In honor of World Breastfeeding Week, I thought I would publish a transcript of an interview I conducted before I started this blog. My guest was Amy Spangler, author of Breastfeeding Keep It Simple. Enjoy reading
Carrie Lauth: I am talking with mother and author Amy Spangler. She is a nurse, a board certified lactation consultant and the author of several very good books on breastfeeding including Breastfeeding, Keep it Simple, which is a personal favorite.
I am talking with Amy about how we can all help produce a more breastfeeding culture in our society. I think every mom who has nursed a baby is in some way a little bit of a lactivist. Every time she chooses to breastfeed her baby out in the open instead of hiding or every time she shares with another mom who may be expecting a baby the benefits that she has experienced with breastfeeding, she is supporting a breastfeeding friendly culture. But there is probably other things that we can do to help produce some more breastfeeding friendly culture and Amy and I are going to be expounding on that a little bit.
Amy Spangler: Hi there Carrie.
Carrie Lauth: It is such an honor to talk with you Amy because I have read at least a couple of your books and I have been a big fan. And you are a fellow Atlanta native! It is nice to talk to a fellow Georgia Peach.
Amy Spangler: Well, I was thrilled with the invitation. I am pleased with what you are doing and the information that you are sharing and it is wonderful to participate.
Carrie Lauth: You know we are celebrating breastfeeding this month because it is the 50th Anniversary of La Leche League and it is World Breastfeeding Week, which is usually celebrated in August. It is good that we are talking.
Amy Spangler: Yes it is. Your timing is perfect.
Carrie Lauth: We were just talking before about this controversy over the Baby Talk Magazine and it really illustrates one of the things that we are going to discuss; and that is how our community, the entire community, our whole society needs to come together to support breastfeeding.
Amy Spangler: Absolutely! I think the magazine cover was a reflection of the progress that many of us in the breastfeeding arena feel we are making in terms of making breastfeeding the cultural norm. At the same time, the reaction of readers and the public to the cover when they saw it is a reminder of how far we still have to go. Their reaction that this (a picture of a baby latched on to his mother’s breast) is in some way indecent, embarrassing, inappropriate, so many different words were used and yet you know the sad part is it could not be more appropriate. It is really the single most important activity I think that women can undertake to ensure optimal health for their babies.
Carrie Lauth: I am going to mention your book really quickly, Breastfeeding, Keep It Simple. That was probably the first one that I read and it is great. It is just a very simple guide, not complicated at all, but it covers everything. Breastfeeding, A Parent’s Guide talks about some of the facts and myths of breastfeeding and Breastfeeding, Your Guide to a Healthy Happy Baby. I agree with you that breastfeeding is one of the most important things that a mother can do to give her baby and herself the best chance as far as their health. It is interesting how we find out more and more to support that every year.
Amy Spangler: I think the reaction of members of the public to situations like this whether it is the cover of the Redbook Magazine, or the cover of Baby Talk, or even the cover of the Time Magazine. It generated that somewhat negative response when it showed the refugee woman fleeing during the Bosnian War carrying a child that was at the breast with almost no breast visible, and yet engendered the same kind of response. I think what it says to all of us individuals like yourself and myself who are very supportive of breastfeeding and consider ourselves breastfeeding advocates, that we need to really think about how we deliver our message, how we frame that message so that we can do it a way that invites support from every member of the breastfeeding community or from the public community and does not alienate segments of that community and that is the hard part.
I think that the National Breastfeeding Awareness Campaign was a reflection of that. It was a campaign that wanted very much to convince mothers that would otherwise not choose to breastfeed, that breastfeeding is something they should think about. So it delivered those risk‑based messages which generated lots of controversy. And we were back that same position of asking ourselves how do we deliver a positive message and change behavior and at the same time not make those mothers who for whatever reasons choose not to breastfeed feel uncomfortable with the choice they have made. That is the hard part and I think it will continue to be the hard part.
Carrie Lauth: That is true because everyone is coming from a different place. Even people who are supportive of breastfeeding, some of them are still uncomfortable with some of these issues like nursing in public.
There are still people who feel very strongly that breastfeeding was the best choice for them and they did nurse their own children but they did it in the bathroom.
They still feel that that is the way it should be handled as if breastfeeding was necessary and good but like urination it should be hidden.
It is not about making women feel guilty who choose a different path but we cannot be dishonest at the same time.
