Is breast best?

THE ‘breast is best’ policy is one that’s pushed by the Ministry of Health, as Jamaica keeps up with the trend set by world agencies, which work off various studies and research showing that babies benefit immensely from being breastfed for at least the first six months of their lives.

The evidence ‘for’ breast milk is astounding. Dr Eva Lewis-Fuller, director of family services in the Ministry of Health, speaking at the launch of the National Breastfeeding Week at the Spanish Town Hospital last year, said that mothers who breastfeed their babies for up to six months or more are less likely to raise children who are psychopaths.

Breast milk provides antibodies to help bolster the baby’s immune system and agencies like the World Health Organisation and UNICEF indicate other benefits, which include adequate and appropriate nutrition, protection against infections and reducing the incidence of Type 1 diabetes.

New mothers are bombarded with the message in government clinics and each year, as the country celebrates Breastfeeding Week, more emphasis is placed on doing what’s right for babies.

Then the mothers return to work.

Dr Tracy Evans-Gilbert, past president of the Paediatric Association of Jamaica in a previous Observer article, pointed to a Ministry of Health released survey, which indicated that many mothers initiated baby formula early in order to allow themselves to return to work. Because for many, work, and breastfeeding don’t, and can’t mix.

“I’ve been quite anxious about how I would cope with breastfeeding and returning to work,” Karen, whose name has been changed, wrote to all woman. “There is nowhere at work for me to express milk (even if I wanted to express at work) and I’m thinking of running home at least at lunch time to feed or express milk.”

She’s a corporate executive and mother of two, who is breastfeeding her second child, and like many women who’ve been following the health guidelines, is worried about how she’ll fit this in with work. Indeed, many new mothers return to work sometime after their baby’s third month, and reports from mothers are that where even those who were adamant that they would not introduce formula to their children, are forced to because of work pressures.

And not only are the demands of the workday to blame, but many new mothers have to contend with one of the pitfalls of breastfeeding – having the milk at hand, and having nowhere to express it.

Expressing milk is necessary for those who are breastfeeding, as the body produces milk as the baby demands. And for a woman used to providing milk on demand – for many babies this young it can be as much as every two hours – if there’s no baby to suckle, the breasts become engorged, and therein lies the dilemma for the working mother.

“I was sharing the concerns with the paediatrician who said it was government policy to encourage women to breastfeed exclusively for six months. She also said work places are required to make provision [for expressing] for lactating mothers. Now I don’t know if the latter is official policy or a hope on the part of the ministry,” Karen said.

Director of the Nutrition Unit in the ministry Charmaine Edwards, told all woman that the ministry is compiling a Cabinet submission for this to be in place.

“We’d hoped it would have gone before the changeover, but hopefully before the end of the year,” she said.

She said women need a screened corner where they can express in privacy, and provisioning for an ordinary restroom isn’t enough.

“It can’t be done openly,” Edwards said. “[But right now] we can only appeal to the conscience and hearts of employers to provide a space for mothers.”

Senior lecturer and head of the Centre for Gender and Development Studies at the University of the West Indies Dr Leith Dunn – who said that the ‘breast is best’ campaign is an excellent one that must be maintained and supported by workplace polices and programmes – pointed to the fact that Jamaica has ratified conventions that protect the rights of the breastfeeding mother, “and so is obliged to improve our practices in the workplace in fulfilment of these commitments”.

“Breastfeeding is a basic human right of both the mother and her child under the Convention on the Rights of the Child (CRC). There is the nutritional value, the psychological and emotional benefits that both the mother and child derive; and it’s essential to ensuring the optimum health of the child,” Dr Dunn said.

“Ideally workplaces with a significant portion of women workers and of a specific size should provide crèches to ensure that women can leave their young babies under expert care and breastfeed them at regular intervals during those first crucial nine months at a minimum,” Dr Dunn said. “This can be a win-win situation for the employer as well as the employee.”

Large companies like GraceKennedy admit to having a private room where lactating mothers can express their milk in private and in comfort, complete with a bed and a chair. Red Stripe says because of the nature of their environment, a crèche would not be suitable, but a private room is provided within their occupational health unit where lactating mothers can go to express their milk in privacy.

But it’s not all hunky dory elsewhere.

“Personally, I can’t imagine expressing at work. Mainly because there are no facilities and some of the men there are so vulgar and immature that I think I would be teased if it were ever discovered,” Karen said. “I found one person who used to have to get a friend to watch the door of the sick bay while she expressed. One woman used to express the milk into the toilet at work to relieve engorgement. The other used to pump at work but gave it up after a while as it was difficult managing work and pumping.”

Beverley Barnes said that though she wanted to breastfeed exclusively, after she returned to work, she realised that the stress wasn’t worth it. “I had my baby in London and so I got the full gamut of material on why I should breastfeed,” Barnes said.

“Then I accepted a job in Jamaica and when I started my baby was just three months old. I had been a stringent ‘pumper’, and I froze milk and everything. But my job sucked so much out of me, that I cold hardly cope.”

She said when she suffered from engorgement, she tried once to express in the company’s ladies’ room, but soon realised that it wasn’t a good idea. “People kept coming in, and one woman even came up, felt my breast and said ‘lawd yuh breast big eh!’ I’m sure the whole office heard.

Then I tried to leave work at lunchtime to go to the crèche to breastfeed, but people started commenting on how I took long lunch hours, and because I was new, I had to stop.”

-Tell us what you think at allwoman@jamaicaobserver.com