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Breastfeeding in the Modern Age

I am sitting on a patch of grass in a public park—topless . Well, almost. The one thing between my boobs and the roughly 1.5 million Chicago Marathon spectators surrounding me is my husband's tissue-thin windbreaker.

Beads of perspiration (hey, it's 84 degrees outside) make pumping under a jacket a slippery operation, but I wasn't going to let breastfeeding my then 3-month-old daughter get in the way of cheering my sister across the finish line.

Let me tell you, ladies: Breastfeeding. Takes. Commitment. And not just the emptying-engorged-breasts-in-the-presence-of-millions-of-people kind of commitment. We're talking about attaching yourself (literally) to either your baby or your breast pump in an era when a successful businesswoman (Yahoo! CEO Marissa Mayer, you know who you are!) announces she's going to work through some of her maternity leave—a move that may make your boss wonder why you're not doing the same. It's a commitment that means dealing with anyone and everyone's opinion. The longer you nurse (which is really the goal here, right?) the more likely the reaction will be amazement or disgust. Just ask Jamie Lynne Grumet, who nursed her then 3-year-old son on Time magazine's cover. Here's the deal: Breastfeeding is more in the spotlight than ever. Beyoncé, Angelina, and Gwen Stefani have done it—openly. The American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the Centers for Disease Control and Prevention (CDC) urge all mothers to do it. Heck, the IRS is even paying people to do it, announcing tax breaks for breast pumps last year. But there are still plenty of moms—one of every four—who start their babies on formula and never look back. “We can celebrate the fact that breastfeeding rates have been rising since 1990, but our work isn't done,” says Cria Perrine, Ph.D., a CDC public-health expert focusing on infant feeding. “Seventy-five percent of women start breastfeeding in the hospital, but only 44 percent are breastfeeding at six months. And there are racial disparities—74 percent of Caucasian and more than 80 percent of Hispanic and Asian moms breastfeed for at least some period of time, but just over half of black mothers do. We're obviously not giving all women the support they need.”

Nursing Moms Unite
How has such a personal choice become such a public issue? First, medical experts today roundly agree that babies are best served by breast milk for their first six months of life. The AAP recommends that babies continue to drink breast milk once they start solids, until at least 12 months, touting benefits to the infants' immune systems including fewer ear infections, plus added protection against sudden infant death syndrome. But even as a mom who had success providing her child with breast milk through year one, hitting that goal alone is a challenge. Our glimmer of hope? The digital age is transforming the way we approach breastfeeding. Yes, pump technology has improved, and that's a big help to those of us who are on the go (aka, every mom), but Twitter, Facebook, smartphone apps, blogs, even text messaging mean that moms in the trenches (like me) can share in ways they never did before. “Moms can tweet me questions at three a.m.,” says Nancy Holtzman, R.N., VP of clinical content and education at parenting resource center Isis Parenting, who also has a dynamic Twitter following of 1,000 moms (follow her on @nancyholtzman). “I'll answer it by the time they wake up.” Google “breastfeeding blogs,” and you'll get more than 8 million results, not to mention hundreds of Facebook groups including “Real Men Support Breastfeeding” and “If Breastfeeding Offends You, Put a Blanket Over YOUR Head.” In fact, when a Houston-area mom was asked by a Target employee to move from the women's clothing section to a fitting room to nurse her 5-month-old son last winter, one of her mom pals set up a Facebook group to mobilize a “nurse-in.” Within days, the group attracted 6,700 followers, resulting in public-breastfeeding protests at roughly 250 Target stores across the country.{C}Booby Traps

But while breastfeeding advocates are more outspoken than ever, some modern moms still haven't gotten the memo that there are tons of resources at their fingertips. While some women don't want to nurse and a small percentage aren't able to, many women throw in the burp towel simply because they lack support. Here, common breastfeeding pitfalls—and ways to overcome them:

1. Lack of info. Women aren't getting the message that breast is best. In fact, some hospitals don't even have lactation consultants available for daily rounds. “Research shows that when you don't start breastfeeding in the hospital, you aren't likely to start later,” says Perrine.