Amy Spangler: Absolutely! We do not hesitate to tell individuals about other important public health activities like car seat safety, bicycle helmets, and healthy eating.
Carrie Lauth: And cigarette smoking in pregnancy …
Amy Spangler: Someone asked me recently, so often we try and draw similarities between cigarette smoking and giving babies infant formula. That recent bill that was put forward by Senator Harkin calling for disclaimers to be put on all infant formula products.
I was asked what my position is on that and I said, “I probably am a member of the advocacy arena that would likely not draw similarities between mothers who smoke cigarettes and mothers to get their baby formula because in reality there is no consumption of cigarettes that is ever recommended, that has ever been official.”
Yet with formula use, there are moments when it is recommended and it has been official.
So, my argument with the formula industry is not always the product that they produce, it is how they market that product. How do we get that idea across? It is not the “good guys and the bad guys”. It is “how do we come together in the best interest of mothers and children everywhere”?
Carrie Lauth: That is a good point.
Well, when it comes to this whole controversy about the Baby Talk Magazine, I could not help but think when I heard some of the comments that were made and reported on, that part of women’s reaction is coming from their loathing of their own bodies.
Being uncomfortable in our own skin so that something that comes so naturally and is so natural, we have this response to. Do you think there is any validity to that? Is it that we are just very uncomfortable with our own womanliness, our own bodies, and that explains some of that response?
Amy Spangler: Well, I think that is certainly true of some women. I am sure that there are probably an equal number of women that are very comfortable with their bodies and do not hesitate to display their bodies in ways that are provocative, or flattering, or inviting, or whatever the case may be.
I like to think more that it is a reflection of the fact that when there is an activity that is not commonly seen, when something is not in the mainstream, when it is infrequently observed or happens with rarity, then when it does happen it triggers a response, not always a positive response. I feel like that is where we are with breastfeeding.
If breastfeeding in public were something that women did nationwide and you saw it everyday, you would not even give it a second glance because you would think that that is just culturally acceptable and normal and therefore why should I observe or think twice about whether it is or is not appropriate. Of course, it is appropriate. That is truly the case in cultures where breastfeeding is the normal way to feed a child.
In America, bottle feeding is the normal way to feed a child and the most common method observed and more importantly the most common method displayed in all segments of the media. You see magazines with fathers giving babies bottles and mothers giving babies bottles. You see baby dolls sold in stores with the baby bottle that comes along with it. We reinforce all of those concepts that this is the normal way to feed a child. Therefore, to do that in public is fine because that is the norm, but to do something that is not perceived as the norm, it causes a reaction. I think that is where we are. We are on that continuum of trying to make breastfeeding the cultural norm. I have to say I do not think, as I approach 60, it will happen in my lifetime. I am confident it will happen in my children’s lifetime.
Carrie Lauth: I believe that, too. The reason that I said what I did was because I have noticed that men seem to be more comfortable with breastfeeding in public than women do.
Some of the really vitriolic comments seem to come from women, so it makes me think that.
One of the women that were quoted in this news coverage that I saw said, “I would not want my husband to accidentally see a breast that he did not want to see,” and she actually went so far as to shred the magazine and I thought you know I have never known a man to be offended by accidentally seeing a breast!
Amy Spangler: My temptation with these mothers is that I always wish I had the opportunity to say to them “please tell me what your experience with breastfeeding has been”. I cannot help but feel that women who respond in that negative a fashion had a very negative experience with breastfeeding; either personally or through friends. Some incident has embedded in them an attitude that truly is not an attitude I think we would see or that can be taught or learned. I think experience has to have given them that.
photo credit: _Shward_
Carrie Lauth: Whenever there is an emotion that is strong there is pain behind that somewhere.
Whether guilt pain, or just some kind of pain somewhere and it is not necessary to have that kind of pain.
I have a good friend; and it is funny because we are opposite in every way and our mothering styles are very, very opposite. She hates breastfeeding and she is very unapologetic about it, but she does not feel the slightest bit of guilt and so it is very refreshing. I have no problem nursing my 11-month-old around her. She has no problem with it either, but she is very open about the fact that “Oh, I can’t wait ’til this baby’s 3 months old so I can wean him, I hate breastfeeding!” She is very, very unapologetic about it. So has decided what is best for her and what is best for her family. She has told me that breastfeeding makes her feel very caged like her flesh is crawling.
