Breastfeeding – a shared responsibility

August is National Breastfeeding Awareness Month here in the Philippines, and the first week is celebrated worldwide as World Breastfeeding Week, and yet again both events are to be held under the shadow of COVID-19. Last year, I wrote about the challenges that the global pandemic had brought about for mothers that wanted to breastfeed their children. Breastfeeding is natural, but it is seldom easy, and the support systems that new mothers could depend on were amongst the many systems disrupted by the pandemic.

There were also fears about whether or not COVID-19 could be passed on through breast milk to the infant. However, the prevailing wisdom then – which still holds true now, even after months of new data – is that COVID-19 cannot be passed through breast milk, as no transmission of the virus through breast milk has been detected yet, as of a UNICEF article on safe breastfeeding that was released last April. For so long as appropriate precautions are taken – mask, hand washing, cleansing potentially unsanitary surfaces – the recommendation of health experts is that breastfeeding can and should continue, even for mothers who have COVID-19 or have symptoms of the same.

Even with the new threat to our health, the old benefits of breast milk have not changed. As stated by the UNICEF and the WHO: “Breastfeeding is one of the most effective – and cost-effective – ways to save and improve the lives of children everywhere, yielding lifelong health benefits for infants and their mothers.” Breast milk, as one study puts it, “is the gold standard for protective nutrients fed to newborn infants.” The promotion of breastfeeding does not only have benefits for mothers and their children, but for the nation as a whole, as the practice can be positively linked to all 17 of the United Nations’ Sustainable Development Goals.

In fact, for those who are able and willing to breastfeed, doing so during the pandemic may provide even more benefits for their infants. While there was initially little data on the effect of COVID vaccines on pregnant or breastfeeding mothers and their children, early results from tests conducted on Pfizer and Moderna vaccines show that the vaccines themselves are not passed on to the children, which was a concern of many mothers due to the effects of vaccines on the very young being yet unknown. (Note that the Pfizer and Moderna vaccines do not use a live, weakened form of the virus, so this data should only be applied to those vaccines. However, even for other vaccines the WHO and the DOH do not recommend discontinuing breastfeeding after vaccination.)

Even better, the studies showed that the protective antibodies produced by the vaccinated mothers were detected in the milk. What this means in concrete terms will require further study, but the presence of these antibodies is a positive sign that breastfeeding may be able to deliver some additional protection.

Yet for all these benefits – tangible and potential – that breastfeeding can bring about, especially during this pandemic, the unbelievable yet undeniable fact is that the stigma against breastfeeding remains firmly entrenched in both systems and minds. While nations such as the Philippines have legislation protecting and supporting the right of mothers to breastfeed, there continue to be instances where breastfeeding mothers around the world are shamed, removed from participation in events or asked to cover up. Even when there is no direct obstruction of a mother’s right to breastfeed her child, the failure to take into consideration the needs and realities faced by these mothers can force them to make unnecessary and difficult choices between a job/opportunity on the one hand, and their ability to continue breastfeeding their babies on the other.

One event that brought this to the fore is the Olympics, where athletes who are breastfeeding mothers have been vocal about their frustration. Initially, athletes participating in the games were afraid that they would not even be allowed to bring their children to Japan because of the country’s COVID-19 restrictions, and while the organizers later relented, the requirements and restrictions placed on the children were found by some to be too restrictive. The babies and/or caregivers were not to be allowed into the residential area of the Olympic Village where the athletes would reside, which meant that the mothers would not be near their infants, an arrangement which anyone who had experience with breastfeeding would know is unmanageable. After all, babies do not feed at regular times. At least half of the athlete mothers who were public about wanting to bring their nursing infants decided not to do so because of the restrictions, which meant they had to stop directly breastfeeding their children.

It’s clear that much work still needs to be done to make sure that women are able to fully exercise their right to breastfeed their children. The theme of this year’s World Breastfeeding Week is “Protect Breastfeeding – A Shared Responsibility” and it’s a timely way to be reminded that while only mothers can breastfeed, mothers cannot do it alone.

They need legislation that codifies in no uncertain terms their right to breastfeed their children whenever and wherever the need arises; they need to have the opportunity to be included in early clinical testing of essential medicines such as vaccines in order to provide better information for mothers who are often left in the dark about the effects of important medication on themselves or their children; they need to have systems that are modified to take their real needs into account.

It’s common for us to declare that nothing is more important than the welfare of our children, and it’s widely accepted now that breastfeeding is one of the best means we have of giving them the protection and nourishment they need. It’s time that we do more than pay lip service to the importance of breastfeeding. It’s time for more than just mothers to ask, to push, to bear the responsibility for it.

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