Showing posts with label Breast Feeding. Show all posts
Showing posts with label Breast Feeding. Show all posts

October 22, 2019

Are We Ready For Breast Feeding Dads

                                   Image result for men breastfeeding

Mr. Cederstrom is an associate professor at Stockholm University.

A young man with shoulder-length dark hair leans back in a chair, his T-shirt pulled up to his chin. Two plastic tubes the size of shot glasses are attached to each of his nipples. Through the plastic, we see his skin inflate and deflate in a steady rhythm.

It’s early autumn 2009, and on a little-watched Swedish late-night television show, 25-year-old Ragnar Bengtsson has begun what the host calls a “scientific experiment.” Over the next three months, three times a day, Mr. Bengtsson will pump his breasts to see whether they will produce milk.

In retrospect, the odds were stacked against him. He was not on any hormonal treatments; his 2-year-old son was not even breastfeeding anymore. No milk, in the end, ever made its way through his nipples. “For me, it was just a fun experiment, and a platform to speak about fatherhood as something more intimate than we’re used to,” he said over lunch in Stockholm 10 years later.

Is it possible for a man to breastfeed a baby? For millenniums, this question has tickled people’s imagination. It has intrigued; it has disgusted; it has also remained largely hypothetical.
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That is, until last year, when a peer-reviewed case report confirmed that a transgender woman, assigned male at birth, was able to breastfeed her child after she was put on a regimen of hormonal drugs. Weeks before the baby’s birth, she was able to produce eight ounces of milk per day, and for the first six weeks, the baby could be sustained solely on that milk alone.

Before the treatment, the patient had been receiving feminizing hormones for six years. We don’t know how long it would take for a cis man to induce functional lactation. But “we have a pretty good idea of the types of hormone cocktails that would be needed,” said Tamar Reisman, an endocrinologist with the Mount Sinai Center for Transgender Medicine and Surgery and one of the two authors of the case report. 

We are unlikely to stumble upon dads openly suckling their babies anytime soon. The hormones are not without side effects; they inevitably entail some degree of breast growth. But as technology has made it increasingly feasible, the potential impact of male breastfeeding on gender roles — who take on what sort of parenting duties, and all of the consequences that result from those early first choices — looms larger than ever. And at least one man is excited about the possibilities.

“I just thought, ‘How cool if it would work!’” Mr. Bengtsson said. “Just imagine the extraordinary consequences it could have for our society.”

Tales of men whose breasts contained milk date back centuries. In the fourth century B.C., the philosopher Aristotle noted that some men were able to produce milk by squeezing their breasts. In the King James translation of the Bible, the breasts of the malnourished Job are described as full of milk. Later, in the Babylonian Talmud, we find a story of a widowed man whose “breasts opened and he nursed his child.”

Just what events those lines were describing has been the subject of much speculation and, for the most part, has been ignored or interpreted allegorically. One reading suggests that Job’s breasts symbolize ponds, where cattle can drink.

A few hundred years later, during the 19th century, a time of scientific discovery and adventurous expeditions, allegorical readings of men breastfeeding gave way to more detailed accounts, albeit ones tinged with an unmistakable colonial exoticism.

In the summer of 1800, during a five-year expedition through Central and South America, the Prussian naturalist Alexander von Humboldt passed through the small village of Arenas in what is today Venezuela. There, he was told the story of a local man who, after his wife had fallen ill, nursed his baby “two or three times a day for five months.” Humboldt got to meet the father later that year and examined his breasts, which were wrinkled, “like those of a woman who has suckled.”

By the end of the 19th century, the American physician George M. Gould and his colleague Walter L. Pyle listed, in their book “Anomalies and Curiosities of Medicine,” a number of instances of men suckling infants, including an unverifiable report, relayed by 16th-century missionaries in Brazil, claiming “there was a whole Indian nation whose women had small and withered breasts, and whose children owed their nourishment entirely from the males.”

Only once do we get a sense of how others reacted to these events. The naturalist John Richardson, while on an expedition through northern Canada in the early 19th century, wrote of a Chipewyan father who nursed his child after his spouse died. He was viewed as “partaking of the duties of women” by other Chipewyan, who saw it as “degrading.”

What Richardson thought of the matter we don’t know. Nor do we have any additional sources to help determine that any of these events actually happened as recorded, or whether cultural misunderstandings or biases may have warped the accounts.

In the 1930s, the search for an answer to whether men could breastfeed moved from expeditions to the laboratory. Although Charles Darwin had observed that there were instances when men could yield “a copious supply of milk,” it was not until the discovery and naming of the milk-producing hormone prolactin in 1933 that scientists could really begin to examine the lactating ability of male mammals. Experiments were performed on rats, monkeys and, in some cases, humans. And they worked. In a study in 1954, three men with cancer who had been on estrogen treatment were injected with large doses of autotrophic, a form of prolactin. One of them, age 64, lactated on the sixth day of the treatment. He didn’t stop for seven years.
What is startling, when we dig into history, is just how many great minds, from Aristotle to Darwin, have earnestly, and without judgment, pondered the question of men’s breast milk. It’s useful to remind ourselves of this, as the theories of these same men are often invoked to argue that men and women are predestined for specific functions and that the mere thought of a man using his breasts to feed a child is immoral, delusional or disgusting.

