Breastfeeding and Child Health
|Featured in the November 2011 issue of Exterminating Angel Press|
|by Kelly Reynolds Stewart
More than just cha-chas, jugs, knockers, hooters, honkers, headlights, melons, and sweater puppies
The businessman in coach class, the one in the shiny watch, complained to the steward as I nursed my three month old as the plane took off. He complained as he peeled off crisp bills to pay for his Bloody Mary. How many dollar bills do you suppose he has folded into a g-string as a reward to some darling for sliding her nipples up and down a brass pole? A sexualized breast is worth money in this country, but a breastfeeding breast is shameful.
At the same time a young woman is funding her college career displaying her goodies, a baby is hungry to feed. Blushing and embarrassed, its mother covers up or hides out in a bathroom stall. Or maybe having given up entirely, she feeds the baby formula in order to spare those around her the shock and horror of her getting ‘all mammal’ and using that nipple for its intended purpose. What the hell is up with our culture that shames breast feeding into a corner, literally?
First let me start by saying, yes, there are reasons that some woman can’t or shouldn’t breast feed. Also, woman have the right to decide they simply don’t like it. This essay is not a condemnation of women that can’t do it out of medical or physical limitations. Nor is this a condemnation of women that give way to the cultural and social pressures that discourage nursing. This IS a condemnation of a culture that discourages woman from making the healthiest choice for their infant by withholding support and making it shameful, inconvenient and impossible. So there.
What is it with the American love/hate relationship with the breast? We rally, walk and bumper sticker ourselves in pink to save breasts from cancer. Entrepreneur Magazine says “breastaurants” are poised to be the fasted growing segment of the industry. In 2010, 318,123 breast augmentations were performed. I think it’s safe to say, Americans like boobies and we want to show them off – as long as there is no baby hanging on.
Deborah Norville’s career was devastated when she posed on the cover of People magazine nursing her infant. Tom Shales, of the Washington Post called the magazine cover ‘a gross exploitation of oneself and one’s child all in the name of career advancement.’
Um, pardon me, career advancement? As I sat with a breast pump in the janitor’s bathroom during my attempt to balance career and family, I pretty clearly got the message that being a nursing mother was not something I was going to be able to exploit for career advancement. My supervisor tapped her watch, how much time out of my day was this ‘process’ going to take, she asked.
I should have been in the best possible situation. Hell, my job was to represent the interests of young children and support community health education for things like….wait for it… breastfeeding. If I couldn’t figure out how to make nursing a baby and a career possible, who could?
And why does it matter?
The American Academy of Pediatrics thinks it matters. The AAP recommends that mommies keep their mammaries out of Victoria’s Secret and in a nursing bra for the first six months of an infant’s life. That’s a long time – especially if you are living in one of the two industrialized countries in the world that doesn’t offer a paid maternity leave (US and Australia). Without paid leave, mothers hurry back to work and can’t breastfeed. Most workplaces, like mine, don’t make it possible to pump breastmilk during a workday. A mother can probably find a way to suck down half a pack of smokes and a Starbuck’s mocha during an eight-hour workday without a problem, but no one is likely to help her with a lactation situation.
The AAP six-month recommendation doesn’t come out of nowhere. Research provides pretty solid support for breastfeeding outcomes.
Examine the following:
In the first year of life, after adjusting for confounders, there were 2033 excess office visits, 212 excess days of hospitalization, and 609 excess prescriptions for these three illnesses per 1000 never-breastfed infants compared with 1000 infants exclusively breastfed for at least 3 months. These additional health care services cost the managed care health system between $331 and $475 per never-breastfed infant during the first year of life. Health Care Costs of Formula-feeding in the First Year of Life. Thomas M. Ball and Anne L. Wright. Pediatrics 1999; 103:Supplement 1 870-876.
