Mandatory Breastfeeding: Yay or Nay?



Some breastfeeding supporters are calling for extreme measures when it comes to the promotion of breastfeeding and the *choice* in infant nutrition. In some cases, many proclaimed supporters feel that mandating breastfeeding would not only benefit the health of the child (and mother) but also our nation as a whole (particularly in terms of health care costs – a savings of $13 billion annually does sounds tempting).

Some push for formula to be treated as a pharmaceutical-like prescription, warranting a doctor’s prescription.

Women giving birth in New York City may have already begun to experience something similar to this due to recent regulations – while NYC mothers are not denied formula if requested, they will receive a mandated discussion from staff on why breast is best and each bottle will be tracked. [*][*]

Some say New York is ahead of its time for embracing such measures. Maybe it is…or maybe the focus should be directed elsewhere. [*]

I, for one, don’t know what to make out of it. Sure, the part of me that wants every baby to be breastfed jumps for joy, but on a certain level, I know the answers to issues like these are not in regulation…

High coverage with optimal breastfeeding practices has potentially the single largest impact on child survival of all preventive interventions. [*]

Absolutely, something must be done to get more babies drinking breast milk – but just because breastfeeding is natural, does not mean it is easy.

Sadly, the most recent data from the CDC shows only 16 percent of mothers exclusively breastfeed for the first 6 months of their baby’s life (which is the current AAP and WHO recommendations).[*][*][*][*] 

Even with this dismal statistic - it is essential to note that according to research, the large majority of mothers truly desire to breast-feed their babies exclusively for at least three months. Even though only 1 out of 3 of them will meet this goal, these numbers can not be blamed on a mother’s lack of interest or desire. [*]

Most mothers really want to breastfeed their baby, however, there are certain factors that may improve or worsen the odds of them their goals - which speaks to the underlying problem at hand.

One improvement - mothers of infants that don't receive formula in the hospital are 2.5 times more likely to meet their breast-feeding goals. Also, those who initiate breastfeeding shortly after delivery improve these odds as well. So it seems that the hospital environment, support and information do play a critical role in developing a breastfeeding relationship (at least early on).

So the changes requested from ‘Latch on NYC’ regarding revising hospital protocol, marketing and the restrictive use of free formula may be onto something…[*]

However, if you've ever breastfed – from experience, you realize it is not the first few days that are the most difficult. It's those following weeks when the pain appears and the support your partner is not only important but essential.

Once you overcome the hurdles of hospital and home, then comes another: the workplace. The majority of U.S. mothers return to work and have to manage some type of pumping arrangement with their employer (with the majority of states lacking any regulation of nursing mothers rights).

The few obstacles mentioned above does not begin to scratch the surface of breastfeeding obstacles, consider infection (thrush), growth spurts, nursing strike, premature baby, tongue tie, difficult latch, cracked nipples, separation from baby, difficult birth, multiple births, medications, etc….

All of which can face a mother who is wholeheartedly willing to breastfeed to 6 months.

Should breastfeeding be optional?

For me, this is the wrong question to solve the problem of our current breastfeeding rates.

The number of women I know wanting to breastfeed (who happen to come across challenging obstacles in the first few weeks) far out weigh those few who choose never to breastfeed or who purposefully dry up their milk supply to feed their babies formula instead, by choice.

We should place resources into breastfeeding education and support for women (and their partners).

We should absolutely be more aware of formula marketing techniques.

But where I start to get leery is when we start placing those resources toward the small group of women who adamantly do not want to breastfeed.

These women should not be forced via legislative measures. Besides, how the hell can you force someone to breastfeed? Really, what would be the logistics of it?

Gioia Albano Mother Art

A Better Way

So what can we do to help support women meet their goals in feeding their baby while not trampling on personal liberties? 

If you truly want more mothers to breastfeed, do something. Attend a breastfeeding support group for new or expecting mothers. Become active in legislation that protects and supports maternal rights (particularly in the work place-for those pumping moms out there). Encourage pregnant friends/family to meet with a lactation consultant prior to giving birth. Learn more about the obstacles and issues at hand and do what you can in your own social network to help.

Media may give the impression that we are losing this war, but that is not the case!

Breastfeeding rates in the U.S. continue to increase.

The increase seen from the most recent data represents the largest annual increase witnessed over the previous decade with rates rising from 44.3% to 47.2% in babies breastfed to 6 months.[*]

The passion among breastfeeding mothers to support fellow moms reaches worldwide. There already exists international code requiring access to education to mothers regarding the advantages of breastfeeding, recognition of breastfeeding rights and the restriction of marketing misbehavior. [*][*][*]

Yes, breast is best – however, if you consider yourself a lactivist I cannot see how supporting a mandatory breastfeeding law helps and supports mothers. The dilemma of our currently bleak breastfeeding statistics goes much deeper then what a compulsory law is capable to handle.

