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The Happiest Place On Earth

What is the happiest place on Earth?

 

According to a 2017 United Nations agency report, it’s Norway. According to a 2015 film, it’s the new house you just bought. And according to my 5-year-old, it’s Disneyland. After all, it’s the theme park’s official tagline!

 

He pleaded to go to “the happiest place on Earth” for his birthday back in late April, so we planned a trip for him and his 6-month-old baby brother.

 

While Disneyland is almost tailor-made for 5- to 8-year-olds, I was told that taking a baby there can be a challenge. To make sure we have a happy family memory, I did lots of preparation: I stuffed my mommy bag with diapers, wipes, sunscreen, and other supplies. I marked the Baby Care Center location on the map and master the route from every attraction to the nursing room. I made a list of all the rides that babies can get on.

 

But my preparation was not super helpful. While our 5-year-old was very excited, the 6-month-old didn’t care much about the rides or the attractions. All he wanted was to be fed and take breaks whenever he liked. The Southern California sun was strong even in spring, which made him thirsty and demand to nurse even more often.

 

I’d rush to the nursing room located in the Baby Care Center whenever he showed the hunger cue, but it was not very practical. Disneyland does have great Baby Care Center with nursing room with chairs, but there are just tow of them in the entire 510-acre park: one located at the end of Main Street in the Disneyland Park, the other one located at Pacific Wharf in the Disney California Adventure Park. Often by the time I got there, my baby has lost patience, got extremely fuzzy, and was crying like a…baby. Any my 5-year-old was certainly not happy about the fun being interrupted by his baby brother!

 

I gave up the thoughts of rushing to the Baby Care Center after two attempts. I just breastfed wherever the need came up.

 

So we breastfeed on roadside benches…

When watching a parade…

 

 

 

 

On a ride…

When moving around…

In a restaurant, of course. Baby gets to eat, too!

It was actually easier

And even when watching the fireworks!

to do it then I expected. I wore a regular T-shirt with a nursing tank underneath, and whenever my baby needed to eat, I just pull up my shirt and pull down my tank, brought him up to my breasts, and continue whatever I was doing. People rarely noticed that I was nursing. And once my baby got what he needed, he was much more calm and we all got to enjoy what Disneyland has to offer!

 

It turned out the happiest place on Earth is mom’s boobs and arms. And to those who told my 6-month-old to eat in a bathroom, this is how he responded.

To-wen TsengThe Happiest Place On Earth
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A California Bill will improve requirements for workplace accommodations in CA!

Current California breastfeeding law requires employers to provide a reasonable amount of break time to employees desiring to express milk for their infant child. Current California breastfeeding law also requires employers to employers to make reasonable efforts to provide the employees with the use of a room or other location, other than a toilet stall, in close proximity to the employees’ work area, for the employee to express milk in private.
Now, SB 937 would require a lactation room or location to include prescribed features and would require an employer to provide access to a sink and refrigerator in close proximity to the employees’ work space.
This is important because in spite of the current California breastfeeding law, many working parents don’t have access to workplace breastfeeding support, including proper lactation accommodations. California Department of Public Health data indicates that, currently, only half of working parents have workplace breastfeeding support.
When I returned to work three months after giving birth to my first child, I had to pump in the restroom. When there was a line in the restroom, I pumped in my car. When the weather was too warm or the pump battery was too law, I sat on the floor under my office desk to pump, covering by a jacket. Some male colleagues claimed that I distracted them by sitting under my desk. Later a female colleague helped me to hide in the company storage to pump. It’s dirty in the storage and there were dead cockroaches on the floor, but I am forever grateful for her help.
What I don’t appreciate was that my previously employer shamelessly claimed that the storage with dead roaches was “a separate office that company arranged for nursing moms” when I alleged them not providing reasonable breastfeeding accommodation. That just disgusted me.
SB 937 would prevent things like this by requiring “the lactation spaces shall be at least 50 square feet, have at least one electrical outlet, have access to a sink with hot and cold running water, and shall be located no more than 500 feet from the farthest employee workspace or within two adjacent floors.”
There were hearings for the bill April 11, 17 and 24 in Sacramento. According to Legal Aid At Work, a non-profit organization sponsoring the bill, the bill has made it out to all committees, but still have a long way to go.
California Department of Public Health data shows that parents with support are two times more likely to exclusively breastfeed at three months. Evidence shows that prolonged breastfeeding benefits both maternal and infant health. New parents should not have to give up breastfeeding in order to return work. Women who choose to breastfeed should not have to worry about access to a clean, private space to pump milk. No mom should have to fear negative consequences at work just to feed their babies. Let’s support SB 937 for the health of California families!
To-wen TsengA California Bill will improve requirements for workplace accommodations in CA!
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Cannabis and Breastfeeding Study