The guilt aspect is something that people often bring up. They say we are making women feel guilty for not breastfeeding.
Amy Spangler: I think your comment is very, probably very perceptive, and very, very important in that you made the reference to the woman having a sense of hurt and that it was really not so much anger that causes those negative comments, but some kind of a hurtful experience that that woman had and I think those of us in the breastfeeding community need to always keep that in mind that when we have someone that makes a very negative comment about something like a Baby Talk Magazine cover, we need to be above the fray.
We need to step back and not do that knee jerk response like “Uh! What kind of individual are you? What kind of mother are you?”
We need to be able to say, “Gosh! What was your breastfeeding experience? Did something happen to make you feel this way?”
I think we all might be amazed at the outpouring of emotions that we might get in return.
If we give those individuals a chance to say why they feel the way they feel because I just think that it is a response to something bottled up inside of them. Maybe guilt is what is driving part of that and I am a firm believer that we do not make woman feel guilty. Guilt comes from within. It belongs to each of us. We allow ourselves to feel guilty based upon decisions we make or choices we make that we felt were outside of our control and like your friend she had significant control over her decision.
So, she is making a decision knowing what the information is and therefore she is comfortable with it. It was not the decision that you make for the child but you can mutually respect one another and that is the point that we all need to get in order for us to achieve a breastfeeding culture.
Carrie Lauth: Yeah. Compassion is always the answer.
Amy Spangler: Absolutely.
Carrie Lauth: No matter what the question, that is always the answer. That is a good point to keep in mind about asking a woman about her experience. That is something that I have told women who are having trouble with their mother or their mother-in-law, you know, undermining their breastfeeding.
That can be such a sensitive time post partum if you are having help around your home, your mother or your mother-in-law, is helping you. You need that help and you need that support but it is often that person who is supporting you and other helpful ways subtly undermining or not so subtly undermining your breastfeeding choice but instead of arguing about it or trying to convince them — talking, listening, and asking questions, it can do wonders.
Amy Spangler: I can remember when I used to teach classes and the concern on the part of many of these young expectant moms was when that mother or mother-in-law came after the baby was born.
The fact that they have not breastfed, would they indeed be supportive or would they actually be a detriment, and I would always encourage them — I do not know what your relationship with this mother or mother-in-law is, but it is always best to be proactive and if possible during the pregnancy say, “I am so looking forward to the help that I know I am going to need afterwards, but I do have some concerns about breastfeeding, can we talk? Because I know you didn’t breastfeed me or you didn’t breastfeed my husband and therefore I want to make sure — you have an understanding of why I’m making this choice and how important it is to me.”
I think if you can diffuse it and get that person to be less defensive, they are more likely to be on your side as a supporter instead of as an adversary.
Carrie Lauth: Yeah, and that is important. That is a good skill to practice and you might as well get it over with right away because when you have children you are going to be having to set boundaries with yourself and your parenting when it comes to other people.
“This is what my husband and I have decided. This is how we are going to do things and we value your opinion very much; however, the final decision rests with us.”
Amy Spangler: I think for many grandparents, the hard part is for them to understand that because you are making a different choice does not mean that you are denigrating their choice. What you are saying to them is I have different information available to me.
Now when I am pregnant with my child than you had when you were pregnant with my husband or my partner or whomever. Oftentimes that grandparent feels like “oh, this mom that is breastfeeding is saying I wasn’t a very good mother because I bottle fed this baby’s father.” That is not what you are saying at all, so I think to open up that discussion and put it out there allows for everybody to quit walking around and to be able to have a comfort level with it.
Carrie Lauth: Right. Well you mentioned that if you we are going to come to a place where breastfeeding is normal then the entire community has to be involved. What does that look like?
Amy Spangler: Oh Gosh! I have a perfect image in my mind. Number one and I think this is at the top of my wish list, if we are going to create a breastfeeding community it would be a community in which breastfeeding education is part of the kindergarten through twelfth grade curriculum. That does not mean for all of those people who might be listening to this that I think we should have mothers coming in and breastfeeding their babies in a third grade class.
It means that in kindergarten we should talk about mammals and we should discuss what is a mammal and what makes it a mammal because it provides its own milk to its young. There are dogs with puppies, there are cats with kittens, and there are human beings with human babies.
It sets that foundation and then we build on it. When my boys were in high school, they are now approaching 30, they had a health assignment, an issue paper that they needed to write.
