Pursuing Health in an Anxious Age by Bob Cutillo, Free for CAPC Members
Dr. Cutillo seeks to engage readers in rethinking, and re-engaging, health and care from a redemptive approach.
Every week in The Kiddy Pool, Erin Newcomb confronts one of many issues that parents must deal with related to popular culture.
Last week, the highest court of Massachusetts ruled that breastfeeding mothers are entitled to special accommodations during state medical licensing exams, which typically last 9 hours and grant 45 minutes of break time. This decision was prompted by Harvard medical student Sophie Currier, who petitioned for extra time to express her milk and was initially denied because lactation is not covered under the Americans with Disabilities Act. The state’s Supreme Judicial Court upheld the conviction that nursing mothers should not be covered under the ADA, but determined that Currier’s argument brings to light a situation that requires special consideration.
The CDC recommends exclusive breastfeeding for the first 6 months of a baby’s life, with combined breastfeeding and introduction of solids through the first year. In 2011, the CDC reports the following statistics: 74.6% of babies were ever breastfed, 44.3% were still breastfed at 6 months, and 23.8% were breastfed at 1 year. In terms of exclusive breastfeeding, the national statistics were 35% at 3 months and 14.8% at 6 months. The CDC establishes breastfeeding guidelines and goals because of the belief that nursing provides a significant public health benefit to both children and mothers. So why do the nationwide statistics fall so far short of the public-health objectives?
Within this conversation, I am a rarity. I nursed my elder daughter for nearly 2 years, what most U.S. practitioners call “extended breastfeeding” though compared to the WHO’s standards and worldwide practices, I cut our nursing relationship short. I am one of the lucky mothers to whom breastfeeding came easily—no infections, a baby who took to the routine easily, and a community of supportive mothers who also breastfed their babies. My husband provided practical support and encouragement for a system we all found more convenient and cheaper than formula. I also work part-time in a flexible job (where about half of my hours are done at home) and my work environment is family-friendly; I never pumped at work because my daughter refused to take a bottle, but the conditions were amenable if I had needed or chosen to do so.
As I read the article about Currier and the comments that followed, I was forcefully reminded how fortunate my circumstances were. There were blatantly hostile comments hoping that Currier would fail her medical boards because she was brash enough to ask for an accommodation; there were remarks about how if her choice to breastfeed conflicts with her exam, then she should either switch to formula or go on home and give up her career. Never mind the facts that a lactating mother can’t just switch to formula for a day without severe consequences (including significant pain, leakage, and possible infection) or the work and time that Currier already committed to her medical education.
But the court ruling raises a number of interesting philosophical questions that respond to the paradox of breastfeeding in our culture. Lactation is not a disability; it’s a choice, yet it points to larger social discomforts about women generally and mothers specifically. Breastfeeding is countercultural because it shows a biological, nurturing use of the breast in a climate that fetishizes the breast; nursing reminds us that, deep down, we’re still mammals, and we’re dependent on our bodies. Breastfeeding positions able-bodied women as affected and influenced by bodily functions in a climate that elevates the mind, trivializes the body, and continually asserts the separation of the two—a dualism that marks the independent, autonomous citizen (i.e., not a lactating mother).
Further, lactation as deserving of accommodation signals a fear of women who want “it all” and will alter the public sphere with demanding agendas and inconvenient bodily functions. How much does, and should, it matter that the choice to breastfeed is often a good one (despite how much social support it requires) or that Currier, like so many mothers, is trying to make the best decisions possible for her child, herself, and her family? The court of Massachusetts and the court of public opinion seem to come up with very different answers to those questions, leaving us mere mortals to keep on grappling with what it means to be the messily intellectual, corporeal, and spiritual beings that we all are.
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