October 21, 2003

Norway Leads Industrial Nations Back to Breast-Feeding

By LIZETTE ALVAREZ
   
OSLO — Norway has revolutionized a woman's right to breast-feed.

Mothers breast-feed when and where they want: buses, parks, cafes, stores. 
With rare exceptions, none leave the hospital without breast-feeding or dare ask 
for infant formula as a substitute. For trouble at home, the phone book 
obligingly lists a company called Breast-Feeding Help.

Working mothers also get a break: two hours off a day to breast-feed their 
child at home or in the office. Breast-feeding at the desk is not off limits.

While many countries, including the United States and Britain, still struggle 
to convince ambivalent mothers, Norway and its neighbor Sweden have 
overwhelmingly succeeded in promoting the benefits of breast milk.

Today, more than three decades after bottle feeding peaked in the late 
1960's, 99 percent of mothers here nurse their newborns in the hospital. Six months 
later, 80 percent are still nursing, a rate that compares with 20 percent in 
Britain and 32 percent in the United States, which are viewed as bottle-feeding 
cultures.

"You are expected to breast-feed here," said Kristine Fossheim, 31, a 
Norwegian nurse who is taking a one-year maternity leave to care for her 10-month-old 
son, Erik. "There is a real focus on it from everybody."

"Women who are not able to are very, very sad," she added. "They feel like 
failures if they cannot breast-feed."

Studies have shown that babies who are breast-fed are generally healthier, 
suffering fewer colds, ear infections and stomach distress than babies who are 
given only infant formula. Some studies have also linked breast milk to higher 
I.Q.'s.

While doctors encourage mothers to breast-feed in America, practical 
considerations sometimes win out. Short maternity leaves and hectic schedules do not 
always make it easy for mothers to begin nursing. 

American mothers do not feel the same intense peer pressure that Norwegian 
mothers feel to breast-feed. Nursing babies may benefit more from breast milk, 
but at the end of the day, formula-fed babies also thrive, American mothers say.

An income gap also exists. The wealthier and better educated the mother, the 
more likely she will nurse. Compared with the United States and Britain, 
Norway is relatively homogeneous.

Formula, so abundant in the United States, seems almost illicit here. In 
American hospitals, mothers are given formula samples on their way out the door. 
Here it is conspicuously absent from hospitals, and advertising it is banned.

Supermarkets offer limited stock because demand is so low. There are few baby 
bottle decorations or baby bottle designs on shower invitations.

Norway succeeded in part because the challenge was manageable: with a small 
population, there are some 50,000 births a year. It is also socially 
progressive, relatively educated and wealthy. But over a span of 35 years it has become 
a role model for how to swap bottles for breasts.

The turnaround began in 1970, with a grass-roots campaign started by one 
Norwegian mother, Elisabet Helsing.

At the time, women in Norway were no different from the rest of the Western 
world when it came to feeding their babies. Bottle feeding was not only modern 
and hip, it was also heavily promoted by formula companies and doctors. 
Millions of women in Norway, and all over the Westernized world, abandoned 
breast-feeding.

"The whole aspect of nurturing was just removed from the breast," said Mary 
Lofton, a spokeswoman for La Leche League, the first organization in the United 
States to promote nursing. "Breast-feeding was a real drag. And if you wanted 
to do it, it was quite a heroic act on your part."

Ms. Helsing, though, said she was convinced that breast milk was better than 
formula. After getting her hands on a book written by La Leche, she wrote her 
own light-hearted book on nursing in 1970. Then she walked into the Health 
Ministry and asked an official whether she could print up a pamphlet.

That official, pregnant with her fourth child, turned out to be Gro Harlem 
Brundtland, who became prime minister in the 1980's and 1990's. "She had just 
taken a master's degree at Harvard, and her subject had been the decline in 
breast-feeding," Ms. Helsing said with a laugh. "She said O.K."

That led to the creation of a number of mother-to-mother groups, which stoked 
national interest in nursing. The mothers lobbied the government to help 
reverse the trend in bottle feeding. Before long, leaflets were distributed, 
mothers' groups secured financing and hospital staffs received training, all done 
with the kind of zeal Nordic countries love to muster.

"It's viewed as the modern way of feeding now," said Anne Baerug, the project 
leader for Norway's National Breast-Feeding Center. "It's something that is 
part of being a mother. It's trendy, good and positive."

The 1990's saw the introduction of "baby friendly" hospitals. Babies were 
left in the same hospital rooms as their mothers. They were fed, not on schedule, 
but when they wanted. Women, whose own mothers knew little about 
breast-feeding, were encouraged and taught how to nurse. Problem cases got extra help.

In Britain, for example, hospitals and midwives are still fighting for proper 
instruction in breast-feeding techniques, something that contributes to the 
country's low success rate.

Two other factors have also been crucial to Norway's success. Mothers receive 
10-month maternity leaves at full pay or 12-month leaves at 80 percent pay. 
And infant formula is used only as an exception to the rule.

The long maternity leave makes it more practical to nurse. Many women in the 
United States, where maternity leaves are often no longer than four to six 
weeks, still feel too uncomfortable or harried to pump milk at work. Sometimes it 
is simply impractical.

Norwegian mothers say everything about the culture compels them to 
breast-feed. "Everybody in the hospital is focused on it," said Nora Brinchmann, 31, who 
was attending a mothers' group at a baby clinic. "Everybody talks about it. 
Everybody else breast-feeds."

Hedvig Nordeng, 31, mother of 9-month-old Elias, said from her usual 
breast-feeding outpost in an Oslo cafe: "When a new recommendation comes out, people 
tend to follow it. In France, people try to find a way around them. We are 
quite obedient, I think."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
i am just curious after reading this, how long do mothers in norway bf? is it 
very common to see them nursing toddlers? or is it common for them to wean 
upon returning to work like moms here in the US seem to? i am also curious if 
the whole society is so open to it, do they not have to worry about being 
'discreet'? is it common to see mothers baring their breasts while bfing in public 
there? (a true sign to me bfing is accepted at all levels of society!) and 
finally and most importantly, is it warm there this time of year and does rachel 
have a guest house attached to her home? LOL!

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