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The Quiet Underground is Quiet No More. Extended Breastfeeding is Officially Out of the Closet.

November 27th, 2012 by avatar

My first reaction to the now-infamous Time magazine cover was to groan out loud. Like many of you, I was horrified by that cover’s mean-spirited tone. If we didn’t get the message from the picture, there was also the antagonistic caption: “Are you mom enough?” It wasn’t until later that I recognized that this cover, and the controversy that followed, actually reflected a positive shift. Many things had changed since I first became aware of this topic more than 20 years ago.

In 1992, I was just finishing my post-doctoral fellowship at the University of New Hampshire and was expecting my second baby.  My first experience had gone not particularly well, so I spent months educating myself about birth, breastfeeding, and postpartum. During this time, I became friends with Dr. Muriel Sugarman. We were both on the board of a local child abuse organization in Massachusetts. Muriel was a child psychiatrist at Harvard’s Massachusetts General Hospital and an amazing ally to the breastfeeding community. She was interested in long-term breastfeeding and had collected some data. (“Long-term” was operationally defined for that study as “six months or longer.”)  We started working on it together, and bit by bit, had some findings to report.

We submitted one of our first articles on weaning ages to [a well-known journal in pediatrics].  Consistent with studies in other parts of the world, when weaning was child led, it tended to occur at ages 2.5 to 3. So far, so good.

But then there were our outliers….the babies who weaned at age 5…and a couple of babies were even older. The reviewers, all women we later learned, went completely nuts. If it had been up to them, we would have been both rejected…and flogged. (Eighteen years later, these are still the worst reviews I’ve ever received.) They hated us, our study, and mostly definitely our “weird” mothers.

I wasn’t sure what to do next, until a colleague handed me an article called, “Darwin takes on mainstream medicine.” It described how extended breastfeeding, babywearing, and cosleeping  conferred a survival advantage for moms and babies, and was presented at the American Association for the Advancement of Science meetings. That was radical stuff in the mid-1990s. I sacked our introduction and rewrote it using this framework.

The next question was where to send the revised manuscript. I called a pediatric researcher I knew in Philadelphia. He said, “Oh, I never send articles to [well-known pediatric journal]. They’re mean!” That had certainly been my experience. He recommended Clinical Pediatrics, where we got a much more positive reception. The article came out. We were happy. End of story….or so we thought.

In 1997, AAP Statement on Breastfeeding was released. Controversy swirled around that statement for months about one bit in particular: that women breastfeed for at least 12 months and “as long thereafter as is mutually desired.” I was going about my business, blithely unaware that Muriel and I were smack in the middle of the controversy. What reference did the AAP cite to support “as long thereafter as is mutually desired”? You’ve got it: Sugarman and Kendall-Tackett (1995)!

That paper taught me a lot. Ten years later, when I applied for APA Fellow, I identified it as one of the most important in my career. I learned firsthand about the intense negative stigma surrounding extended breastfeeding. I was equally amazed to discover a quiet underground of women who were defying cultural norms and nursing their older babies right under the radar of family, friends, and healthcare providers. Avery described this phenomenon as “closet nursing,” and noted that extended breastfeeding had a lot in common with revealing sexual orientation. Brave souls who chose to be up front faced marginalization—or worse.

Through much of the decade that followed publication of our article, Muriel and I, along with Liz Baldwin and Kathy Dettwyler, frequently had to write letters to courts and child protection agencies on behalf of mothers who were being investigated for child abuse. Their crime? Extended breastfeeding.

Which brings us up to the present time. Yes, the Time magazine article said mean things. But look at it this way: extended breastfeeding is being discussed in a mainstream publication. In addition, thanks to social media, the “quiet underground” is quiet no more. I’ve been amazed at outpouring of support from both celebrities—and ordinary moms—speaking opening and positively about extended breastfeeding. It was something I couldn’t even imagine in 1995. I think it’s safe to say that extended breastfeeding is officially out of the closet.

In closing, I’d like to suggest that we all owe a debt of gratitude to Drs. Ruth Lawrence and Larry Gartner, and the other brave members of the 1997 AAP Committee on Breastfeeding. Their statement did much to move extended breastfeeding out of the margins and into the public square (and Muriel and I were happy to have a small part in that). We still have a ways to go. But let’s take a moment and savor this small victory.

And to the members of the 1997 AAP Committee, I say this: We, the quiet underground, salute you!

The two articles published from that data set are:

Kendall-Tackett, K.A., & Sugarman, M. (1995). The social consequences of long-term breastfeeding.  Journal of Human Lactation, 11, 179-183.

Sugarman, M., & Kendall-Tackett, K.A. (1995). Weaning ages in a sample of American women who practice extended nursing. Clinical Pediatrics, 34(12), 642-647.