It seemingly wasn’t until the 1970s that the notion of male breastfeeding became politicized. That’s when Shulamith Firestone, a 25-year-old activist, wrote her blazing manifesto, “The Dialectic of Sex.” In it, she called pregnancy barbaric (she compared it to excreting a pumpkin) and argued that the only way for women to become free was to liberate them from the tyranny of reproduction. Childbearing, Ms. Firestone argued, should be taken over by technology, and sex distinctions eliminated.

This vision was brought to life in Marge Piercy’s 1976 sci-fi novel, “Woman on the Edge of Time,” in which a woman named Connie is transported into the future — the year 2137 — where she sees a bearded man breastfeeding a child. She notes that he has breasts, “like a flat-chested woman temporarily swollen with milk.” Connie is angry at first: “How dare any man share that pleasure?” she thinks. But in the end, the world depicted in the book is ultimately intended as a gender-free utopia.

We are, from a scientific and, some would argue, a cultural point of view, growing closer to Ms. Firestone’s vision of eradicating sex differences. (Not everyone who calls himself a dad today, for instance, was assigned male at birth.) And maybe that’s also why the image of the breastfeeding father provokes such strong feelings. Male breastfeeding was once the sole province of the exotic “other,” observed on faraway expeditions; today the breastfeeding father seems to be just around the corner.

The breastfeeding dad may be a threatening image. He may never actually come to be. But it’s worth, at this moment, also remembering how alien stay-at-home fathers first seemed in the 1970s, when they were viewed as unmanly and as having abdicated their breadwinning responsibilities, said Michael Lamb, a psychology professor at Cambridge University and a pioneering fatherhood scholar.

Last year, Marie-Claire Springham, then a product design student at Central Saint Martins, in London, developed a kit for expectant fathers, including hormonal drugs and a breast pump, which she submitted for a design award.

Two weeks before it was announced that she had won, photos of the actor Daniel Craig (James Bond) carrying his child in a BabyBjorn on his chest appeared in the tabloids. Piers Morgan, the British television presenter, lamented on Twitter, “Oh 007 not you as well?!!!” Soon after, the comedian Ricky Gervais tweeted a link to an article about Ms. Springham’s breastfeeding kit, writing: “I know what I’m getting @piersmorgan for Xmas.”  

“And then, it really blew up,” Ms. Springham told me.

When she appeared on “Good Morning Britain,” she was attacked from all sides, women and men alike. “I was called a perverted fetishist,” Ms. Springham said.

And yet even as the media derided the kit, Ms. Springham says, her mailbox quietly filled up with letters from expectant dads who wanted to know more. “If these emails are to be believed, I’ve got a large enough group of dads who’d be up for a medical trial.”

Carl Cederstrom is an associate professor at Stockholm University.

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A version of this article appears in print on Oct. 20, 2019, Section SR, Page 4 of the New York edition

July 16, 2018

Contrary to Trump's Non Knowledge of Breast Feeding, In Many Countries, No Breast Feeding No Milk

