Sunday, September 28, 2014

Breastmilk Movie Review

by Carrie DiStefano, CLEC, Mom2Mom KMC Education Director 

I will admit that I had a slightly skewed view before I even saw this movie.  A couple of friends had posted that they had seen it and were both disappointed.   Always one to keep an open mind, I thought to myself, “it can’t be THAT bad”.  I was hoping that my friends were wrong and that once I saw it I would be excited and think that we could save the world with breastfeeding and then chest bump all of my breastfeeding  girlfriends.  

I put the DVD in my laptop and tell my husband that I am doing “school work” and need to be left alone.  I start the movie, and the scene opens to a woman at her baby shower opening gifts of breastfeeding related paraphernalia.  Not exactly attention-grabbing as a high speed chase, but I keep watching.   The film follows 6-7 women on their breastfeeding journeys.   Following them from about the time they are 7 months pregnant through the first year of the baby’s life, each woman has a unique, yet often similar story of breastfeeding.     Almost all of the women face hurdles that are, unfortunately, all too commonly found in America.    Some of the challenges these women face include:  a late-term preemie, an unexpected c-section, a baby that has problems latching, and a tongue and lip tie.   One thing that all of these women have in common was that they all said they wanted to breastfeed when they were pregnant.    All of these issues, if addressed by a knowledgeable professional with lactation training, can be remedied and breastfeeding goals can be met. 

Women often have ingrained in them that breastfeeding is “natural”, “instinctive”, and “what the breasts were made for”.  While all of this is, in fact, true many women still decide breastfeeding is not for them and switch to artificial baby milk.   Why are so many women starting out saying they want to breastfeed and then not following through?   Breastmilk provides a great insight into the perceptions that women have about breastfeeding and why they switch.   What this movie had the capacity to do, but failed miserably, is to educate people about breastfeeding.   Breastmilk essentially educates people about the challenges of breastfeeding, not the success stories and how challenges can be overcome.  In fact, only one of the moms was still breastfeeding when her baby turned a year old.  Almost all of the others started some type of supplementation, if not a full transition to formula, prior to the baby turning 6 months.   I want to take this opportunity to dispel some of the myths and misinformation presented in the movie. 

Karin was told that her 36 weeker, born just a few weeks early and weighing in at nearly 6 pounds needed human milk fortifier.   FACT:   Preemies can latch on to the breast and get what they need VERY early on – even prior to 36 weeks.    There’s no need for any sort of fortifier (read:  formula) unless it’s medically necessary, for example, galactosemia which is a rare condition, or very low birth weight preemies under approximately 3 pounds, or infants with phenylketonuria.  In fact, introducing foreign substances to a baby (including formula) can sometimes harm the baby as it increases the risk for necrotizing enterocolitis (one of the most common and serious intestinal diseases among preemies) versus breastmilk which contains immunological properties that can help protect preterm infants. 

Karin also believed that breastfed babies gain weight more slowly in the beginning and then speed up their weight gain as they are older.   FACT:  The opposite is true.  Breastfed babies often gain weight quickly in the first 3-4 months and then slow down.  

Colleen is a biologist and she wants her baby to latch on his own as it’s an instinctive, innate behavior that he can do without any assistance.  Yes!  This is true – thank you, Colleen!   Unfortunately what happens with Colleen is that she has a bit of an impatient and assertive nurse who wants the crying baby to hurry up and latch on.  So while Colleen watches her baby grab on to her breast, even though he’s not sucking, the nurse insists on helping her and takes the baby’s head and tries to help position him to latch on.   FACT:   Babies can and will latch on without any help from anyone.   Skin-to-skin immediately after birth will help facilitate this instinct known as the breast crawl, where the baby is searching for the breast and is able to find it and begin nursing.  It may not necessarily be a perfect latch as baby has to learn how to perfect his or her technique, but he can latch on and suck – two instincts that babies are born with.     

Colleen’s baby is also diagnosed with a lip and tongue tie.  Ties are common in breastfeeding and can cause a lot of barriers to breastfeeding success if not diagnosed and corrected.   They restrict movement which creates problems with breastfeeding as the baby’s tongue cannot reach the top of his or her mouth.   The baby cannot get a good latch at the breast and causes pain to the mother.   Babies who have ties also sometimes do not gain weight as well due to their inefficient sucking ability.   The movie actually does a good explanation of a tongue and lip tie and how they affect breastfeeding.  If only they had included more of these teaching moments, the movie would have been much better.  

Only one mom was still breastfeeding at one year.  She had attended a breastfeeding support group meeting with her baby to get reassurance from other moms (it’s unclear from the movie if she attended more than one meeting).  However, this mom did start pumping prior to her baby being born as she was concerned about her milk supply.  Her pumping likely caused her to have contractions and she went into labor that night.   A lot of moms believe that nipple stimulation can help with supply and/or to prepare the breasts for breastfeeding.   FACT:   This is absolutely not true and as shown in the movie may cause a mom to start contracting and go into labor.   A mom-to-be does not need to prepare her breasts for breastfeeding and any sort of artificial nipple stimulation is discouraged.
One of the mothers in the movie also was faced with an unexpected c-section delivery.   After the delivery, she says she felt very out of it and was not comfortable holding or feeding her baby.    What many women don’t realize, especially first time moms, is that the delivery can affect breastfeeding.   In the movie, it’s obvious how the delivery affected the young mother, but moms who have long labors and/or may have received extra fluids can also be very much affected when it comes to latching their baby to the breast.  Extra fluids may cause water retention which in turn may cause issues with a baby being able to latch on.    The extra fluids may also cause a delay from the transition of colostrum to mature milk.   A procedure known as reverse pressure softening can help with extra water retention in order to help the baby latch on.  And regarding the mature milk, the mom just needs to understand that a couple of extra days may be needed before she has her mature milk.  

The movie went on to interview a family who many breastfeeding moms likely would not be able to relate to.  It is this family that was used as an example of what full-term breastfeeding looks like.  That is, the mom was still nursing her toddler who was probably between 2 and 3 years old.   The American Academy of Pediatrics recommendation is that “exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby”.  The World Health Organization’s recommendation on breastfeeding duration is, “Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”. 

There are a lot of moms that nurse past one year and to use a couple who most viewers would not be able to connect with is doing a disservice to the idea of breastfeeding into toddlerhood. 
While this movie IS an accurate representation of a typical American mom’s breastfeeding journey, it leaves much to be desired in educating the audience on breastfeeding.     Not only is it missing an opportunity to educate moms, but it also lacks focus and a purpose.   I turned off my laptop feeling a bit confused and disappointed in a movie that I had such high hopes for.    


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