My name is Amanda de Leon and I work for the Center for Better Beginnings, the birth defects prevention division in the School of Medicine at University of California, San Diego.

We are looking for study participants and donations for our confidential cannabis (marijuana) in breastfeeding research through the Mommy’s Milk Human Milk Research Biorepository, the first-ever human milk research biorepository in the nation. The participants will not be asked to consume cannabis while breast feeding, we are simply looking for mothers who are already consuming cannabis in it’s various forms. The aims of this project are to discover whether or not infant exposure to marijuana through breast feeding is harmful. Extensive growth and development of the infant’s brain and body occurs during the first 1-2 years of life, and breastfeeding is strongly recommended during this critical time. More analysis of breastmilk is needed to fill in the gaps about whether mom’s marijuana use while breastfeeding affects a child’s growth and neurodevelopment. Our goal for our findings is that they will be able to inform healthcare providers so they can counsel their patients for the best possible outcomes for both mom and baby.

Amanda de Leon

Department of Pediatrics | Center for Better Beginnings

7910 Frost Street, Suite 370, San Diego, CA 92123

T: 858.246.1707| F: 858.822.3761 | ardeleon@ucsd.edu

Heidi Burke-PevneyCannabis and Breastfeeding Study
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Breastfeeding is Public Health Priority

The American Academy of Pediatrics (AAP)’s Breastfeeding and the Use of Human Milk policy statement opens up with “Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.”

Yes, public health begins with breastfeeding. The Center of Disease Control (CDC) recently released a new infographic titled “CDC’s Work to Support and Promote Breastfeeding in Hospitals, Worksites, and Communities.” This resource highlights the public health problem associated with low breastfeeding rates.

The AAP recommends infants be exclusively breastfed for six months and then breastfeed with the addition of complementary foods for an additional year or more. Both moms and babies “can benefit from breastfeeding, with infants gaining protection from various infections as well as diabetes, leukemia, and childhood obesity and mothers decreasing their risk for various cancers among other benefits,” according to the AAP.

The problem is, according to the CDC, only one in four infants is exclusively breastfed as recommended by AAP by the time they are six months old. Low rates of breastfeeding add more than $3 billion a year to medical costs for the mother and child in the United States. Thus breastfeeding is an investment in health, not just a lifestyle decision.

Infants who are breastfed have reduced risks of asthma, obesity, type 2 diabetes, ear and respiratory infections and sudden infant death syndrome (SIDS). Breastfeeding can help lower a mother’s risk of heart disease, type 2 diabetes, ovarian cancer and breast cancer.

Dr. Ruth Petersen, the director of the CDC’s Division of Nutrition, Physical Activity, and Obesity, stated in the new infographic that “breastfeeding provides unmatched health benefits for babies and mothers. It is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. We must do more to create supportive and safe environments for mothers who breastfeed.”

Mothers need support throughout their breastfeeding journey. More than 60% of mothers stop breastfeeding sooner than they planned. Certain factors make the difference in whether and how long babies are breastfed, including hospital practices, education and encouragement, policies or supports in the workplace, and access to community supports.

San Diego County Breastfeeding Coalition (SDCBC) has been increasing breastfeeding support for mothers across the county. We promote best practices in health care settings by supporting the ten steps to successful breastfeeding, a global standard to promote breastfeeding in hospitals. We encourage obstetricians, pediatricians, and nurses to educate new moms about breastfeeding.

We support mothers at work and in their communities by providing working and breastfeeding resources, and recognizing breastfeeding-friendly workplaces. We are making a difference!