 About Kathleen Kendall-Tackett

Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA is a health psychologist and board-certified lactation consultant. Dr. Kendall-Tackett is Owner and Editor-in-Chief of Praeclarus Press, a new small press specializing in women’s health. She is a research associate at the Crimes against Children Research Center at the University of New Hampshire and a clinical associate professor of pediatrics at Texas Tech University School of Medicine in Amarillo, Texas. She is Editor-in-Chief of the journal, Clinical Lactation, a Fellow of the American Psychological Association, and is president-elect of the APA Division of Trauma Psychology. www.KathleenKendall-Tackett.com

 

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World Breastfeeding Week: Stories of Success

August 4th, 2011 by avatar

[As World Breastfeeding Week winds down, we thought it appropriate to share some uplifting stories of breastfeeding gone right...and the joy, empowerment, health and wisdom written between the lines of these stories.  Thank you to all who contributed. ]

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Never Judge, Nurture and Educate

I was helping a Hispanic mother who had an infant in the special care nursery.  When asked if she wanted to breastfeed her baby the mother refused on several occasions.  Finally I approached the mother; we discussed the baby’s progress, feedings and possible discharge from the hospital.  The mother began to cry saying “I don’t want my baby to become sick from my breast milk.”  The woman was under the impression that breastfeeding after an argument with her husband would spoil her breast milk.  This was an old wives tale that had been told by her family.  I talked with the mother each time she came in about the benefits of breastfeeding, evidence as it relates to breastfeeding premature infants and slowly gained her trust. By the time the infant was discharged mom and baby had bonded, breastfeeding was established and I had an eye opening cultural experience.

Sandra Escobosa, RN, Childbirth Educator
Charlotte, NC
Hip Chick Birth                   www.hipchickbirth.com

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Becoming a breastfeeding Peer Supporter, was an opportunity I couldn’t let amiss. I have not long completed my training, but already I feel proud to have helped mothers and their babies along the path of a successful breastfeeding experience! I volunteer on a placement within a maternity hospital, and one experience will always stay in my mind. A brand new mother desperately trying to encourage her beautiful newborn baby to attach, and to find what she had been searching for. Struggling and on the verge of giving up, she finally asked for a helping hand. With a little help and guidance, and heaps of positivity, the mother looked up with the widest grin I had ever seen and tears of joy running down her cheek. This tiny, clever baby of hers had just latched on for the very first time. Beautiful.

Samantha King
Southampton, UK.

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The Survival Hold

Quite often, I make a home visit for lactation challenges in the first week postpartum.

Without a doubt, the one skill I teach that gets the biggest applause is simply showing a mom how to use the side lying position to feed her baby. I call it the “Survival Hold”. Mastering the side lying position will help a sleep deprived new mommy “SURVIVE” the first few weeks.

Lying down for feeds often will reduce moms fatigue level tremendously.  As an additional benefit, when lying on her side, the breast is compressed and often baby will feed more efficiently.

Lying down while nursing is a wonderful breastfeeding position that is often under-utilized.

Liz Pevytoe, RN, IBCLC

Keller, TX

http://www.askthelactationconsultant.com

 

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We got the phone call we’d been waiting for. We were getting a foster/adopt placement. Suddenly one day I had a new baby but no milk!
My little girl was a “safe surrender” baby. She was born in a campground weighing 3 lbs. 2.8 ounces. No prenatal care, drug exposed. Her birth mother relinquished her rights at the hospital. We met her when she was 17 days old, and brought her home the next day. One of my first calls was to my IBCLC, Debbie. Bring me the rental pump, and the SNS!
Debbie helped me with her weak suck, and was such a big support. It took me six months to bring in a full milk supply, but it was worth it! She is now 2 years old and still nursing.

Teglene Ryan
http://thebreastfeedingmother.blogspot.com/

 

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I am one of the lucky ones. I have been an IBCLC for 10 years now and get paid full time to do what I love to do.  Our hospital currently hovers at a 90% breastfeeding initiation rate so every day is a busy day! Today was just another ordinary day; I assisted a 36 weeker (born 4 weeks early) wake up and latch for the first time. I checked the latch of another newborn, whose mom I assisted with her first baby and told a third time breastfeeding mom that she was fabulous. My triumph today was when I assisted a mother of a sleepy 6 pound baby to latch for the first time after hours of attempts.  Mom looked up at me and smiled in relief while tears of joy welled up in our eyes. And this was just a regular day. I am so lucky.

Donna Sinnott, BBA, IBCLC
Paoli Hospital, Paoli, Pa

 

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Breastfeeding is normal, natural…and so darned hard for so many of us in the beginning!  Desperate to make breastfeeding work with our first child, I sought help from one person after another—lactation consultants, family practice doctors, La Leche Leaguers, friends…in the end, I nursed our daughter for a year—but ended up supplementing her part time due to an ultimate lack of confidence in my own body.  Two children, much reading, practicing, and accessing adequate help later, I finally discovered that my body really was able to do what it was designed to do.  I breastfeed our second child for 14 months (still with some supplementation, but not much) and I exclusively breastfed our third child for six months, and continued on until he was nearly 18 months old.

~ Anonymous

 

[It’s not too late to add your story!  What breastfeeding success have you been apart of?  Please chime in via the Comments section…]

 

 

Posted by:  Kimmelin Hull, PA, LCCE

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