What you can do: Learn the breastfeeding basics before the hungry babe arrives. Websites like Kelly Mom (kellymom.com) contain great tips, including positions to try when starting out. Some branches of Women, Infants and Children (WIC), the federal program supporting low-income mothers, offer lactation consultants who pay complimentary visits to new moms in the hospital, too—call yours to see if you're eligible. When shopping hospitals, call around to see which ones have lactation consultants visiting with new moms daily.

2. It's hard work. Some women try to breastfeed and truly can't—this includes the 5 percent of moms who have a low milk supply, often due to glandular problems (prior breast surgery could be a factor). But plenty of moms mistakenly think they can't make enough milk—when in fact their baby just needs help latching more effectively or is going through a growth spurt.

What you can do: Some WIC-affiliated lactation consultants make free house calls for latching problems or pain. If you can, spring for a session with an International Board Certified Lactation Consultant—they may charge between $20 and $200 per session, but some insurance plans cover the cost. Find one at ilca.org. (To troubleshoot common problems yourself, see page 78.)

3. And it's hard at work. While breast milk may be free—saving upward of $1,200 a year in formula costs—breastfeeding isn't, especially for working women. The Family and Medical Leave Act ensures 12 weeks of job protection for new mothers in workplaces of 50 people or more, but no promise of paid leave. Pumping is easier courtesy of 2010 legislation that requires companies to provide women with a clean, quiet place to breastfeed, but the law doesn't cover small workplaces or require employers to pay women during pumping breaks.

What you can do: Talk to your boss and human resources rep about your breastfeeding plans in your second trimester. Try to negotiate as much paid leave as possible—you may want to tack on vacation days. Push for the creation of a clean, private space to pump milk, if there isn't one (the ladies' room, by law, doesn't count). If you're an hourly worker, see if you can come in early or stay late at work to make up for pumping breaks.

4. It's completely foreign to me. “Most mothers today were born at a time when formula-feeding was the norm,” says Nancy Mohrbacher, a certified lactation consultant and author of Breastfeeding Made Simple. “Women often turn to their mothers for guidance, and if there's no experience there, there may be no support.”

What you can do: Make breast friends. The La Leche League (llli.org) links nursing moms through local support, and Breastfeeding USA (breastfeedingusa.org) connects women with “breastfeeding counselors,” experienced mothers who've gone through a four- to six-month training program. The Black Mother's Breastfeeding Association has a Facebook page where moms trade tips. “Breastfeeding can be isolating,” says Mohrbacher. “But the more you surround yourself with other moms who are doing it, too, the more you'll understand your experiences are normal.”

Boob Battles 
Everywhere you turn, somebody's girls are making news. A look at the latest boob battles:

HOW LONG IS TOO LONG? Jamie Lynne Grumet's then 3-year-old son climbed on a chair to latch on for Time magazine's May 21 cover, setting off a firestorm of ewws and aahs.

NANNY STATE OR HELPING HAND? About 600 hospitals across the country have banned formula swag bags, and Rhode Island and Massachusetts have made it illegal for hospitals to give out free formula. New York City recently launched itself into the headlines with the Latch On NYC law that restricts access to infant formula by hospital staff, tracks formula distribution, discontinues the distribution of free infant formula, and prohibits promotional materials about formula in and around the hospital.

WHAT'S THE DEAL, ZUCKERBERG? Want to show off your new boob job in a bikini to your 500 closest friends? Go for it. Want to show your family how you feed your infant? Forget it. Facebook continues to come under fire for removing “inappropriate” photos of nursing moms.

YOU NURSED WHERE? Breastfeeding mamas caused a stir last winter when they organized simultaneous “nurse-ins” at Target stores across the country. This August, they went one step further, gathering in Washington, D.C., for the first-ever Great American Nurse-in—a huge display of nursing in public.

MOST LIKELY TO BREASTFEED: California, Oregon, Washington

LEAST LIKELY TO BREASTFEED: West Virginia, Mississippi, Louisiana

•98% of our readers support moms breastfeeding in public.

•15% of U.S. moms breastfeed exclusively for 6 months.

•3 out of 4 moms breastfeed at birth

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