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  • Have you ever heard the one about how breastfeeding is free?

  • (Laughter)

  • Yeah, it's pretty funny,

  • because it's only free if we don't value women's time and energy.

  • Any mother can tell you how much time and energy it takes

  • to liquify her body --

  • to literally dissolve herself --

  • (Laughter)

  • as she feeds this precious little cannibal.

  • (Laughter)

  • Milk is why mammals suck.

  • At Arizona State University,

  • in the Comparative Lactation Lab,

  • I decode mothers' milk composition

  • to understand its complexity

  • and how it influences infant development.

  • The most important thing that I've learned

  • is that we do not do enough to support mothers and babies.

  • And when we fail mothers and babies,

  • we fail everyone who loves mothers and babies:

  • the fathers, the partners, the grandparents, the aunties,

  • the friends and kin that make our human social networks.

  • It's time that we abandon simple solutions and simple slogans,

  • and grapple with the nuance.

  • I was very fortunate

  • to run smack-dab into that nuance very early,

  • during my first interview with a journalist

  • when she asked me,

  • "How long should a mother breastfeed her baby?"

  • And it was that word "should" that brought me up short,

  • because I will never tell a woman what she should do with her body.

  • Babies survive and thrive

  • because their mother's milk is food, medicine and signal.

  • For young infants,

  • mother's milk is a complete diet

  • that provides all the building blocks for their bodies,

  • that shapes their brain

  • and fuels all of their activity.

  • Mother's milk also feeds the microbes

  • that are colonizing the infant's intestinal tract.

  • Mothers aren't just eating for two,

  • they're eating for two to the trillions.

  • Milk provides immunofactors that help fight pathogens

  • and mother's milk provides hormones that signal to the infant's body.

  • But in recent decades,

  • we have come to take milk for granted.

  • We stopped seeing something in plain sight.

  • We began to think of milk as standardized, homogenized, pasteurized,

  • packaged, powdered, flavored and formulated.

  • We abandoned the milk of human kindness

  • and turned our priorities elsewhere.

  • At the National Institutes of Health

  • in Washington DC

  • is the National Library of Medicine,

  • which contains 25 million articles --

  • the brain trust of life science and biomedical research.

  • We can use keywords to search that database,

  • and when we do that,

  • we discover nearly a million articles about pregnancy,

  • but far fewer about breast milk and lactation.

  • When we zoom in on the number of articles just investigating breast milk,

  • we see that we know much more about coffee, wine and tomatoes.

  • (Laughter)

  • We know over twice as much about erectile dysfunction.

  • (Laughter)

  • I'm not saying we shouldn't know about those things --

  • I'm a scientist, I think we should know about everything.

  • But that we know so much less --

  • (Laughter)

  • about breast milk --

  • the first fluid a young mammal is adapted to consume --

  • should make us angry.

  • Globally, nine out of 10 women will have at least one child in her lifetime.

  • That means that nearly 130 million babies are born each year.

  • These mothers and babies deserve our best science.

  • Recent research has shown that milk doesn't just grow the body,

  • it fuels behavior and shapes neurodevelopment.

  • In 2015, researchers discovered

  • that the mixture of breast milk and baby saliva --

  • specifically, baby saliva --

  • causes a chemical reaction that produces hydrogen peroxide

  • that can kill staph and salmonella.

  • And from humans and other mammal species,

  • we're starting to understand that the biological recipe of milk

  • can be different when produced for sons or daughters.

  • When we reach for donor milk in the neonatal intensive care unit,

  • or formula on the store shelf,

  • it's nearly one-size-fits-all.

  • We aren't thinking about how sons and daughters may grow at different rates,

  • or different ways,

  • and that milk may be a part of that.

  • Mothers have gotten the message

  • and the vast majority of mothers intend to breastfeed,

  • but many do not reach their breastfeeding goals.

  • That is not their failure;

  • it's ours.

  • Increasingly common medical conditions like obesity, endocrine disorders,

  • C-section and preterm births

  • all can disrupt the underlying biology of lactation.

  • And many women do not have knowledgeable clinical support.

  • Twenty-five years ago,

  • the World Health Organization and UNICEF established criteria

  • for hospitals to be considered baby friendly --

  • that provide the optimal level of support for mother-infant bonding

  • and infant feeding.

  • Today, only one in five babies in the United States

  • is born in a baby-friendly hospital.

  • This is a problem,

  • because mothers can grapple with many problems

  • in the minutes, hours, days and weeks of lactation.

  • They can have struggles with establishing latch,

  • with pain,

  • with milk letdown

  • and perceptions of milk supply.

  • These mothers deserve knowledgeable clinical staff

  • that understand these processes.

  • Mothers will call me as they're grappling with these struggles,

  • crying with wobbly voices.

  • "It's not working.

  • This is what I'm supposed to naturally be able to do.

  • Why is it not working?"

  • And just because something is evolutionarily ancient

  • doesn't mean that it's easy or that we're instantly good at it.

  • You know what else is evolutionarily ancient?

  • (Laughter)

  • Sex.

  • And nobody expects us to start out being good at it.

  • (Laughter)

  • Clinicians best deliver quality equitable care

  • when they have continuing education

  • about how to best support lactation and breastfeeding.

  • And in order to have that continuing education,

  • we need to anchor it to cutting-edge research

  • in both the life sciences and the social sciences,

  • because we need to recognize

  • that too often

  • historical traumas and implicit biases

  • sit in the space between a new mother and her clinician.

  • The body is political.

  • If our breastfeeding support is not intersectional,

  • it's not good enough.

  • And for moms who have to return for work,

  • because countries like the United States do not provide paid parental leave,

  • they can have to go back in as short as just a few days after giving birth.

  • How do we optimize mother and infant health

  • just by messaging about breast milk to moms

  • without providing the institutional support

  • that facilitates that mother-infant bonding

  • to support breastfeeding?

  • The answer is: we can't.

  • I'm talking to you, legislators,

  • and the voters who elect them.

  • I'm talking to you, job creators and collective bargaining units,

  • and workers, and shareholders.

  • We all have a stake in the public health of our community,

  • and we all have a role to play in achieving it.

  • Breast milk is a part of improving human health.

  • In the NICU, when infants are born early or sick or injured,

  • milk or bioactive constituents in milk can be critically important.

  • Environments or ecologies,

  • or communities where there's high risk of infectious disease,

  • breast milk can be incredibly protective.

  • Where there are emergencies like storms and earthquakes,

  • when the electricity goes out,

  • when safe water is not available,

  • breast milk can keep babies fed and hydrated.

  • And in the context of humanitarian crises,

  • like Syrian mothers fleeing war zones,

  • the smallest drops can buffer babies from the biggest global challenges.

  • But understanding breast milk is not just about messaging to mothers

  • and policy makers.

  • It's also about understanding what is important in breast milk

  • so that we can deliver better formulas

  • to moms who cannot or do not breastfeed for whatever reason.

  • We can all do a better job

  • of supporting the diversity of moms raising their babies