For those of you that are inclined to think this breastfeeding stuff is some sandal wearing warm hearted fuzzy hippie crap, those are numbers. Less visits to the doctor and fewer health care services. Those numbers translate into money. For the employer that rolls eyes at the idea of accommodating a nursing mother, those few minutes she spends each day with a breast pump could save you on sick days. A fewer days that the employee calls in absent due to a snotty-nosed kid.
Speaking of money and healthcare, everybody got their panties all wadded up about Obama Care. As it so happens, I would have really appreciated a little Obama Care while I was shamefully milking myself in the janitor’s bathroom at a branch of the largest non-profit community charity in America.
H.R. 3590 and H.R. 4872 Section 4207 requires an employer with over 50 employees to provide reasonable break time for an employee to express breast milk for one year after the child’s birth. Don’t worry, the employer is not required to compensate an employee for any work time spent for such purpose but they do have to provide a place, other than a bathroom, for the employee to do the deed.
These small changes could improve some pretty paltry statistics, at least a bit. According to the Centers for Disease Control and Prevention, approximately 75 percent of mothers start breastfeeding after birth, but less than 15 percent of those moms are breastfeeding exclusively six months later.
That is likely because six months into this parenting trip, a mother has been exposed to a mind numbing amount of unsolicited opinion and garbage misinformation about breastfeeding. Fifty-seven percent of respondents told BabyTalk Magazine they disapprove of public breastfeeding. With the nasty looks and clucking tongues it’s no wonder so many say ‘screw it’ and buy a can of formula.
I am going to assume the origin of the problem and intolerance stems from ignorance, as it often does. Perhaps a little science-y goodness will create a little awe for this mammalian function.
Here are a few upsides of being a mammal, reasons we should think our branch of the taxonomic tree is pretty special.
Nonsense and Bullshit
So, if breastfeeding makes for healthier, smarter kids. Healthier kids turn into healthier adults. Healthy adults require less healthcare services and are more productive people. Most of corporate America has acknowledged that looking out for health has a financial upside. Companies offer healthcare discounts and incentives to quit smoking and get your butt to the gym. Companies encourage employees to adopt healthy habits that produce better outcomes for the whole group. Everyone benefits from greater productivity and lower healthcare costs.
So, um, where are the incentives to breastfeed a baby? Where are the insurance premium discounts, the free seminars, products and services? My company will reimburse me for Nicotine gum, but they will not reimburse me for a breast pump or the ten minutes I spend in the janitor’s closet with it. Surely a healthy baby with fewer ear infections and a decreased likelihood of chronic disease would create a lesser burden on resources.
Several states have begun to acknowledge the importance of encouraging breastfeeding and have pretty unique laws to support it. For example,
So there are little shining lights of support for breastfeeding, but we need more. Breastfeeding is a choice. Just one of a million that a parent makes on behalf of their child. It’s a great choice, it’s a healthy choice. As a culture we need to do what to support parents that are trying to make decisions in the long term interest of their child’s health. We need to invest in breastfeeding as health strategy. If only we spent as much on breastfeeding support programs each year as we do on the Sports Illustrated Swimsuit Edition.
|September 2011, Exterminating Angel Press|
|by Kelly Reynolds-Stewart
Just as she had with most things over the last ten years, she had developed a systematic approach to the most mundane of tasks. After each bed was stripped nude of its sheets, they were packaged in a dirty wad in the pillowcase and catapulted with some zest down the stairs. If the house was silent and empty during this process, she would do it with such force the glass would rattle when they hit the shabby front door.
She would then proceed to carefully apply the sheets to each bed. Each sheet had been dutifully washed, in the hottest water and soap with acceptable balance of scent, effectiveness and affordability. Each sheet selected with love and attention to personal preferences. Three hundred thread count skull crossbones and guitars. Soft microfiber for some and practical, durable cotton for others. She placed her hands in the corners of each fitted sheet and in one fluid motion covered the corner of the bed. She folded hospital crisp edges that would be pulled from their position within the next four hours – undone quickly and without thought, as with most of her efforts.