The solution starts with our awareness in our own ability to influence, educate and support new mothers – each and every one of us (the hospital worker, the coworker, the friend, the sister, the neighbor, the stranger).

With each generation we can observe the support and education growing - this isn’t a time to segregate and impose regulation. Now is the time to connect and do your part!

Lactivist (n.)

            A word combination from the word ‘lactation’ and ‘activist’

One who seeks to promote the health benefits of breastfeeding over formula-feeding and to ensure that nursing mothers are not discriminated against

Can't Do Vegan? Consider a Pescetarian Diet

Sure, you’ve heard people drone on and on about the benefits in becoming vegetarian or vegan, but maybe the thought of giving up meat (and *gasp* dairy) seems too overwhelming and difficult (especially when cooking for your family).

In this post, I encourage my readers to consider trying and learning more about the pescetarian diet (also termed ‘sea’gan).

Personally, I chose to eat a pescetarian diet nearly one year ago and it has had a tremendously positive affect on my health. I’ve lost 25 lbs (mostly lost in the first 2 months), have more energy, sleep loads better (‘loads better’ is a scientific measurement used by moms of toddlers in case you were wondering) and (what I’m most proud of) have influenced my family’s overall health (short and long term).  

So, what exactly is pescetarianism and why the heck should you care? Read on -

Pesce-what?

As known as pesco-vegetarian, the word itself is a blend from the Italian word ‘pesce’ which means fish and the English word ‘vegetarian’.

People who adhere to pescetarianism eat any combination of fruits, vegetables, beans, nuts, grains, fish and seafood – however, they do not eat mammals (ex. cows, pigs, deer) or birds (ex. chicken, turkey). Some pescetarians may eat eggs and/or dairy, whereas others do not (I do not).

To put plainly, it is someone who chooses to eat seafood but not any other meat (or dairy in some cases). Pescetarianism is closely compared to the Mediterranean Diet and, by some, has been used to transition into vegan/vegetarianism if desired.

Why give up my cheeseburgers for fish?

Consider this – try opting for fish instead of meat for your main entrée. Here are just a few of the benefits you (and your family) will gain:

Raises good cholesterol (while lowering bad)

Once a person starts eating a Pescetarian diet they experience a raise in HDL (aka ‘good cholesterol’) levels which immediately begins to lower the risk of cardiovascular disease which prevents coronary artery disease and reduces the chance of stroke and heart attacks.[*][*]

Helps manage weight

Foods that are typical consumed in the pescetarian diet largely help stabilize blood sugar (beans, nuts, vegetables, fish) which combats binge eating. There is a reduction for the risk of obesity, diabetes and hypertension when choosing opting for fish instead of red meat (or even chicken).[*]

Better mental wellness

Pescetarisns naturally consume large amounts of omega-3 fatty acids due to the larger consumption of seafood. Diets rich in omega-3s have been shown to reduce depression and improve cognitive assessment.[*][*]

Keeps blood pressure in check

Adopting a pescetarian diet does wonders for blood pressure. Since the diet typically omits foods high in sodium and saturated fats, it naturally reduces the risk for hypertension which plagues diets that consume red meat and dairy. Also worth noting, the high intake of omega-3 fatty acids with helps lower anxiety (particularly social anxiety disorder) and stress.[*][*][*]

Reduces risk of cancer

It is no surprise, the more you or your children consume red meat the risk of cancer mortality increases (of various types). On the flip side, diets higher in fiber and that are plant-based (such as pescetarians) reduce cancer risk in a number of the most common cancers.[*][*]

Improves women’s health

For those of us that are pregnant or nursing (or essentially childbearing age) a diet rich in fish and omega-3 fatty acids is superbly beneficial for brain, eyes and central nervous system development in the fetus and nursing infants. The effect of mom isn’t lost either, forgoing meat and substituting for fish will support a better heart, immune system and inflammatory response in mothers-to-be (or all moms in general).[*][*][*][*]

Better eating habits for children that stick for life

Science confirms the consumption of fish reduces rates of all-cause mortality, cardiac and sudden death in adults, yet the research is currently insufficient regarding infants, children and adolescents. What can be said, however, is healthy dietary patterns that include fish are established early in life – of which influence dietary habits and health as an adult.[*]

Power boost of Vitamin D3

For the average American, diet accounts for approximately 10% of the total vitamin D intake. The remaining 90% would then be at the mercy of light exposure (or supplementation). A significant portion of the population is deficient in vitamin D. Diets rich in fish (particularly salmon and other fatty fish) significantly increase vitamin D levels which largely impacts immune function, mental health regulation, and lowers the risk of cancer.[*][*]

Ethically speaking, you can sleep better at night

There is no doubt that a pescetarian diet is kinder to our animal friends and the environment. An omnivorous diet (consuming cows, pigs, chickens, eggs, etc) uses an extrapolate amount of fossil fuels and water (contributing to forest depletion and water pollution) – it also contributes to the current grossly inhumane treatment of billions of animals a year.  

