they’re incredibly useful.

I’m not going to jump into an active discussion of breasts here, so don’t get nervous. I’m going to chip in on the debate surrounding breastfeeding, however.

The AAP recommends exclusive breastfeeding during the first 6 months of life to minimize the incidence or severity of diarrhea, ear infections, and bacterial meningitis. The academy also suggests that breastfeeding may offer protection against sudden infant death syndrome, diabetes, obesity, and asthma. Early supplementation of infants with water, teas, or other liquids is not recommended by the AAP or the WHO, because of the nonnutrient values of these beverages, the solute load of juice, the possibility of introduction of contaminants or allergens, and the possibility that these liquids will displace breastfeeding. The academy policies state that healthy infants require no supplemental water, even in hot weather, because both formula and breast milk provide sufficient amounts of water. Water supplementation has also been associated with oral water intoxication in infants.

That said, some nursing pairs have a really rough time. The mother not be able to produce milk, the baby might refuse it. Allergies, intolerance to something in the mother’s diet, illness and prior surgeries (mastectomies, implants, reductions, etc.) can interfere with the ability of a mother to breastfeed. That said, breastfeeding is best.

Why am I jumping into this topic? Well, I’d say there are two main reasons. First, billions of dollars have been spent my multinational corporations (MNCs) to try to encourage formula feeding instead of breastfeeding, with a heavy focus on Latin America. Incidentally, the above quote comes from a paper on infant formula, tea and water supplementation of Hispanic infants in the United States (Wojcicki et al, 2011 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139537/). Quite a bit of fuss has been made about Nestle’s involvement, and boycotts took place in the 1970’s and 1980’s in response, but the biggest problem might not be the MNCs.

I’ve heard through female friends and family here in the DF that doctors in the government health system actually ADVISE their new mothers to supplement with formula, and feed newborns water if they seem excessively hungry, instead of providing breastmilk on demand. A doctor providing the same advice in the United States could easily be sued for malpractice. Why? Simple.Read the above quote and you get an idea of the potential problems associated with water supplementation. Common sense says it’s a bad idea. And yet, one of the reasons given for water supplementation here is to prevent the baby from getting fat. Ludicrous. Babies are far better self-regulators than adults, and for every month that an infant is fed breastmilk, the likelihood for obesity decreases 4% (Dr. Garcia Velasco, personal communication, 2012).

If the public health system is providing advice which endangers the general population, and cultural belief is that formula is better, or at least equal to breastmilk, how can progress be made? For information on the cultural aspect of breastfeeding in Mexico, see Faliciagayle’s comment in this forum: http://www.mothering.com/community/t/933275/mexican-culture-and-breastfeeding.

Mexico has an extremely low exclusive breastfeeding rate, coupled with high neonate, infant, and child mortality rates (http://www.oecd.org/dataoecd/30/56/43136964.pdf , http://www.unicef.org/infobycountry/mexico_statistics.html). That shouldn’t come as a surprise when the concept of Montezuma’s revenge is brought up. Traveler’s diarrhea. Anyone who has traveled abroad is familiar with the concept, although hopefully the majority have been able to avoid it. So why the connection to Mexico? Because Montezuma was who? Oh, right. It’s a misspelling of Moctezuma, referring to the Aztec emperor. And where was that empire situated? Hello – Mexico City. But what exactly is it? Well, there are a few nasty bugs that are pretty common down here. 8% of the population has amoebiasis, (you’ve heard of dysentery, right?) which comes in second place to malaria for protozoan diseases (http://emedicine.medscape.com/article/212029-overview#a0199).

There’s no shortage of salmonellosis, either – a large portion of the population buys their meat on the street in tianguis. That means no refrigeration – bacterial heaven. Add to that the cultural habit of storing eggs at room temperature, and you’re in microbial stew. It’s a public health disaster waiting to happen. Oh, wait, it is happening.

So back to the boobs, and the question of fetal nutrition south of the border. When I first started looking into this topic, I took a little web-trip to that magic search engine known as Google. Using Google, I located all three lactation consultants in Mexico City with international certification. What an incredible presence! No wonder the population here is so up to date on lactation. Can you sense the sarcasm? Of course, La Leche League International is operating here – thankfully. The problem with their efforts is two-fold, though. Their centers are rather unfortunately located where they are least-needed – in the wealthier areas of the cities, where women can afford private doctors with up to date information on lactation, and the general population’s response to “what do you know about La Leche League International?” is “the what-what league?” It seems they are in need of some PR/marketing work…

This metropolis houses ~23 million individuals. Its mega-city status has provided a mystique and sophistication that much of the rest of Latin America tries to replicate. Poor children on the streets of Venezuela dream of the glamor of Mexico City, as displayed in the myriad telenovelas produced here (Cacho, Esclavas de Poder, 2012 – excellent book on human trafficking and the sex trade, by the way). It seems that if a real change in Latin American breastfeeding can be accomplished, a good starting point might be the DF. So why aren’t there more lactation activists here? Where are the international campaigns? Why are even the doctors still practicing ideas that went the way of the dinosaur in the 1970’s? Why, when major MNCs have spent billions to eradicate a healthy, natural practice, do we see a failure to respond on the part of pro-lactation NGOs and organizations? With infant nutrition as a primary development goal, where are UNESCO and UNICEF? Probably drinking cappuccino in La Condessa, Roma, or Santa Fe with a few Nestle execs…

Pardon my rant for the night. I’ve reached my goal of 1,000 words, so I’ll let this topic rest for now. Cheers to boob-juice and a milkier tomorrow!

 

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