Five young boys came to my home who were sophomores in high school at the age of 16. Among the topics that they could choose was the topic “The Benefits of Breastfeeding.” Now, they did not come to my house because they thought “oh gosh, this is a wonderful topic.” They came to my house because they knew I would have everything they needed to write this paper in the smallest amount of time, but that is okay because as a result of that these boys will be very different fathers and very different husbands.
That is what has to happen. We need to see it there and then we need to see a worksite where when mothers return to work at a reasonable period in time, not at six weeks post partum, but closer to three months or 12 or six months post partum. Ideally, yes, would a year be wonderful, but is six months reasonable to ask for? Yes, it is.
Even at three months it is far more negotiable and will interface better with breastfeeding than at six weeks but when those mothers return, they have co-workers that say, “Oh gosh! I’ll answer your phone for the next few minutes. I know you need to go and pump.” Or better yet, onsite childcare where you could go and breastfeed your baby and come back to the worksite.
There are so many things at the worksite that need to happen and in my mind a breastfeeding community would provide that kind of support. When you went to church on Sunday, you would have a place where if you wanted to breastfeed privately, a little room attached like we do at out church, it is the family room and you can sit in there with a noisy toddler, but there is a glass window that you can see the surface and that is piped in through a sound system so you can hear what the minister or the priest is saying. So those are just a few examples.
I used to say that a breastfeeding community would have — every state would have a law to protect the mother’s right to breastfeed and yet the reality is in a breastfeeding community you do not need a law to protect the mother’s right to breastfeed.
Laws are something we put in place as we try and move along in this continuum. I used to say that it would a place where when mothers came in for their prenatal visits, you would not ask them are you planning to breastfeed or bottle feed. You would simply say to them please tell me what you know about breastfeeding. You would make that assumption that breastfeeding is something every mother does and so this is the time to begin to learn more about it and for us to know what you do and do not know so we can fill in around it.
So those are the things that I think probably highlight — you look at all the service centers, you look at the national parks, we say, “Oh gosh! We want all of these public places to have a room where a mother can go.” Breastfeeding is the norm. A mother should be able to breastfeed wherever she is. We should not have to put her in a room behind a closed door even if it is not a toilet stall, even if it is a comfortable room with a chair and a footstool.
We are still isolating her and suggesting that what she is doing is something that should not be seen or heard and I find that unfortunate. That is why I encourage young women, if they have a comfort level doing so to please breastfeed their babies wherever they are because until we get that critical mass of women doing just that, we are not going to change the attitudes of the general public. It is going to take repeated exposures to help people along that comfort level continuum.
Carrie Lauth: Yeah. That is true. Well, you mentioned education in schools. I was just talking with a couple of teenagers yesterday. One of them had been home-schooled for years and was about to enter high school, public school, and the other one had not been home‑schooled. They were just talking about some of the things that they learned in school and how useless they feel as it is and they wish that they could learn some of the useful things like how to balance a checkbook. I thought that was interesting. How to be a good parent? Why do not we have parenting in classes in high school? How to be in relationships? How to fight fair? How to be emotionally intelligent? Well, we have sex education in school, what is wrong with breastfeeding education? I do not know if — I know that sex education is pretty uncomfortable for kids in school so I do not think adding a breastfeeding mother would be that much worse.
Amy Spangler: You know the fact that sex education is uncomfortable says something to us. Maybe it goes back again to if your premise is true that women have a discomfort with their bodies, that is a discomfort that they learn at a very young age. They learn it in the schools or at least if they learn it at home, the schools could play a role in helping them have a different attitude toward their bodies and body parts and why you have arms and legs, breast and teeth, and all of the other pieces.
Carrie Lauth: Uh-hmm. Yeah, that is right.
Women who embrace breastfeeding and do not have kind of a block with it, they find it pleasurable, not in a sexual way at all, but pleasurable the way that me hugging my 5-year-old is pleasurable or holding my 8‑year‑old’s hand in the store is pleasurable.
Perhaps it does go back to that being comfortable with our bodies. I am sure that is part of it. One other thing I was thing and now I have forgotten, but…
Amy Spangler: In response to the comfort issue, I remember when I first breastfed my first child and I was not that young girl that was comfortable with her body. I was a young girl where I grew up in an era where sex education in the home was you were given a small little booklet on menstruation and so forth and how mothers become pregnant and where babies come from and I remember being handed that book by my mother with directions “if you have any questions ask me.”
