said than done, i know

but remember it

feel it

perceive it

apply it

as a form of resistance to your own bombardment of blame…”