The Power is Yours

When it comes to food and dietary choices there are numerous factors on what ultimately is chosen (taste preference, social influences, expert advice, etc).

The choice is yours – in essence, the choice of what we (our children) decide to consume is the ultimate power over our genetic code (just check out the research of nutritional genomics).[*][*][*]

All and all, I hope this information provides some information on a possible alternative to yoru current eating habits that might helps you make better choices for you are your family – I know it has mine.

"The doctor of the future will no longer treat the human frame with drugs,

but rather will cure and prevent disease with nutrition”

Thomas Edison

Research Confirms Risks of Spanking - So Why Are We Still Doing It?

Spanking is perhaps one of THE most strongly debated parenting issues out there and I can pretty much guarantee that no matter how I approach this subject someone will take offense or feel judged by it.

So, just in case -

Disclaimer:  I am not judging YOU. In fact, my consideration towards the act of judgment is that it results in a shut down of the free-flowing exchange of information and alternatively opens up the gate to tension, polarization and insensitivity. My goal in this post is to offer information that I have gathered – I urge every parent to use this as a catalyst to learn more.

Discipline is one component of proficient parenting and every family (and each parent) has a unique way of teaching what is/is not acceptable conduct.

In the United States, corporal punishment (CP) is used by parents of toddlers roughly 50% of the time as a means of communicating what is/is not tolerable. That number was seen to increase up to 94% when kids reach preschool age.[*][*] 

cor·po·ral pun·ish·ment

           

a form of physical punishment that involves the deliberate infliction of pain as retribution for an offence, or for the purpose of disciplining

**for the research referenced below corporal punishment signifies non-injurious, openhanded hitting with the intention of modifying child behavior

These numbers shouldn’t be all that surprising, after all, us parents learn how to parent from our own parents and in the United States corporal punishment has a strong tradition.[*][*] 

Fortunately, tradition transforms over time as the understanding and knowledge of a society is advanced and broadened. Unfortunately, societal change typically occurs at a much slower rate then the contribution of data is accumulated.[*]

The knowledge base of corporal punishment on children has grown over the last several decades building upon hundreds of research studies in several diverse fields: psychology, medicine, sociology, social work and education.[*]

What does the large majority of research reveal regarding discipline that incorporates CP?

Putting Kids at Greater Risk

The vast amount of data that has been accumulated over all disciplines supports that corporal punishment (physical discipline, spanking) is no more effective than other forms of punishment.  Most importantly, not only it is no more effective but this form of correction exposes the child to added adverse effects.[*][*] 

In an unprecedented degree of consistency, 94% of the 117 tests reviewed in an 88 study meta-analysis confirmed that CP is associated with an increase in harmful side effects (these studies controlled for ‘parental warmth which illustrates that CP is harmful even when it is performed by loving parents): [*][*][*]

Increase in:

Aggression

Delinquency in childhood

Crime (as an adult)

Antisocial behavior

Depression

Anxiety

Physical aggression toward parent(s)

Physical aggression toward dating partner

Sibling rivalry

Vulnerability to stress

Decrease in:

Empathy

Parent-child relationship

Cognitive development/abilities

Scores in educational achievement

Language comprehension

Self-esteem

I understand not every child who is spanked or slapped for discipline purposes will develop all, or any, of the above negative outcomes listed – however, it is abundantly apparent that corporal punishment places a child at risk for both short and long tem negative effects.[*][*]

The Immediate Need to Adjust Behavior in Safety Scenarios

Effective discipline can be analyzed in three time periods: immediate, short-term (hours/days) and long term (months/years).[*]

There remains a consensus that spanking is the most effective means in stopping misbehavior in an immediate need. In fact, this is one of the main listed benefits in using CP.

For example, if your child repeatedly grabs pots off the stove or is baiting his/her luck running into traffic - safety is paramount and if spanking works best, then this might trump any future adverse risk(s) that may or may not come to fruition.

If corporal punishment is effective when other methods fail in this instance, it would debatable to eliminate spanking. However, tremendous evidence exist from short-term prospective studies on this particular issue that show this is not the case.[*] 

This may not be all that surprising, but, when it comes to toddlers, research shows that every mode of discipline has a high short-tem failure rate. This is because it takes a great deal of time and many repetitions for standards in behavior to be internalized.[*][*] 

But when it comes to spanking, at least two other factors interfere with it being the best choice.

