My octagenarian psychoanalyst, Dr. Lenny, said:
"Debbie, you can't leave your breast at home while you go to work."
The Huffington Post is starting a Huffington Post Parenting blog. In
honor of this auspicious beginning, I thought I would start by opening a
discussion about breast-feeding and the 21st century man and woman.
I am starting here because, in a way, suckling at the breast could be
conceived as the first moment of parenting. It seems to me the moment
your baby first sucks at mother's breast, your identity as a parent, the wave
of enormous responsibility, the terror of your charge, and the incredible
excitement and joy that somehow comes through, concretizes in that exact
moment. That exact split second. That instant that becomes frozen in
time and indelible in your mind.
So much has been written over the last century on this matter. Melanie
Klein, a prominent figure in the history of psychoanalysis, who worked
with children and did her most important studies in wartime and post-
war London, is perhaps the most famous of all. Dr. Klein coined the
phrases "the bad breast" and "the good breast" as she came to understand
an infant's relationship with the breast/mother. She helped us all. But
she especially helped those of us in the psychoanalytic field, enabling us
to talk about, and deeply contemplate, the importance of life as it occurs
between the mother and infant during breast-feeding. And here we are in
the 21st century - now with one major problem to face. One that refuses
to go away. Many women aren't at home for the 1 to 4 years that would
be optimal for breast-feeding. The breast is not even present. The breast is
not at home.
Which leads me to the topic of "pumping." As I view it, breast-feeding is
a beautiful, highly sensitive, almost miraculous and intricate system. The
mother makes milk that becomes exquisitely attuned to her baby's need,
her baby's patterns of feeding, and even the particular idiosyncratic ways
her baby suckles. I would imagine that most mothers, especially mothers
that are set to return to work, are told that not only the pump is a necessity,
but are reassured it can actually be an adequate substitute.
It can't.
Of course, there is a legitimate place for pumping. However, it is not and
can never be, a substitute for breast-feeding.
Breast-feeding is a process, the building blocks of an intimate relationship
with one's child. It is the process that is as important, if not more so, than
the result. It's the first step on the path toward working out with our
children how we give and take, ebb and flow, with his or her particular
temperament. It is incredibly difficult physical and emotional work. And this
work is incredibly important.
Now for the biggest and important question: how can we push our culture
to new heights of understanding and support? How do we lobby for
working women to be with and breast-feed their infants for at least a year?
It seems to me that this issue is one that could and should unite liberals
and conservatives. Men and women. Young and old. I can't imagine
anyone would choose to decrease the chances for a child to survive well.
For families to grow well.
Most pediatricians would agree, breast milk for at least the first year of
life is optimum. Six months is ok. Three months is ok. Never is ok. But
for immune health, nutritional health and mental health, at least a year of
breast-feeding is unanimously recommended.
We need to ask ourselves "How do we work to support this in our society?"
As an ultimate illustration of the irony of our social system, why is a child
psychiatry/medical doctor resident/trainee allowed ten days of pregnancy
leave, and then expected to return to work full time or forgo her earnings?
Why would we as men and women want that for our child? Is the answer
that mothers should not be permitted to work? That seems radical and
pretty ridiculous, but I know some would support that. Most of us would
not (see Marlo Thomas' Monday HuffPo blog). Or should our society, all of
us, men and women, parents and non-parents, begin considering effective
solutions that allow our kids to at least get off to the best start possible in
life. The emotional and health benefits would probably, without doing an
official cost analysis, outweigh the cost of supporting a mother while she
breast-feeds.
I open for discussion some ideas, some solutions:
1. Professional support especially from the field of pediatrics,
psychoanalysis, child and adolescent psychiatry, general psychiatry,
psychology, internal medicine, immunology, educators, to develop
solutions perhaps first for their own professionals. I will begin by asking
my colleagues to gather ideas for a financial support program to help
fellow psychiatrists who are new parents and find themselves facing this
dilemma.
2. What kind of work-place innovations can we make for mothers who
work? Mandatory nurseries that welcome infants and nannies in every
office?
3. Tax breaks for families where the mother stays at home for a year and
breast-feeds?
Dr. Lenny died recently, he was sage and always able to capture the
tension that we face as women and men, mothers and fathers, who want
a world populated by healthy children. He would interpret to me, "Debbie,
you are tearing out a page from your past and reliving it. Our job here is
to just make sure your blindfold is off, allowing you to at least consciously
choose to either keep making the same mistakes or make different
choices.'"
It is time we look at this for our American society. Can we make new choices or keep repeating the mistakes of the past?