Women who choose to breastfeed face numerous barriers—and it’s not their personal problem, it’s a public health issue. Given the importance of breastfeeding on the health of mothers and children, it is critical that we take action to support breastfeeding.

To-wen TsengBreastfeeding is Public Health Priority
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Support for Breastfeeding in Early Education

Have you ever heard about “breastfeeding-friendly childcare?”

According to Center of Disease Control (CDC), support for breastfeeding in early care and education is an important strategy.

Early care and education can be pre-kindergarten (pre-K), childcare center, in-home care…various types of childcare arrangements. These programs play an important role in supporting breastfeeding mothers and their infants by welcoming nursing moms and making sure staff members are trained to handle breastmilk and follow moms’ feeding plans. Increasing access to breastfeeding-friendly childcare programs will help women start and continue breastfeeding

According to Bureau of Labor Statistics, in 2016, 58.6% mothers with infants were employed. As a result, many children under one year old are regularly cared for by someone other than their mother. Daycare providers and teachers influence the lives and health of the families they serve and can be an important source of support for working moms who want to breastfeed.

Data from the Infant Feeding Practices Study II, a longitudinal study that followed mothers from the third trimester until children were age one year, found that breastfeeding at 6 months was significantly associated with support from childcare providers to feed expressed breastmilk to infants and allow mothers to breastfeed on-site before or after work. The study used a questionnaire to ask mothers five questions about breastfeeding support. Results showed that mothers who said they received five of these breastfeeding supports were three times as likely to be breastfeeding at 6 months as mothers who said they received fewer than three breastfeeding supports.

In 2011, the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA) published the third edition of Caring for our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Program. This publication provides national guidelines on how daycare programs should accommodate breastfeeding mothers.

Specifically, the AAP and APHA recommend the following, “the facility should encourage, provide arrangements for, and support breastfeeding.”

All childcare programs, including center-based and home-based, can lower a breastfeeding mom’s anxiety by:

  • allowing her to feed her baby on-site,
  • having a posted breastfeeding policy that is routinely communicated,
  • making sure procedures for storing and handling breast milk,
  • feeding breastfed infants are in place, and
  • making sure staff members are well-trained in these procedures.

My two children attend different daycare, both center-based. I breastfed my older child several times in the center’s nursery room when he was little. I once nursed him at the center’s Christmas event. My younger one is now 5 months old, I’ve never breastfed him at the center, but I know mothers are welcome to pump or nurse at the director’s office. One time another mother accidentally took my breastmilk home, the manager ran to her house and picked up the milk for me. When I told the daycare teacher that my milk supply seemed to be dropping, she kindly brought me fenugreek. I was so touched. If it takes a village to raise a child, daycare centers can be a modern day “village”. Welcoming environment encourages moms to breastfeed longer. That’s what it counts.

To-wen TsengSupport for Breastfeeding in Early Education
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Breastfeeding Controversies: SDCBC Mini Seminar Highlights

In spite of the backlash against breastfeeding, science continues to prove that breastmilk is the best nutrition for babies. Dr. Susan Crowe (MD, FACOG) discussed the making of breastfeeding controversies at a recent San Diego County Breastfeeding Coalition half-day seminar.

How the billion pound formula industry hijacked breastfeeding

We’re all familiar of the Nestle’s infant formula scandal: Outrage started in the 1970s, when Nestle was accused of getting third world mothers hooked on formula, which is less healthy and more expensive than breastmilk. The allegations led to hearings in the Senate and the World Health Organization, resulting in a new set of marketing rules.

The rule, now known as the International Code of Marketing of Breast-milk Substitutes, forbids advertising of bottles or substitutes, free samples, gifts to health care workers, free or low cost products to hospitals.

But today, most medical professional organizations still accept formula funds or conference sponsorships. More than 50% of women receive free formula in the mail.

US formula manufactures spend around $480 million in advertising, while La Leche League International has a $3.5 million annual budget. “Formula manufactures spend the money because it works,” said Dr. Crowe. And what formula marketing tells mothers?

“You do not have to nurse your child. Scientific evidence today indicates that children who have never been nursed are just as healthy, sometimes more healthy, both physically and emotionally, as children who are nursed. If you are reluctant to nurse your child, if it makes you feel tense or uncomfortable, do not attempt it.”

