Is it Cultural Elitism to Teach, or Not to Teach, Breastfeeding?

Over the last few weeks I've come across several online articles, statistics, and advocacy sites that have left me wondering just how strong and universal 'mother-wisdom' really is. When I had my first child, and was spending a lot of time breastfeeding her, I believed I felt connected to all mothers, contemporary, timeless, and not just to human mothers of all races, but to mothers of all mammalian species as well - orangutans, cats, elephants, squirrels, you name it. There's a reason they call her Mother Nature :-) She's BIG.

But human beings are human beings, and sometimes we're just so "smart" that we defeat Mother Nature herself, and ourselves! Recently there was a BBC article covering a birth in a small village in Bangladesh. The mother had a village midwife who used traditional methods and was not trained in modern medicine. In fact, the birthing mother had a decided distrust of hospitals, which perhaps she learned from the midwife. Despite methods that would confuse, bewilder, and yes, horrify village outsiders, the mother and baby managed to survive, but really just barely. The tradition in that village is that early colostrum is considered poisonous to the baby, and breastfeeding is withheld for days on end until the mother's milk really fully comes in. And by then, sometimes its too late.

The journalistic team hesitated and hesitated, not wanting to cross a journalistic ethical line for non-interference in a story they are covering, but it was clear to them the baby was going to die, and on the fifth day they brought a doctor with them. Luckily, very luckily, the village restriction had been lifted and they found the mother finally feeding her baby, who now had a lot of ground (and weight) to regain. So they left, very relieved that they hadn't had to "interfere" after all, since they had already filmed a baby in a neighboring village who had died eight days after birth, having never tasted his mother's breast milk. It's dawning on them that this is not uncommon after all in that part of the world, hence the reason for the article. It's not just infant mortality they would like to make a difference in, but in the maternal mortality rate too, since the traditional village birthing methods themselves are not always, helpful.

Near the bottom of the article is this shocking quote:

"Even the most motivated and well-meaning NGOs can find it hard to challenge these traditional beliefs, for fear of offending local cultures or being accused of being opposed to religious values.

Excuse me?? We citizens of a giant world village, who through science, experience, and mass communications, know how to save many of these babies, are letting fear of offending someone get in the way of sharing the truth with them?? Don't we think they would want to save their own babies?? Wouldn't they want to know that colostrum, the very first breast milk a mother produces immediately following childbirth, is the most nutritious and infection-fighting food substance you can possibly give a newborn?

I think operating out of the fear of committing cultural insensitivity is the most foolish position we can possibly take. Of course we should make every effort to be diplomatic, but total inaction is not diplomatic. Nor is it truly culturally or racially "sensitive". Exactly how "sensitive" is it if we are withholding information that they can use to save their own babies' lives? So we don't want to "look down on" traditional ways, and we don't want to come off as "educated snobs", but at what point does cultural sensitivity become cultural snobbery? Is it when we don't let their babies die? Or when we do let their babies die?

A look at a map of the distribution of Lactation Consultants in the world does suggest a racial and cultural unevenness in the recognition of the importance of breastfeeding. Major continents have only one or two LCs: South America, Africa, Asia, India, Australia. (Australia?) But that does not mean it is time to hold back. That means it is time to find ways to bring our worldwide sisters into the equation. We should not fear they will resent us for enabling them to save their own babies.

Now looking at a map of infant mortality rates in the world - do you see a similarity? While there are many variables we cannot account for on these maps, such as diet of the mother, prenatal care, and pre-term labor, which might get lumped under miscarriage rates any way rather than infant mortality, I can't help but be struck with the idea that improving the breastfeeding literacy of a country might well improve its infant mortality rate.

So what's with the U.S.?? While our infant mortality rate is relatively low compared to most of the world, it's still approximately twice the rate of many European countries. And this is despite the heaviest concentration of Lactation Consultants in the world. So what else is going on here? Well, for one thing the U.S. is one of the countries with the fastest pace of living. Most mothers are expected to bring in a second or primary income as well as care for their children, so off to work they go, dropping their little ones off at daycare centers. If they are determined to breastfeed, yes they can use a breast pump, but eventually, the marketing pressures of the formula industry, the entire spans of grocery aisles devoted to dozens of different milk and soy formulations, usually overwhelm the desire to breastfeed.

Add to that the wide racial and cultural diversity of the U.S., and you will find that some ethnic groups are far less likely to breastfeed than others. In fact, black Americans have the lowest breastfeeding rate of all American ethnic groups. If breastfeeding is to be considered the gold standard norm, culturally, there seems to be something going on here. I recently came across the web site The Pasadena Project, which is devoted to campaigns for addressing the infant mortality rate of American black babies. While I'm sure it addresses serious racial issues, it makes no mention whatsoever of breastfeeding. Why? Why don't they address the one thing that would most empower our black American sisters to save their own babies?

I only became aware of possible breastfeeding aversion among black Americans many years ago when that weird overpriced European clothing company "Benetton" put out a campaign image of a black woman breastfeeding a white baby. To American whites, it possibly represented affection and looking up to strong black women as loving mother-figures. But to American blacks? It stirred up 100 year old historic horror at a whole race having once lived in slavery, whose "duties" included wet nursing the white massa's children. Of course there was outrage and righteous indignation at the campaign.

But what is the long term result of these deeply held feelings? Are American black women likewise feeling aversion to breastfeeding itself, even of their own children?? If so, what a huge huge loss! With the rest of the U.S. moving past racism and white guilt with the election of its first black president, wouldn't it be wonderful if American black mothers could move into a forgiveness phase, and be able to look at breastfeeding as no longer a racial issue, but as a gift of Mother Nature to all mothers of the world?

I see a huge opportunity for American black women to swell the ranks of Lactation Consultants, with their unique perspective on cultural issues, and to bridge the gap so that American mothers of all colors can work hand in hand with Mother Nature for the best for all American children.

On the world scale, I see a huge opportunity for those of us from LC-populated countries to fearlessly step out and sing the praises of the importance of their own breasts to mothers in all countries and cultures.

Mother Nature is as colorblind as children, and that is the only way to be.

All the Breast,