As an almost full-time lurker and exceptionally rare poster, I just had
the opportunity to read Alicia's posting about the depressing fall-off
in breastfeeding rates in the U.S. when mothers return to work. I hope
the members of the community will allow me to comment on it.

I'm always so glad to see young nursing students taking an interest in
breastfeeding, even if Patty Vari does make it a major part of her
curriculum. ;-)

But I think we have two separate issues here, and I'm not sure if
they're specific to the U.S., or if these are issues also seen by our
international members.

The first issue concerns breastfeeding persistence. The U.S has seen a
"renaissance" (if that is the best word) in the initiation of
breastfeeding over the last 20-25 years, thanks in part to the hard work
of so many people, some of whom are members here. But persistence is an
issue. Many women quit nursing when they return to work at 6 weeks
(financial and cultural factors, including family leave policies, are a
separate discussion), especially if they return full-time. As a single
mom, I was lucky enough to receive some financial support from my
parents (basically, they paid my rent for 2 months), but not all
families can do this, and some couples feel it is necessary to have the
full-time income, either to support the consumptive lifestyle they've
become accustomed to pre-baby or because they have a tremendous number
of financial commitments they must meet simply on a day-to-day basis. I
returned to part-time work when my son was 7 weeks old, and did this for
6 weeks until I got a job working as a nanny (making far less than
minimum wage, but I could walk to work and take my son with me). I had a
13 year old car and two roommates (3 bedroom apt), and a food budget of
$20/week. How many of us know others who would make these sorts of
sacrifices?

Many other women quit nursing around six months, either because they've
received a lot of disinformation about breastfeeding or because they're
receiving not-so-subtle pressure from "friends"/"family members"/"loved
ones" that nursing for "that long" is "abnormal" or "unnecessary" or
"makes the baby too dependent" or any of the other stupid statements we
run into concerning breastfeeding on a regular basis. Others quit at one
year, for similar reasons. Basically, what it boils down to is that at
the age of one year, only one in eight infants is still nursing, and the
breastfeeding persistence rate continues to decline as the babies age
into toddlerhood, mainly, I think, as a result of the mother deciding to
wean before the child is ready, rather than allowing natural weaning. In
my own family, my mother has five grandchildren. My son nursed until age
7 years 11 months. My third sister used a breast pump for eight weeks
for her premature son who was in the hospital, until her c-section
healed and she was released by her doctor to return to full-time
employment in a furniture factory. My second sister is an A-cup girl and
will tell you her breasts weren't "big enough" to nurse her 2 children,
and she has a master's in Biology from Iowa State and was a presidential
scholar at Monmouth College. My sister-in-law, who has her doctorate and
teaches in an unnamed department at the University of Texas, Austin, to
the best of my knowledge didn't even attempt to nurse her son. Out of
these five children, therefore, we have an average breastfeeding
duration of almost 16 months, but this is a misleading average, because
the college drop-out nursed the longest and if we take her child out of
the pool, the remaining four children were nursed for almost two weeks
each. And that two week figure is much more typical of the breastfeeding
pattern you see in the U.S.

How will we lengthen persistence? A large part of that is generational.
As the children who have been nursed over the last 20-25 years grow up
and start having children of their own, I think we're going to see gains
in initiation AND persistence of breastfeeding. We're just going to have
to grit our teeth and hang in there until this second generation starts
showing up.

The second thing I wish to comment on is probably the unspoken
assumption I find most glaring and consider my most important point: the
idea that a working, nursing mother needs a breast pump. I was given a
hand-held breast pump by our local WIC department, and I wasn't smart
enough to figure out how to operate it. When I went back to work, I
hand-expressed my milk in the bathroom while eating my lunch (it was a
VERY clean bathroom). Whenever I'm involved in a breastfeeding group,
either in person or on-line, and pumping comes up, I make sure to raise
my hand and remind folks of the non-technical method available for
getting human milk. No batteries or outlets needed, no equipment or
tubing that needs to be cleaned, and silent and cost-free to boot.
Pamela Morrison and others outside of the U.S. have commented here on
how the mothers they work with use hand expression, not pumps. Why do
Americans always assume that every problem has a technical solution? Any
other hand-expressing members out there who care to join me?

Best wishes to Alicia and others in North Dakota,

Lynn Stuckey

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