1 Interference of Cognitive Function

For a young child, being struck by a parent is a frightening event. The negative emotions felt be young children (sadness, anger, humiliation, shame, fright, stress, etc.) are able to result in cognitive deficits which impede learning and may be one explanation for the elevated failure rate among spanking in the long-term.[*][*] 

2 Absences of Explanation, Strategy, & Resolution in Conflict Situations   

Parents may offer an explanation along with corporal punishment which may reduce adverse effects however, they are not eliminated.[*]

Consider what a child is denied when a parent resorts to spanking as a form of discipline: The opportunity for the child to observe and participate (age-appropriately) in resolution strategies that are important to learn in future life situations are diminished (such as explanation, creating appropriate alternatives, and compromises).[*]

But Why Do Most Parents Think Spanking is More Effective?

Perception

Although the high-failure rate of spanking is observable, few perceive it.[*][*]

Children who were spanked had an increase in misbehavior two years later, whereas children who were not spanked had a decrease in misbehavior.[*][*]

When a child throws a toy at their brother or sister and the parent explains that the behavior will not be tolerated and places them in time out….  the child does it again a few hours later – the ineffectiveness of time-out is attributed to the repetition of behavior.

But if the child is spanked and required to be spanked again it is not perceived as being ineffective – instead, it is indicated that the child merely needs spanked again.

However, the existing literature overwhelming supports the understanding that all methods of discipline, including CP, have a high failure rate in young children.[*] 

It is the consistency and persistence of the discipline used that makes it effective.[*]

Repetition of spanking a child will result in compliance – as will other discipline methods.

The consistency and persistence used by parents that support spanking are precisely right but unfortunately they are applying a method that has increased risk of harmful side effects.

In fact, the majority of studies completed demonstrate that spanking does not have the effects parents intend; rather it has the reverse effect of increasing undesirable behaviors.

Information

Parents may perceive CP as effective, if not more then other discipline methods because they are not informed of the possible long-term effects. (see above)

Now – all methods of discipline are likely to carry side effects; in fact, the end-goal to discipline is behavior modification. However, there are tremendous amounts of evidence illustrating that the side effects associated with spanking is not something a parent would desire. (again, see list above)

This underscores the urgency for professionals that work with parents to advise them of the detrimental consequences coupled with spanking/ hitting a child which is supported by research.[*] 

The American Academy of Pediatrics (AAP) does not endorse spanking under any circumstance. According to the AAP, it is a form of punishment that becomes less effective with repeated use.[*][*]




If a person is more affluent and better educated,

they are less likely to support corporal punishment

in children (Source: 2003 TGI  Brasil)

 

Should There Be a Ban on Spanking?

Using the world as a compass

Beginning with Sweden in 1979, over the last 34 years there has been a total of 33 counties to ban the practice of corporal punishment of children by parents, teachers or any other adult.[*][*][*]

Sweden pioneered the way by using informational campaigns and meetings with parents to inform them of spanking there are other options that are as effective.[*][*]  

The purpose of banning CP is not to put parents in jail. Rather, it is about prevention. It is to encourage attitudes and practices to promote nonviolent methods of child rearing. This hopefully lessens the likelihood of children at greater risk of physical punishment (those who come from a lower socio-economic background, minorities, and those with disabilities).[*][*][*]   

Corporal punishment in homes and schools remains constitutional in the United States. (You can review the State by State comparison here on the laws protecting children for physical punishment)

The countries that have banned corporal punishment did so on the basis of human rights obligations, supported by the very strong research evidence of the potential damage that this type of corrective discipline presents.[*][*]


Conclusion

I do find it ironic that the research illustrating the risks of CP is largely gathered and published in the United States, however the data is informing legal and policy changes in other countries around the world before it has any impact here.[*][*]

There is absolutely no doubt in my mind that every parent is doing the best of their ability with the resources available to them.

I hope the information presented here facilitates just one parent that uses corporal punishment to consider learning more about other means of discipline that may carry less risk to their child(ren). 

"Violence against children, including corporal punishment, is a violation of the rights of the child. It conflicts with the child's human dignity and the right of the child to physical integrity. It also prevents children from reaching their full potential, by putting at risk their right to health, survival and development. The best interests of the child can never be used to justify such practice" [*]

-UN Deputy High Commissioner for Human Rights, Kyung-wha Kang

Some resources for learning more about effective discipline:

Effective Discipline Techniques for Parents

University of Florida IFAS Extension

Cassandra Deas and Eboni J Baugh

Positive Discipline Techniques

CWLA (Child Welfare League of America)

American Academy of Pediatrics – Guidance for Effective Discipline

Committee on Psychosocial Aspects of Child and Family Health

1998

101 Positive Discipline Techniques

Discipline & Punishment

Family Education Network Website  (Pearson Education, Inc.)

Elizabeth O Cooper