This is misleading: Evidence shows that breastfed babies become healthier adults, and breastfeeding is a learned behavior. It is unfortunate that mothers are manipulated by the marketing forces of infant formula companies. Breastfeeding decisions needs facts, not marketing.

How maternity care practice supports breastfeeding

Safe sleep and skin-to-skin care in the neonatal period for newborns remain a hot topic. Some argue that skin-to-skin increases the chance of Sudden Unexpected Postnatal Collapse (SUPC). On the other hand, solid number shows that early skin-to-skin significantly raises exclusive breastfeeding rate. Dr. Crowe encourages skin-to-skin. And there are some components of safe positioning for the newborn while skin-to-skin:

  1. Infant’s face can be seen.
  2. Infant’s head is turned to one side.
  3. Infant’s nose and mouth are not covered.
  4. Infant’s neck is straight, not bent.

What to do with extra milk

Dr. Crowe made it clear that more milk isn’t always better. She discouraged excessive pumping, noting that too much pumping can cause risks of mastitis, plugged ducts.

Mothers who can produce more milk than what her baby needs, they may sell it, share it, freeze it, or donate it. Dr. Crowe encouraged moms to donate extra milk to members of Human Milk Banking Association of Nor America (HMBANA). She donated 900 oz  of her milk. “HMBANA provides essential breastmilk to newborns at risk for NEC. I’m concerned that other options may put the supply of this milk at risk.”

To-wen TsengBreastfeeding Controversies: SDCBC Mini Seminar Highlights
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Why I pump for other’s kids

Breastfeeding moms’ days are long, years are short. Before I knew it, my baby was turning five months old and started to show interests in his big brother’s food. Our pediatrician recommended us to introduce solid food to him, which we did. Before this he’s been exclusively breastfed and with the sucking simulation, my milk supply has always been good. I can’t believe he’s weaning from breastmilk to solids already! Looking at my freezer that is full of frozen breastmilk, I realized that he’s rapidly growing. I felt happy and sad.

I could stop pumping now. But I decided to continue to pump. After completing a series of screening, this week I packed my breastmilk for Mother’s Milk Bank of San Jose.

Some may ask, who would need donated breastmilk when infant formula comes in so handy?

Well, for a healthy, full-term baby, infant formula wouldn’t do much harm. But for a sick or pre-term baby, that’s totally a different story. There are more than 200,000 preterm births in the U.S. per year. For these babies, breastmilk is not only the best nutrition, but also a life saver.

The number one cause of death among preemies is necrotizing enterocolitis (NEC). It is a devastating disease that affects mostly in the intestine of premature infants. Infants with NEC need to stay in the intensive care unit (NICU) for months, go through many surgeries to remove the necrotic tissue, which can cause various complications and lifelong sequelae. The medical costs for each case can be as high as $600,000, and the process is unpredictable painful for the parents and infants.

Breastfeeding is the best way to prevent NEC. Human milk contains ingredients that reduces NEC which formula industry simply cannot duplicate. According to Best for Babes, exclusive breastfeeding can reduce the incidence of NEC among preemies up to 79%. When a preemie’s mother doesn’t have enough milk supply, donated breastmilk can save the infant’s life.

That’s why breastmilk is becoming big business. Currently in the U.S., the market price of breastmilk is $2.5 per ounce. Breastmilk is truly gold liquid. Biotechnology companies like Prolacta Bioscience that buy breastmilk, research and sell breastmilk products have received tens of million dollars in investments from life science venture capitalists. In hospitals, the extremely premature babies can be fed on the high-protein products by the company and get optimal nutrition.

But I can’t be optimistic about that cutting edge companies trying to replace traditional non-profit organizations. The Prolacta Bioscience products can surely help premature babies recover, but at a cost of thousands of dollars a baby. Not all the families can afford their products. On the other hand, these companies are buying breastmilk and attracting mothers with extra milk supply to sell instead of donate their mother’s milk, which has caused the freezers of mother’s milk banks around the country low and families rely on milk donations troubles.