The sheets that covered the bed in which she slept were nearly threadbare. They had been purchased from a predictable and practical mid-western mail order catalog seven years earlier. They were utilitarian and unoffensive off-white. Their thread count was acceptable. They were not colorful, exotic, bamboo, organic or in any way exceptional, as they might have been had she selected them to please only herself. In the last seven years her relationship with them had been surprisingly intimate. From these sheets she had scrubbed cum, the early blood of labor, amniotic dribble, and breast milk. She had pulled them from the bed in the early hours of the morning when they had been covered with the baby vomit and the contents of a poorly applied diaper. Bloody noses, green snot from sleepless children. It was on these sheets that she laid a seizing baby and carefully administered small rescue breaths to blue lips while waiting for paramedics.
She had never thought about it, but assumed this intimate relationship with the sheets afforded her some ownership of them, as well as the bed they covered, even though she had not paid for them. Today, as she handled them, they felt strange and unfamiliar. They were no longer hers. She had been informed that her failure to contribute to their purchase gave her no ownership. They were at the kernel of the matryoshka doll – not the sheets, not the bed, not the bedroom and not the house. None of them were hers.
That night as she slept in those sheets the dream returned. It reoccurred with a force that excluded all others now. She slammed her foot through the paper-thin bottom of a submerged and sinking boat. As she stomped in panic she understood that only by making the boat sink faster would she be able to rise to the surface and take air.
How Chows Brown Cow
featured in Exterminating Angel Press
July 1, 2011
And the flesh you so fancifully fry
is not succulent, tasty or kind
-The Smiths, Meat is Murder
The slab of tasty goodness plated on my table was born no more than eighteen months ago. For about a year she lived munching grass and feeding from her mother. After packing 650 pounds onto her selectively bred Angus frame– she headed for the big time.
Her last days were spent confined, sucking down eleven liters of fresh water each day and as much government subsidized corn as she possibly could on an industrial feed lot. In a few short months, she packed on a sweet 450 pounds of velvety, marbled meat and she started getting the eye from management.
Considering the puddle of grease forming around the parsley and the effortless way my husband’s knife cuts through the flesh, I think it is safe to say, that the marbling efforts directed at this little lady, were fantastically successful. So much so, that eighteen ounces of her lower back can be considered “Prime” by the USDA and served up to a single diner for a twenty five dollar price tag.
I can’t stop staring at her. I have a mixed and tumultuous relationship with meat.
Sometime around the age of 15, I pronounced myself a vegetarian at family dinner. My mother responded with the only moment I ever remember her table manners as anything short of the Emily Post standard. With a mouth full of Chicken Divan she said,
“You want to be what?”
It was with great restraint (and a napkin over her mouth) hearing my reply she said, “humph.”
Having been raised with the hearty comfort foods of the casserole and meat and potatoes 1980s, this seemed unthinkable. Vegetarianism was reserved for odd religious sects and bra-less women with yogurt makers on their kitchen counters. Cooking in mid-western suburbs didn’t happen without meat.
There are many things I can’t clearly recall about being 15 and my reasons for adopting vegetarian habits are no different. At the time I probably thought it was for the love of animals, the same love that still drives me to watch Internet cat videos. Realistically though, it was the burning desire of a 15 year-old girl to piss off her parents (which worked splendidly btw).
Much like when I quit shaving my legs and drove an earring through my own ear – pain dulled only by an ice cube and The Smiths album – it was nothing more than an act of teenage defiance. But as teenage rebellion goes, it was a pretty decent choice. I was not smoking Virginia Slims in the Girls’ bathroom during Algebra II (okay, maybe a few times); I was decreasing my risk of modern disease by a staggering rate.
I was blissfully naive about so many things then. In the early 1990s I was primarily looking to rage against the machine. Now in my late thirties, on the days I have the time and energy for rage, I rage against heart disease, diabetes and the unfortunate pull of gravity.
As luck would have it, research continues to support that the high-volume American meat machine that I turned my back to in my youth, is the same machine that is contributing to the decline of American health and well-being.
