Wednesday, August 17, 2016

Breastfeeding Is Easy, Right? No, It's Not

As World Breastfeeding Week ends, I want to talk breastfeeding and how the Affordable Care Act (ACA, aka ObamaCare) has assisted breastfeeding women.

My nursing background includes assisting breastfeeding dyads in hospitals and in homes while Mr. ZJ was stationed overseas. I earned the certification of IBCLC (International Board Certified Lactation Consultant), which is the gold standard for clinical lactation practice. I assisted women with complicated breastfeeding problems, taught the military base's monthly introductory breastfeeding class (and a big "YAY!" for the new dads that showed up for my class alongside moms!), and advocated for women on base who were forced to pump breastmilk in their cars to ensure privacy. One mother I knew was told to leave a toddlers' playgroup because she wasn't allowed to breastfeed her newborn there. Through these experiences, I learned a great deal about properly assisting a mother to meet her breastfeeding goals.

Think back on your own feelings during your first pregnancy. Excitement is probably the first thing that comes to mind, but don't forget about the hard realizations of I don't know what the fuck I'm doing or How the hell am I going to keep this poor, helpless baby ALIVE? So the research, book buying, and advice seeking (with plenty of unsolicited advice thrown in, to boot) commence. Like a small droplet in a huge sea of unknowns, the question of breastfeeding or bottle feeding pops up. One might think Well, everyone knows that 'breastfeeding is best,' right? and Every mother wants the absolute best for her baby, so of course I'm going to breastfeed!

For all of these mothers who begin with lofty breastfeeding goals, the results are dismal. The World Health Organization recommends exclusive breastfeeding for the first six months of a baby's life, but only 18.8% of mothers in the United States reach this goal. Seriously, what the fuck is going on here?

Women are set up from the start to fail at breastfeeding. Some factors that contribute to this are babies being separated from their mothers in the hospital and hospital policies that discharge women barely 48 hours following birth. For every 1,000 births in the U.S., there are only 3.5 IBCLCs to assist them. After mothers arrive home with their babies, assistance with breastfeeding is even more limited. Most people haven't even seen a breastfeeding dyad, as most women are shamed into covering themselves up. Some mothers must return to work as early as 6 weeks after their babies are born, which makes a deteriorating breastfeeding situation even worse. These are not good odds for a new, sleep-deprived mother to meet her breastfeeding goals; in fact, it only makes her feel like a failure that she can't succeed at something so "natural" and beneficial to her baby.

There is frequent talk about dismantling the "disastrous" Affordable Care Act, but let's look at what it has achieved for breastfeeding mothers:

1.  ACA mandates that insurance providers provide breastfeeding mothers with assistance, counseling, and support. A mother may seek out an IBCLC for help (who can then bill her insurance for those services) before problems completely derail breastfeeding.

2.  ACA mandates that insurance providers supply a breast pump free of charge. This is the most important piece of equipment to help a working mother be successful at breastfeeding.

3.  ACA provides coverage for breastfeeding recommendations, as your provider sees fit.  If you have milk supply problems and need a stronger pump, it's much easier to get insurance to cover the cost of a rental hospital-grade pump than ever before.

The ACA has brought breastfeeding to the forefront of medical issues, which is where it belongs.  Granted, we still have A LOT of work to do to increase the number of breastfeeding mothers, but the ACA puts us leaps and bounds above where we were before. Additionally, I am very supportive of paid family leave as a way to keep a mother and baby together for more than just the standard, unpaid 6-8 weeks. Babies who are with their mothers breastfeed much more frequently than those whose mothers are at work... who would've thought?

Any candidate who advocates for dismantling these important advances for mothers will not be getting this IBCLC's vote.


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