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Opinion

Op-Ed: Is pumping as good as breast-feeding?

Breastfeeding ‘nurse-in’

A group of mothers breastfeed their children on the steps of retailer Anthropologie during a “nurse-in” in Beverly Hills on Aug. 20, 2014, after a mom was asked to nurse her 6-week old son in a bathroom at the store.

(Los Angeles Times)

Over the last decade, pumping breast milk has become an integral part of the American practice of breast-feeding. One study found that 85% of women who breast-feed in the United States use a pump, although breast pump manufacturers put that number even higher. American women make up 40% of the world breast-pump market. There is no place else in the world, even in other developed countries, where pumping is such a universal feature of breast-feeding.

Lots of mothers love breast-feeding... But I bet there isn’t a woman alive who loves pumping.

Many new mothers feel they have no choice. Almost 60% of them work. On average, American women take just six weeks of maternity leave, and 30% take no time off at all. Faced with the contradiction between the official recommendation to breast-feed exclusively for six months and the absence of federally mandated paid maternity leave, mothers pump breast milk so that someone else can feed their babies human milk from a bottle. They also use pumps to maintain their milk supply so they can breast-feed their babies when they get home. Even mothers who don’t work often pump milk to avoid disapproval of breast-feeding in public view.

But it’s not at all clear that the trend toward pumping is beneficial, or even neutral. There is no research that compares outcomes among babies who are breast-fed and those who are bottle-fed breast milk.

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The popularity of pumping depends on the assumption that what is valuable about breast-feeding is the chemical composition of human milk. Yet many doctors believe that, if breast-feeding boosts cognitive development, it is because of mother-infant interaction at the breast. It is the human contact that’s significant, not the human milk.

Even supposing it’s the chemical composition that matters, many studies have found that freezing, thawing and heating — routine steps between pumping and feeding — degrades the proteins and vitamins present in breast milk. One study found that even breast milk refrigerated for as little as one day is degraded into unbound fatty acids that can cause cell death in babies’ intestines. Studies have also found that when breast milk comes in contact with pump parts, storage containers, bottles and teats, it often picks up bacteria along the way.

Whether or not pumping is as good as breast-feeding in terms of infant health, it is nothing like breast-feeding when it comes to a mother’s experience. Lots of mothers love breast-feeding. They love watching their infants’ contented focus; they love the comfort it offers babies after a fall or a long day; they love the simplicity of never having to carry snacks. But I bet there isn’t a woman alive who loves pumping. Pumping is embarrassing. If you have to do it at work two or three times a day, holed up in an unused storeroom, or even half-naked at your desk with the door locked, it can be hard to maintain your hard-won dignity and professionalism. Pumping offers mothers all of the potential discomfort of breast-feeding — painful conditions such as mastitis and blocked ducts — along with none of the convenience. Mothers have to lug around a pump and constantly clean and sterilize bottles and pump parts.

Despite the lack of scientific evidence that pumping imparts the same benefits as breast-feeding, most recent breast-feeding initiatives have promoted it. In 2011, the Affordable Care Act amended the Fair Labor Standards Act to require employers to provide nursing mothers with space to pump breast milk at work — during unpaid breaks. In 2012, the IRS changed its rules to make breast pumping equipment tax deductible. That initiative was superseded in 2013 when the ACA mandated that private health insurance plans and Medicaid cover the cost of breast pumps for new mothers. Suddenly every new mother in the United States was entitled to a free breast pump from her insurance company.

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Driven by initiatives such as these, the global breast pump market is expected to reach $2.6 billion in the next few years. Pumping has also turned human milk into a commodity sold on the open market through such online sites as Only the Breast and Craigslist. A company in the City of Industry called Prolacta Bioscience uses human milk purchased from nursing mothers to make infant nutritional supplements. Whereas breast-feeding was once considered a countercultural challenge against big business, a protest against the multinationals that make formula, pumping is thoroughly commercial. And its business model depends on the premise that human milk consumption is a faithful substitute for the intimate interaction between mother and baby that is the hallmark of breast-feeding.

The rise of pumping has quietly realigned our expectations of what new mothers should be prepared to do to feed their infants. Not long ago, we thought of work and breast-feeding as mutually exclusive — a mother could do one or the other, but not both. Now that women have the “right” to pump breast milk at work, “breast-feeding” appears to be perfectly compatible with full-time employment. As the Department of Health and Human Services crows, “Mothers do not have to choose between providing human milk for their baby and returning to work, and employers can retain valuable employees!”

As this upbeat message confirms, pumping offers a good solution to employers who would rather offer nursing mothers unpaid work breaks than maternity leave. It’s also a boon to the corporate fortunes of the companies that make pumps and to companies that use human milk in their production process. It seems as if the only potential losers in this win-win-win scenario are mothers and babies.

Courtney Jung is the author of “Lactivism: How Feminists and Fundamentalists, Hippies and Yuppies, and Physicians and Politicians Made Breastfeeding Big Business and Bad Policy.”

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