Gender Equity, Co-Parenting and Infant Feeding Choices

Jessica Pratezina, MA, is a Ph.D. student in Interdisciplinary Studies (Child and Youth Care; Sociology) at the University of Victoria, British Columbia, Canada. Her doctoral research studies gender equality, father involvement, and early family formation.

Research shows that a father’s positive involvement significantly impacts every domain of their child’s development. Less attention has been paid to how a father’s involvement can improve a mother’s health, well-being, and especially relationship satisfaction. Not every happy, healthy family wants or needs a dad (like lesbian couples or single mums). But when a father is an expected part of family life, they can make a world of difference not only to his children but to his partner. In particular, when couples share childcare and household responsibilities equitably, the benefits to a mum can be significant.

Yet, gender equality isn’t one of the topics parents are encouraged to discuss during their parenting transition. In between learning how to clip those impossibly tiny newborn fingernails and piecing together cribs that seem to require an engineering degree to assemble, talking about how to keep childcare and housework tasks fair and equal isn’t something most couples are supported to do.   

 Gender equality is also not usually discussed as a factor influencing parents’ feeding choices. When I worked as an infant development specialist, I was taught to ask all sorts of questions about a mother’s feeding plans. The intention was to guide (or possibly guilt) the mum into choosing exclusive breastfeeding. 

I was never taught to ask a mum how she wanted to involve the baby’s dad in feeding and how the different feeding options might support or hinder an equal sharing of the baby’s care.

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The Ten Steps to Ethical, Successful, And Inclusive Infant Feeding

In most hospitals and prenatal educational materials, exclusive breastfeeding (EBF) is the recommendation for infant feeding. EBF is promoted as the only healthy way to feed a baby, with partial breastfeeding, temporary supplementation, and formula feeding falsely characterized as “suboptimal.” Other infant feeding options, such as exclusive pumping or formula supplementation, are discouraged, even when requested by parents. But does this narrow definition of healthy infant feeding support patient rights and ethical infant feeding principles? No, it does not

 Infant feeding support in postpartum units should consider ethical principles of autonomy, beneficence, justice, and non-maleficence when considering the extent to which lactation should be promoted. 

What Are The Principles of Ethical Infant Feeding?

Autonomy: The parents choose how they intend to feed their baby at each feeding, and maternal bodily autonomy is affirmed and respected.

Beneficence: The benefits of infant feeding types are provided to the parent to help them make an informed decision. Healthcare providers must not decide what is best for the parent.

Justice: Do not assume a feeding method. Ask the parent how they want to feed their baby. Affirmative consent must be obtained before touching a patient’s body. 

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National Women’s Health Advocate Describes How A Baby-Friendly Hospital Starved Her Baby

Sarah Christopherson is a mother and the Policy Advocacy Director at the National Women’s Health Network, a non-profit advocacy organization in Washington, D.C. She talks about her breastfeeding experiences and her recent experience in a Baby-Friendly hospital where her child became severely dehydrated and lost 15% of her birth weight while in the hospital. She discusses how policies can negatively affect patient health and how systemic change is needed to support positive patient health outcomes and prevent patient coercion.

Is Formula More Dangerous than Irreversible Brain Damage?

Is that some kind of sick joke? Infant formula is safe nutrition—scientifically created to replace human milk and thus consists of fluids and nutrients necessary to nourish a baby. Brain damage is irreversible.  That should be glaringly obvious, but it looks like the AAP Breastfeeding Section responsible for the recently released “Breastfeeding and the Use of Human Milk” (June 2022) has lost sight of this critical fact.

Let’s focus on this appalling statement:

“The need for phototherapy in an otherwise healthy infant without signs of dehydration and/or insufficient intake is not an indication for supplementation with formula unless the levels are approaching exchange transfusion levels.”

Hyperbilirubinemia (excessive jaundice) and Phototherapy

To explain why we are horrified, let’s look carefully at what the statement means. Jaundice is a common and usually benign condition experienced by about 60% of healthy newborns. It is caused by a substance called bilirubin, a breakdown product of fetal red blood cells after birth to transition to mature red blood cells. However, if a baby’s bilirubin levels are greater than a certain level and continue to climb, the risk for brain damage increases.

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A Nurse Speaks Out About The Emotional Distress Parents Endure From Mandated Exclusive Breastfeeding Policies

“The sight and sound of babies crying out for food and fluids are why I decided to speak out. Babies are denied food and fluids to promote exclusive breastfeeding.”

As a mother-baby nurse, I’ve seen many preventable episodes of emotional distress for families in my thirty-year career. Unfortunately, The emotional distress increased significantly when the Baby-Friendly Hospital Initiative was implemented at my hospital. Some episodes of emotional distress are unforgettable, so I felt compelled to speak out about them, hoping to bring about the much-needed change to protect newborns from hunger and maternal mental health.

Mothers are incredibly vulnerable after giving birth, as their bodies transition physically and hormonally. They have a new life to take care of while recovering from birth and require compassionate, respectful, and individualized care. However, the Baby-Friendly breastfeeding protocol is one-size-fits-all and does not allow individualized care. Mothers must follow the BFHI protocol regardless of how they feed their baby or how complicated their birth was. We know as health care professionals that no protocol can be safe and effective without individualized care.

 Evidence based medicine cannot replace clinical judgment or account sufficiently for the complexity of individual cases. The limitations of EBM must be acknowledged and addressed so that it can be used effectively and without compromising patient care. -Mark R. Tonelli, MD, MA

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