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Time Waits for No Hungry Infant

Understanding why may help business

This article originally appeared in The Huffington Post on May 12, 2014.

By Malika Shah

Breastfeeding in public has been a hot button global debate over parental rights and public behaviors for decades. New furor ignited recently in England when a mother was ousted from a store for nursing her child.

Store employees recently asked Wioleta Komar to leave a Sports Direct store in Nottingham, England for breastfeeding her 3-month-old son in the store. They claimed it was due to company policy.

Other customers helped her out the door with the baby buggy so she could feed her child in the rain. Hours later, more than 100 women gathered outside the store to demonstrate with a "nurse-in."

Often thought of as a protest method, nurse-ins are emerging as a powerful tool to dispel myths about breastfeeding, both internationally and in the United States. Over the last few years, they have occurred outside many United States establishments including airports, Target, Chick FilA, ABC Studios and Whole Foods.

While women involved in these incidents have often received apologies from the company owners and spokespersons, companies continue to be ignorant of laws that exist to protect an infant's right to receive breast milk. And it may be to their economic peril.

Companies view the convenience of a mother feeding a child in an inconvenient location as a nuisance, or disruption to the order of business. But it is a legally protected practice.

Breastfeeding in public is protected in the United Kingdom through the Equality Act 2010. In the United States, all 50 states have passed legislation protecting women from being prosecuted for breastfeeding in public.

Virtually every American health care organization and public health agency including the American Academy of Pediatrics, the White House Task Force on Obesity and the CDC have issued statements supporting breastfeeding.

Yet often the media portrays this important public health topic as a women's issue. What is less publicized is the biology that drives infant feeding.

A lactating mother will produce milk at regular intervals as a direct consequence of hormones controlled by infant feeding. Just as a hungry infant needs to be fed, a lactating woman needs to feed. The two together must be viewed as a dyad with a symbiotic biological need that is not actually a choice. Neither is it voluntary.

Delaying feeding a hungry infant has the obvious consequence of hunger and crankiness for the baby but can also pose health risks for the mother such as engorgement, clogged ducts, and an infection called mastitis. Breast milk supply can also wane, leading to early weaning. That result has higher costs.

If United States infants were exclusively breastfed for six months, an estimated $13 billion in health care would be saved annually, according to the U.S. Surgeon General.

Recent promotional efforts have resulted in more women breastfeeding their newborns, adding up to current breastfeeding initiation rates as high as 80 percent just after birth.

According to UNICEF, increases in breastfeeding practices in many countries has resulted in 39 percent of all children globally being breastfed exclusively until six months of age. Breastfeeding has the greatest impact on a child's survival, and can prevent more than 800,000 deaths of children in the developing world, UNICEF states.

Yet, the length of time a mother breastfeeds, continues to be low. Fewer than 16 percent of new mothers are breastfeeding their newborns at the child reaches six months of age.

But breastfeeding not only makes health sense but also economic sense for stores, companies and businesses to acknowledge the necessity of breastfeeding. Women control $20 trillion in consumer spending worldwide. Women account for 80 percent of U.S. spending and 65 percent of global spending, according to the World Bank. Millions of them may be breastfeeding.

To be sure, the sight of a woman breastfeeding her child in public may be offensive to some. In certain cultures with high breastfeeding rates, it is actually common for women to be homebound and only pursue errands between feeds. In the United Arab Emirites, it is the law for mothers to breastfeed their children for two years, but mothers are seldom exposed in public.

Aside from the health benefits and the physiology of the need to feed a hungry child, accommodating breastfeeding mothers instead of ousting them may boost store sales as well as engender consumer loyalty for companies. While many will argue that breastfeeding is good for both mother and child, nurse-ins staged on the front stoop of stores cannot be good for business.

- Malika Shah is an assistant professor of pediatric medicine at Northwestern University.

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