The 1999 Meta-Analysis compared vegetarian death rates to non-vegetarians in North America and Europe.
• Occasional meat eaters (less than once per week) had a 20% reduced rate of dying of heart disease and a 10% reduced rate of overall mortality.
• Those who ate no meat other than fish had a 34% reduced rate of dying from heart disease and an 18% reduced rate of overall mortality.
• Lacto-ovo vegetarians had a 38% reduced rate of dying from lung cancer, a 34% reduced rate of dying from heart disease, and a 15% reduced rate of mortality.
Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J, McPherson K. Mortality in vegetarians and non-vegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S.
Eventually I did shave my legs and agree that cartilage is no place for an earring, but I held on to my vegetarian ways for well over ten years.
In my early twenties, being extreme seemed virtuous. Concerned that I might not be extreme enough, I toyed with veganism (that’s no animal products at all). For me that experiment ended with a six egg feta and spinach omelet at a diner called Angelo’s. I stayed on the vegetarian wagon until the hormonal fits of early pregnancy had me craving grilled chicken in some primal sort of way. My reunion with meat was passionate and hormone fueled. It burned hot and fast and like any fleshy indulgence, left me feeling guilty and filled with regret.
Now I have found some strange equilibrium between extremes that satisfies both my appetite and concerns for health and environment. Understanding more now about meat production than ever, the meat that speckles my family’s diet is selected with careful consideration.
The reasons for converting to vegetarianism or cutting down on meat consumption are more than just cute furry faces. There are solid environmental and health reasons for picking up this habit. Vegetarianism is no longer only for the Mink Liberation Army and naked starlets on PETA billboards. All sorts of folks are becoming concerned with the impact of large scale meat production. Books by authors Michael Pollan (The Omnivore’s Dilemma) and Eric Schlosser (Fast Food Nation) opened eyes to the industry and what they see isn’t pretty.
Andrew Rimas and Evan Fraser penned a volume called Beef: The Untold Story of How Milk, Meat and Muscle Shaped the World. It is an excellent read, but an unfortunate choice just prior to arriving at Northern Michigan’s premier destination for gross quantities of conventional meat. It should be noted that while my husband was dining on eighteen ounces of beefy madness, I ordered the Ahi Tuna, it too was likely loaded with ethical quandary, but none I could taste this day.
I know, you think your Prius and naturally low serum cholesterol level entitles you to eat more ribs and strip steak than the average American. Environmental and individual health aside, there are still reasons you may want to reconsider choosing conventional meat. Industrial farming methods are a significant threat to public health as well.
Just a few weeks ago, The New York Times ran an editorial, The High Cost of Cheap Meat . For those that don’t want to take the time to fully read 278 words on a pretty important topic – antibiotic resistance, here is a quote:
It is time for the F.D.A. to stop corporate factory farms from squandering valuable drugs just to promote growth among animals confined in conditions that inherently create the risk of disease. According to recent estimates, 70 percent of the antibiotics sold in this country end up in farm animals. The F.D.A. can change that by honoring its own scientific conclusions and its statutory obligation to end its approval of unsafe drug uses.
That’s right. Because of the sucky and overcrowded conditions in high-intensity farming, antibiotics are given prophylactically. When they DO get sick, you can be assured that whatever germ they incubate is way beyond the reaches of antibiotics. Then you can just queue up the scary news stories about “SuperBugs” and the rush on medical masks. Apparently the FDA is okay with this. They must be if they are condoning the very practices that encourage the development of these resistant superbugs.
It is the perfect example of how short sighted high-volume agriculture and the agencies that regulate it are. The motive: produce meat as cheaply as possible, despite long-term consequences for public health and the environment. The public demands it. They demand cheap Sam’s Club Value Pack of Rib-eyes.
For all these reasons I prefer to use locally sourced meats raised in decent and sustainable conditions. What does that mean? Well, for the cows that are being converted to beef, that means that they are not in overcrowded conditions and they eat grass.