Breastmilk is love. Love is for sharing, not for selling. Dear moms, if you’re as lucky as I am and can produce more milk than what your baby needs, please consider join me and become a breastmilk donor. Please contact Mother’s Milk Bank at (408)998-4550. Thank you for sharing your liquid gold!

 

To-wen TsengWhy I pump for other’s kids
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Breastfeeding and Racial Inequality

Helping Mothers of Color Reach Their Breastfeeding Goals

Last year I joined a group of healthcare providers and concerned individuals in Southern California to form the Asian Breastfeeding Task Force. We feel it’s clear that there are special and unique cultural and education issues when working with this population and breastfeeding practices.

I used to be a staff writer at a self-describe largest Chinese language newspaper in North America. Four years ago when I returned to work after giving birth to my first child, my employer refused to provide a reasonable area for nursing moms to pump. When I talked to my supervisor and our HR about the lactation accommodation rights, they responded to me that they were not aware of the law. One of my colleagues told me to formula feed, adding that “my son was formula fed and he goes to Harvard. Formula-fed babies are smarter.” I tried to invite some medical or lactation professionals to the company and talked about the benefits of breastfeeding, but I couldn’t find even one Chinese-speaking professional who would talk about breastfeeding. And that was in Los Angeles, home to the largest Asian American population in the US.

Speaking of breastfeeding, a persistent racial disparity exists: Colored mothers have lower breastfeeding rates than white mothers. African American women have the lowest rates of breastfeeding initiation: 62 percent of American black babies were breastfed at birth, compared to 79 percent of white babies.

A study by the Centers for Disease Control (CDC) found that certain hospitals that serve black communities are failing to support breastfeeding. In a recent Morbidity and Mortality Weekly Report, the CDC reported that hospitals may play a role in the racial discrepancies. The CDC found that facilities in zip codes with more than 12.2 percent black residents were less likely than hospitals in zip codes with fewer black residents to meet five of 10 indicators that show hospitals are supporting breastfeeding.

The CDC looked at the 10 indicators it identified in its Maternity Practices in Infant Nutrition and Care (mPINC) survey. They included: educating mothers and health care staff properly, helping mothers initiate breastfeeding within one hour of birth and making sure not to give pacifiers or artificial nipples to infants. The researchers coupled these mPINC indicators with U.S. Census data to analyze 2,643 hospitals across the country.

Culture, education and family support are also huge equalizers. Of infants born in 2013 in China, 20.8% were breastfed at 6 months, comparing with 49% were breastfed in the US. High percentage of foreign born Asian mothers brought their formula culture to the US. It is also reported that black mothers often believe that “breastfeeding is for poor people.”

Before these factors—preconceptions about breastfeeding, family influence, professional support—come into play, there is something that hospitals can do. A 2016 research published by Chapman University found that in-hospital formula introduction is something that hospital policy makers and breastfeeding advocates can seek to change.

Given that most babies in the United States are born in a hospital, the short time that a mother and a newborn spend there can have a long-lasting effect on breastfeeding.

After that, professional support is much needed. And this is when breastfeeding organizations kick in!

To-wen TsengBreastfeeding and Racial Inequality
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Moms Beware! Scammers on FB page requesting donated breastmilk are selling it on other pages

Facebook groups for breastfeeding mothers are sending out a warning to its users.

Human Milk 4 Human Babies Ohio said it received a large number of complaints from multiple people about a couple from Cleveland, OH requesting breastmilk and then selling it in other places. The page was not set up for selling breastmilk for money. It has banned the couple.

Human Milk 4 Human Babies Kentucky also received similar complaints. Ronna Mariah Rhodes, a mother from Lexington, KY and a member of the group, posted on the page and warned other mothers.

“I am making this post as a public announcement to this community about a local mom getting donated milk from many of you and turning around to sell it…” wrote Rhodes. “Lexie Whittaker has been asking for donations since December because she was ‘returning to college and needed help.’ Now she has 1,500 ounces in her possession that she was caught trying to sell.”

Rhodes had screen shots captured to back up her claim. “As a fellow donor, this is frustrating,” she wrote. “Milk sharing is an amazing thing that helps babies in need. It is disgusting that someone turn it into something so ugly. Please get to know your donor or donee!”