Well, after I read the book I was shocked. I was appalled. I thought, “Oh, my gosh!” and I was so embarrassed I said I will never ask my mother a question.
First of all, I cannot believe that my mother and father would even do this. So here you are this young adolescent and then there was no reinforcement. Rather than it being that mother saying, “I want you to read chapter one and then I’m gonna ask you some questions and we’re gonna sit down and talk about this.” Again, that was just my mother probably if I could clone her I would because she was the most wonderful mother and grandmother, but she brought with her her own attitude toward sexuality.
She passed those on to her children and then we, as we grow up, try real hard to pass on the good things and not the things that were not so good to our children. So when I breastfed my child for the first time, it was not because I was necessarily comfortable with my body. It was because as an educated nurse I knew this was what was best for my child, but then as you said the joy and the pleasure that it gave me and not at all from a sexual standpoint, but when I teach classes still I say to parents I never make the assumption that a mother who is pregnant has made the decision to breastfeed.
I always make the assumption that they are thinking about it and then I say to them of all of my parenting experiences, it is the one that I would most like to do again because I loved every minute of it. There is not many things in parenting that we can say that about.
Carrie Lauth: Right, that is true. That is something that you will experience when you are out and about with your nursing and, say, you will have woman approach you. I have had that happen so many times, “Oh, I miss those days.” I have only had one negative experience ever with breastfeeding in public, but I have had many, many, many positive experiences, so I know that things are changing.
Oh, but I remember what I was going to say about schools. When we talk about mammals, we need to remind people, children, that a cat or a dog does not worry whether she is going to have enough milk.
Amy Spangler: Yes, you are right.
Carrie Lauth: She just nurses the babies when they want to.
Amy Spangler: They all have multiple babies!
Carrie Lauth: Yes, but she does not ever worry about her milk supply.
Amy Spangler: I find it interesting that we are supposed to be the most intelligent of the mammal species and yet we are the one with the greatest amount of doubt and insecurity about our ability to do what should be very basic body functions.
Carrie Lauth: Right. Yeah, it comes from that huge intellect that we have.
Amy Spangler: Yes, maybe we think too much?
Carrie Lauth: We do. We think too much. We do not feel enough and we do not rely on our instinct enough.
Amy Spangler: I used to think as a lactation consultant and a nurse, is there a point where we worry too much about the guilt issue and how it is going to make someone feel and if the price we have to pay is someone feeling guilty in order to promote something that saves lives maybe that is a fair tradeoff, but deep down inside I want to believe that we can do both.
We can sell breastfeeding in a manner in which it should be sold as optimal activity for every mother and not make those mothers who choose not to breastfeed feel badly about that decision. I think we can find a happy meeting point. I just think we need to continue to work on that.
Carrie Lauth: Yes. Well, Amy, it has been a pleasure talking with you.
Amy Spangler: Carrie, you also. You are just a delight. My reassurance and hope for the future is always reinforced when I talk to young mothers with babies that are being breastfed well beyond those early weeks and hopefully well into that into the first year and into the second and who knows how far beyond because you are really the model of what we want other moms to be able to follow and have a comfort level with.
Carrie Lauth: Well, one mother can change the future of the world because of the way that she parents her children. I had a funny experience at a restaurant one time, my 5‑year‑old who was 4 at the time he saw a grandmother bottle-feeding an infant and my children cannot keep their hands off of babies. If they see a baby anywhere they are just right there oohing and cooing over the baby, but Julien looks up at me and he goes “Mommy, what is that lady doing to that baby?” “I suppose she is feeding the baby.” He goes “What is that thing?” It was so out of his…
Amy Spangler: It was so foreign to him. I love it.
Carrie Lauth: It was so foreign that he had absolutely no idea that that was a bottle and that she was feeding the baby and so I had to explain that some mommies give their babies milk from their mimmies and some mommies give their baby milk in a bottle, but that one thing just illustrates that his perspective is that breastfeeding is normal. Anyway, we could go on and on for hours…
Amy Spangler: You are right and hopefully both of us will be around long enough to see the day come where maybe it will be a bottle-fed baby on a cover of a magazine and it will incite such commentary that people will say, “Oh yeah, you’re right. We probably shouldn’t have done that.”
Carrie Lauth: Okay. Well Amy you have a wonderful day.
Amy Spangler: Carrie, thank you. You take care.