“What? I thought grain-fed is best?” you say.
Well, not if you’re a cow. Cows are ruminant animals. In simple terms, their stomach has evolved to feed primarily on grass. Grass and corn are different. Corn is starchy and the stomach of the cow isn’t adapted to handling large quantities of it. But the government doesn’t subsidize large, green, organic pastures of grass. What it does subsidize is corn, so there is a lot to get rid of. This provides the beef grower with an unnaturally cheap source of cattle feed. This in turn makes the cows fat. (yum yum yum)
We have come to think of “corn-fed” as some kind of old-fashioned virtue; we shouldn’t. Granted, a corn-fed cow develops well-marbled flesh, giving it a taste and texture American consumers have learned to like. Yet this meat is demonstrably less healthy to eat, since it contains more saturated fat. A recent study in The European Journal of Clinical Nutrition found that the meat of grass-fed livestock not only had substantially less fat than grain-fed meat but that the type of fats found in grass-fed meat were much healthier. (Grass-fed meat has more omega 3 fatty acids and fewer omega 6, which is believed to promote heart disease; it also contains beta-carotene and CLA, another “good” fat.) A growing body of research suggests that many of the health problems associated with eating beef are really problems with corn-fed beef. In the same way ruminants have not evolved to eat grain, humans may not be well adapted to eating grain-fed animals. Yet the U.S.D.A.’s grading system continues to reward marbling—that is, intermuscular fat—and thus the feeding of corn to cows.
It makes them fat, tasty, cheap and perfect on the grill for your cookout, but it also makes them sickly. Enter antibiotics.
Cows rarely live on feedlot diets for more than six months, which might be about as much as their digestive systems can tolerate. “I don’t know how long you could feed this ration before you’d see problems,” (Dr. Mel) Metzen said; another vet said that a sustained feedlot diet would eventually “blow out their livers” and kill them. As the acids eat away at the rumen wall, bacteria enter the bloodstream and collect in the liver. More than 13 percent of feedlot cattle are found at slaughter to have abscessed livers.
What keeps a feedlot animal healthy—or healthy enough—are antibiotics.
So if the circumstance of the cow doesn’t convince you, selfishly consider your own health (please). The nutritional profiles of grass-fed and grain-fed beef are quite different. Check this out.
A 2009 study by USDA and researchers at Clemson University compared grain-fed and grass-fed beef and found grass-fed to be:
1. Lower in total fat
2. Higher in beta-carotene
3. Higher in vitamin E (alpha-tocopherol)
4. Higher in the B-vitamins thiamin and riboflavin
5. Higher in the minerals calcium, magnesium, and potassium
6. Higher in total omega-3s
7. A healthier ratio of omega-6 to omega-3 fatty acids (1.65 vs 4.84)
8. Higher in CLA (cis-9 trans-11), a potential cancer fighter
9. Higher in vaccenic acid (which can be transformed into CLA)
10. Lower in the saturated fats linked with heart disease
S.K. Duckett et al, Journal of Animal Science, (published online) June 2009, “Effects of winter stocker growth rate and finishing system on: III. Tissue proximate, fatty acid, vitamin and cholesterol content.”
One would think that these substantial nutrition benefits would have my friends at the American Dietetic Association (ADA) all fired-up to encourage dietitians to recommend pasture-fed beef and dairy products. Nope, not so. In my studies toward a Master degree and a future in dietetics, my ADA approved textbook offered 30+ pages dedicated to dairy without mention of grain versus pasture fed production. In the 48+ pages (pictures excluded) dedicated to “Meat and Meat Cookery” the only mention of grass-fed beef is on page 495, where they instruct future dietitians that,
Grass or forage fed-steers have a less desirable flavor characterized as grassy, game, and milky-oily than those finished on grain. –Bennion, M. and B. Scheule, Introductory Foods. 13th Edition. Prentice Hall. 2010.
Well that doesn’t do much to encourage the budding dietitian to recommend a better nutritional choice, does it?