This post upset many other mothers.

“As a donor, this is heart breaking,” responded Jenna Michele, a member of the group who donated milk. “I never considered selling my milk. There are so many people who need to supplement their supply or don’t produce at all. It is an incredible gift to be able to help nourish another human being. I echo others—to reach out to the person who is in need of milk. There are a lot of people who are genuinely in need of milk and are very grateful and appreciative of donors’ gifts.”

“This makes me so mad!” responded Lizz Swift, another member of the group who rely on donor’s milk. “My son can’t gain weight because I don’t produce enough…then there are women like this getting the milk then selling it? This is ridiculous!”

It is understandable that moms rely on online forums to get donated milk, but some dangers need to be considered. The main risk is disease from bacterial infections to HIV. Another risk is the medication that the donating mother may be taking.

Here at San Diego County Breastfeeding Coalition, we encourage lactating mothers to become breastmilk donors, but only through Mothers’ Milk Bank.

Currently Mothers’ Milk Bank of San Jose is in need of donated breast milk. Moms interested in donating can fill out the form here to be screened and registered with Mothers’ Milk Bank. Once screening is completed, it’s pretty simple: Milk can be dropped-off at Sharp Mary Birch Hospital for Women and Newborns or the Milk Bank will arrange for pick-up and shipping.

It’s a beautiful to share and donate your breast milk. And beware, don’t let anyone to take advantage of your generosity and sell your liquid gold!

To-wen TsengMoms Beware! Scammers on FB page requesting donated breastmilk are selling it on other pages
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Breastfeeding in Public: Why and Why Not?

This is a selfie I recently snapped of myself breastfeeding my 2-month-old in our local YMCA’s “mother’s privacy room”— a great nursing room with beautiful furniture, soft carpet, comfortable couch, dim light, and everything that a great nursing room should have.

But what I really wanted was to breastfeed by the pool, so that I can feed my baby and watch my 4-year-old swimming at the same time.

My baby finished the nursing session just when my preschooler finished his swimming lesson for that day. When I stepped out of the mother’s privacy room, my older child grumbled, “I did very well today, Mom. But you were not there to watch me!”

“I’m sorry,” I said. And I meant it. “I wanted to watch you but Jasper was hungry. I had to feed him.”

“Why don’t you just feed him by the pool? I saw other kids eating on the pool chaise lounge. That should be okay.”

For one moment, I wasn’t sure how to answer his question. Apparently breastfeeding is a totally natural thing to him. He sees babies eating mother’s milk just like toddlers eating gold fish.

But to many adults, that’s not the case. We’ve seen mothers shamed for breastfeeding at Walmart, Disneyland, and yes, YMCA.

The hostility makes many moms, including me, hesitate to nurse in public. In theory, I am all for breastfeeding in public. But in reality, I don’t always feel comfortable breastfeeding in public. I would only nurse in public when my baby is absolutely hungry, I absolutely cannot find a nursing room, and I am absolutely sure that no one would notice me.

That’s unfortunate. Breastfeeding in public is a civil right. And it should be not just a civil right, but also a social norm for two reasons.

One, mothers need to have their normal life keep going while breastfeeding. No mother could breastfeed for one year (which is really just the minimum recommendation) if she could not continue her life while doing so. If a nursing mom has to stay at home, unable to dine out, to go shopping, or to watch her older children swimming in the pool, how can it be possible for her to breastfeed for one whole year?

Two, children need to see breastfeeding in public. Some argue that breastfeeding in public would offend other parents with kids. This is insane. Breastfeeding mothers are not something that was recently invented. Merely two generations ago, it was not unusual to see a woman nurse her baby in public. All the trouble started with the using of female bodies to sell cars. There is nothing inappropriate about breastfeeding in public, except the people who are sexualizing it. And if our children grow up surrounded by sexualized images of breasts from Hollywood but never, or only rarely, see the normal, natural act of breastfeeding a baby, how can they have healthy ideas about women’s bodies?

Breastfeeding will not be seen to be natural until we see more women breastfeed in public. If you’re a nursing mom, please breastfeed on​. If you’re not nursing, please show some support.

To-wen TsengBreastfeeding in Public: Why and Why Not?
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