The long-running breast milk vs. formula debate made headlines earlier this week.  
The New York Times reported that the Trump administration had tried to remove language from a WHO resolution that would, according to reporter Andrew Jacobs, "promote and protect breastfeeding around the world, especially in developing countries" and limit the promotion of infant formula.
President Donald Trump tweeted his rationale for the U.S. position: "The failing NY Times Fake News story today about breastfeeding must be called out. The U.S. strongly supports breastfeeding but we don't believe women should be denied access to formula. Many women need this option because of malnutrition and poverty."
Public health professionals have a different perspective: In poor countries, a mother's decision about breastfeeding can be critical for her baby's survival. That's because formula carries special risks for low-income families.
The first problem arises because powdered formula requires a dependable source of clean water, which is not available to some 780 million people, according to the World Health Organization. "In countries where women live in poor households with poor sanitation, it becomes a matter of life and death," says Rafael Perez-Escamilla, director of Global Health Concentration at the Yale School of Public Health. "If the water is not clean, the formula becomes a death sentence for the infant."
Even in the best of circumstances, formula feeding has disadvantages. According to decades of research analyzed and summarized in a 2016 Lancet series on breastfeeding, the harm caused by formula feeding includes increased risk of diarrhea and respiratory infections. In addition, according to the Lancet series, more than 800,000 formula-fed infants who die each year could be saved by breastfeeding mostly by reducing diarrhea, respiratory infections, and malnutrition from a diluted formula.   
Breast milk has been proven, over decades of research, to be unarguably the best nutrition for babies with its nearly perfect mix of easily digested vitamins, protein, and fat. In addition, new research in the July 2017 JAMA Pediatrics has shown that beneficial bacteria from the mother colonize in the baby's gut, helping the infant establish a healthy microbiome — bacteria in the intestine that help fight disease throughout life. Because the bacteria are unique to mother and baby, the establishment of the microbiome has been called nature's first personalized medicine and cannot be replicated in formula.
Harms from formula-feeding fall disproportionately on poor women in poor countries, says Perez-Escamilla, not only because of unsanitary drinking water but also because of poverty. Purchasing formula can use 30 percent or more of an impoverished family's income, he says. "Then, women start diluting the formula to make it last longer," he says. Drinking watered-down formula leads to malnourishment, illness and even death. "And then, too, the money spent on formula is not available for other things the baby might need, like health care," he says.
No additional research is needed to prove that breast milk is the gold standard of nutrition for infants, says Dr. Adriano Cattaneo, an epidemiologist retired from the Unit for Health Services Research and International Health, Institute for Child Health "Burial Garofolo," in Trieste, Italy.
He has grown tired of pointing out and defending the proven benefits of breast milk for mothers and babies. "From a scientific point of view, carrying out research on the benefits of breastfeeding doesn't make sense. Would anybody carry out research on the benefits of breathing, chewing, hearing, a passing stool?" says Cattaneo.
"The burden of proof should fall on those who propose alternatives to breastfeeding," Cattaneo says in an email interview with NPR. "Formula feeding lags far behind ... breastfeeding in terms of safety and benefits. So we should never talk of the benefits of breastfeeding. We should talk about the harms of formula feeding."
Cattaneo argued in 2007 in an editorial in the Journal of Paediatrics and Child Health that research should center on effective methods to encourage and support women in breastfeeding. That was the goal of the resolution at the meeting of the World Health Assembly in Geneva in May.
As for the belief that poor women who are themselves malnourished cannot adequately provide breast milk for their babies — that's not true, says Cattaneo.
"I'm very aware of the arguments from Trump," says Perez-Escamilla of the president's assertion that many poor women "need access to formula."  
"Many poor women are undernourished, and that spreads the notion that their milk is low quality and low quantity," he says. "But their milk is still better than formula."
Cattaneo agrees. "When the formula industry says that mothers in low-income countries are too sick and malnourished to breastfeed, that is false. Breast milk is of excellent quality even if a mother is sick or malnourished. Quantity is also adequate, except in rare cases of terminal disease or very severe malnutrition."
There are few medical conditions and treatments that rule out breastfeeding, says Perez-Escamilla. Today, even women in poor countries who are infected with HIV can follow the same recommendations for breastfeeding as uninfected women, provided they are on anti-retroviral therapy, according to the World Health Organization. (But the Centers for Disease Control and Prevention recommends that HIV-infected women in wealthy countries who have access to clean water and affordable formula avoid breastfeeding.) "Women receiving some types of chemotherapy, or on some types of antidepressants or who are substance abusers should not breastfeed," he says. "But overall, there are very, very few situations where she cannot breastfeed."
Nestle, along with Danone, Mead Johnson Nutrition, and Abbott Laboratories, is one of the four leading corporations selling infant formula around the world.
In 1977, Nestle's formula practices made headlines when a boycott was announced in the U.S. in response to what breastfeeding advocates termed "aggressive marketing" of formula, especially in poor countries.
Then and now, Nestle has defended its practices.
In a statement emailed to NPR this week, Nestle said: "Nestlé strongly supports breastfeeding and has not wavered on this position. We have not, nor would we ever, lobby any governments — including the US government — to oppose breastfeeding policies anywhere in the world."
A study on industry practices by Save the Children finds that the top six formula manufacturers sometimes use marketing practices at odds with the code of marketing practices for infant formula drawn up by the World Health Assembly, the decision-making body of WHO. The International Code of Marketing of Breast Milk Substitutes includes a call for no promotion of breast milk substitutes to the public, no gifts to mothers or health workers, no free samples to pregnant women or mothers and no sponsorship of meetings of health professionals. The report found cases of companies paying doctors to recommend their milk formulas and offering coupons, contests, gifts and other incentives to mothers to buy formula. The results are in line with earlier findings of ARCH, Assessment, and Research on Child Health, an organization that investigates how foods for children are promoted. ARCH's 2016 study of Tanzania, Cambodia, Nepal, and Senegal found similar promotional activities by formula companies.
"At the end of the day, it is the woman's decision to decide how she wants to feed her baby," says Perez-Escamilla. "It should be a truly informed choice on a level playing field. But that is impossible in low-income countries in an environment that is pushing them to formula feed."
Susan Brink is a freelance writer who covers health and medicine. She is the author of The Fourth Trimester and co-author of A Change of Heart.

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