So now it’s time for the regular part of the article where I advise you to close your blinds and get out your tinfoil hat. I smell conspiracy. Just like every other food industry special interest, the conventional meat industry pours a shit-load of money into the American Dietetic Association. Right here in my little neighborhood, the 2010 Michigan Dietetic Association Conference was sponsored by, among others: The Dairy Council of Michigan, Cargill, and the Michigan Beef Industry Commission. Given this information, what do you think the likelihood is that the ADA will EVER advise against traditionally raised, feed-lot fattened meat? Do you think they will systemically educate dietitians about the benefits of meat raised against the grain –pardon the pun?
Um, I would guess never.
For me it seems pretty easy to understand without a degree blessed by the ADA. I acquire my beef through a local source that pasture feeds. The Farmer’s Market is a terrific place to find a source. But you have to make sure you take the opportunity to ask some questions before you buy. Well, surely if they’re at the Farmer’s Market in a John Deere hat, this must be happy meat, right? No, conventional farmers look just like those that sell grass-fed meat. You will need to open your mouth and ask some questions of your food farmer, something American’s aren’t used to doing, at least not a the Wal-Mart Bargain Meat Bin. You will soon find how satisfying it is to have a better understanding of and a closer connection to your food.
After all of this, what do I have for recommendations? Here you go…
1. Eat more meatless meals,
2. do not make meat the centerpiece of the meal when it is served, and
3. select local (if possible), humanely raised and sustainably fed animals.
Your first objection to my recommendations is probably going to be your budget. True, grass-fed beef is more expensive. Raising beef on unsubsidized green pasture is more costly and time consuming than it is on subsidized corn chow. So you won’t likely be able to afford eighteen ounce portions. Let me go out on a limb and say you have no business eating that much of anything anyway.
Your second objection is likely to be ignorance of vegetarian cooking. It is made out to be some complicated and mysterious skill, but I assure you it is not. If you aren’t familiar with many vegetarian recipes, my first suggestion is to remove the meat from dishes that you already serve to your family. That means leaving the meat out of stir-fry, spaghetti sauce, homemade pizza, tacos, lasagna, soups, etc. You might be surprised how little you miss it. And no, you will not be lacking in protein, trust me. American’s have an absurdly over-proteined diet, but we’ll get to that another day.
Here is one to try. I have taken a recipe for ground beef tacos and modified it to use tempeh (a fermented soy product available at most grocery stores) and black beans. My kids hardly notice the difference. Oh yeah, and throw out those shitty little packages of taco seasoning. Those are packed with sodium and MSG. You will be surprised how easy it is without them.
Tempeh and Bean Tacos
• 2 teaspoons vegetable oil
• 1 small onion chopped
• 3 medium garlic cloves, chopped or pressed
• 2 Tablespoons chili powder
• 1 teaspoon ground cumin
• 1 teaspoon ground coriander
• 1/2 teaspoon dried oregano
• 1/4 teaspoon cayenne pepper
• salt, to taste
• 8 oz. (1 package) tempeh
• 1 can black beans, drained and rinsed
• 1/2 cup low sodium canned tomato sauce
• 1/2 cup low sodium vegetable broth
• 1 teaspoon brown sugar
• 2 teaspoon vinegar
• Ground black pepper, to taste
Heat oil in a medium skillet (cast iron is great for increasing iron content in an acidic dish like this) on medium heat until simmering but not smoking. Add onion and cook until softened. Add garlic, spices and about a 1/2 teaspoon of salt. Cook until fragrant. Add tempeh and break it up with a wooden spoon (much as you would beef) for about 3-5 minutes. Add remaining ingredients and bring to a simmer and reduce heat. Cook until thick and season to taste with salt and pepper.
Serve just as you would regular tacos, being sure to offer a wide variety of healthy toppings like raw spinach or romaine lettuce instead of iceberg, low-fat cheese, plain Greek yogurt, salsa, avocado and tomato.