Though a dual certified birth doula, my decision to practice a “radical” form of breastfeeding, which eschews all bottles and pacifiers (even if filled with breastmilk), means in practice that being present at births is nearly impossible...a fairly serious impediment to practicing my trade.  However, despite hearing of its frequency in other breastfeeding moms, in fourteen years of nearly continuous breastfeeding, I have only once come close to mastitis—and that was during one of the handful of times I have assisted as a birth doula and was separated from my baby for longer than usual.  Staying with one’s baby the bulk of the time certainly makes breastfeeding simpler.

The Community Health Worker featured in Breastmilk wondered aloud what it would be like if WIC didn’t give mothers formula—in her words, if they “forced” mothers to breastfeed exclusively.  Yet the stories of the mothers featured in the documentary demonstrate that withholding formula doesn’t go far enough.  If we want to make breastfeeding easier for normal, healthy moms and babies, we also have to withhold the pump, and keep moms and babies together.  Doesn’t seem realistic?  For those moms who are unable or do not wish to be stay at home mothers, work places with on-site childcare need to receive public praise and public support.  And we need to be unequivocal about our babies.  I find it hard to believe that the librarian complaining about the lack of onsite childcare in Breastmilk was the only mother in the school district who wanted such care.  For all the moms at work places that do not yet offer onsite childcare, determination is needed to reach out to the other pregnant or nursing mothers at your company.  Get together and brainstorm ways to help your babies stay with you at work; don’t sit around and wait for someone in management or leadership to come up with a solution.  Encouraging nursing moms at the work place requires an entire work place culture of breastfeeding support, but it will likely start with determined mother-workers who themselves come up with creative, business-positive solutions.

While great strides have been made over the past 45 years in breastfeeding initiation, improvements in length of breastfeeding lag behind.  About half of America’s babies are already weaned by 6 months of age and less than one third are still nursing at one year of age, (3) despite the recommendation that babies receive at least some breastmilk for at least a full year by the AAP (4) and a full two years "or beyond" by the WHO (5).  If the mothers in Breastmilk are representative, most mothers begin their breastfeeding relationship convinced of the benefits and cautiously optimistic about their own chances for success.  However, interventions in the birthing process and immediate postpartum; easy access to artificial baby milk; well-meaning but ill-informed physicians, government workers, and other authorities; baffled, worried and exhausted husbands, partners and relatives; worries about baby’s growth; a desire by the mother for some sense of control in a process that seems mysterious and lacking in objectivity; as well as misinformation and the undeniable “evidence” from the pump all conspire to undermine the mother’s confidence.  Pretty soon she’s supplementing and without the message from her body to make more milk, her supply drops and with little encouragement or practical help, she may quit all together, convinced she couldn't make 'enough'.