TERESA PITMAN
Originally published October 2016 and republished with the express permission of the author.
Celebrating 60 years of La Leche League International (LLLI).
60 years ago
Seven women in Chicago met 60 years ago to talk about helping other women who wanted to breastfeed. They all had families with young children and were active in their communities: they would have been perfectly justified in saying, “We’re too busy to take on something new. We figured out how to make breastfeeding work, other mothers can too. Who wants the hassle of starting a new volunteer organization anyway?”
But they didn’t. They saw a need and stepped up. And they went beyond that: over time they developed a series of statements that summed up what they thought about breastfeeding and parenting. With a philosophy defined, this brand new organization didn’t just focus on getting human milk into babies: breastfeeding was talked about in the context of parenting and raising healthy children (both physically and emotionally).
Those ten statements, were pretty radical. They remained pretty radical and different from the advice that most parents would be given by their medical caregivers and peers for the next 30 years or more. Then, very gradually, the medical profession began to catch up with La Leche League (LLL).
It certainly didn’t happen overnight. In 1956, only about 20% of the babies born in the U.S. were breastfed at all. (It is a little difficult to determine the exact percentages because the government wasn’t tracking this data—that’s how uninterested people were in breastfeeding.) Rates were similar in most other Western countries.
60 years growing
For the first few years after LLL was founded, its influence was small. But it grew. Eventually the medical profession noticed. Dr. Samuel J. Fomon wrote: “The increase in breast-feeding in industrialized countries in the 1970s was worldwide, and the reasons for the increase after several decades of decline are not easy to identify. The movement toward increased breast-feeding seemed to arise from the general public rather than from health professionals.” (1)
Dr. Fomon may not know why this happened, but I am pretty sure I do. I believe LLL played a major role in spreading the message that breastfeeding was possible and worthwhile—even without health professional support.
Growing interest in breastfeeding brought more research and the findings of these studies started to validate what LLL had stated in its philosophy. People’s view of the “crazy radical ideas” from LLL shifted as these became mainstream medical advice.
For example:
Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.
When I had my first baby, in 1977, prevailing medical wisdom and the practice in my hospital was to whisk all babies away at birth to the hospital nursery, where, for the first 24 hours, they received nothing but a little sugar water. I actually had to meet with hospital management while I was pregnant to get permission to feed my baby shortly after his birth.
After those first 24 hours, the baby was allowed to breastfeed for two minutes on each breast every four hours. The next day, you could increase that to four minutes on each breast. You won’t be surprised to hear that the majority of mothers who tried breastfeeding had problems with milk production.
oday, the World Health Organization and the Baby Friendly Hospital Initiative, as well as national health organizations, are very clear: babies should stay with their mothers for at least an hour after birth and breastfeeding should begin as soon as the baby shows an interest. After that, the baby should breastfeed as often as possible: frequent feedings in response to baby’s cues are the key to establishing a good milk supply.
And what about that “satisfying relationship”? Studies have shown that mothers who were with their babies in that first hour after birth were more positive in their interactions with the baby weeks and even months later. (2)
Here’s another one: For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.
When I had my first baby, mothers normally stayed in the hospital for five days after giving birth. The woman who shared my hospital room was instructed by her doctor to start giving her baby infant cereal and orange juice before she left the hospital. Yes, at five days! I have photos of her spooning the rice cereal into her newborn’s mouth; the bottle of orange juice is sitting on the bedside table.
My roommate’s physician was apparently unusually fond of early solids, but most physicians at the time were recommending solid foods between four and six weeks. Mothers were told that their babies would become anemic (and potentially brain damaged) if they didn’t start on iron-fortified infant cereal by six weeks. One doctor who wrote a newspaper column in my community stated that it was impossible for breast milk to provide enough calories to sustain normal growth in an infant after eight weeks, so solid foods were essential.
The message from LLL about a baby’s readiness for solids being so much later was shocking for many parents at the time. It certainly generated intense discussion at my LLL meetings! Yet today, the World Health Organization (along with every national health organization I can think of) recommends starting solids at the middle of the first year. Once again, LLL was right.
Another concept that was considered very radical at the time: Ideally the breastfeeding relationship will continue until the baby outgrows the need.
Despite the practices that made it tough to get breastfeeding off to a good start, some mothers in the 1950s, 60s and 70s did manage to breastfeed—only to find that their medical health care providers (not to mention friends and family) were soon asking, “When are you going to stop?” We had to wean before our babies got teeth (my oldest had teeth at three months!), by seven months, by nine months, and ABSOLUTELY before a year. There was no nutrition in human milk after a certain point, we were warned …
If, defying those warnings, our babies continued to grow and be healthy, then there were additional warnings of dire psychological consequences. A baby who nursed beyond nine months would be “too dependent” or “never have any self-confidence.”
Today, the World Health Organization and most national ones also recommend that breastfeeding continue for two years and beyond, as long as mother and child desire. Research has shown benefits in both physical and psychological health when mothers breastfeed longer. (3) Yes, LLL was right again.
Here’s another one: From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.
In the 1950s and for decades afterwards, this was an unusual approach. More commonly, the role of a parent back then was to keep the child in line, usually with punishments such as spanking. I was spanked as a child and most of the parents I knew when my children were small believed that spanking was the best way to discipline a child. It was only through La Leche League that I learned about a different way to guide my children.
Once again, current research and evidence has caught up with LLL. A meta-review of studies on the effects of spanking found universally negative outcomes. Among the 79 statistically significant effect sizes, 99 percent indicated an association between spanking and a detrimental child outcome. Those outcomes were: “low moral internalization, aggression, antisocial behavior, externalizing behavior problems, internalizing behavior problems, mental health problems, negative parent-child relationships, impaired cognitive ability, low self-esteem, and risk of physical abuse from parents.” (4)
One more: In the early years the baby has an intense need to be with his mother, which is as basic as his need for food.
In the 1950s, many people believed that the baby’s connection to her mother was all about food. She cried when separated from her mother only because she saw her mother as the source of nourishment. But LLL pointed out that the intensity of the mother-baby relationship was more than just food. Babies want to be with their mothers: that’s attachment.
Researchers have found that a secure attachment between baby and mother is the foundation for a baby’s future relationships. (3), (4)
The wisdom and insights the Founders put into developing the concepts is impressive. There have, though, been necessary changes over the years. I have, for example, used “mother” throughout this essay to talk about the person who gave birth to and breastfeeds the baby, as the Founders did. I suspect that the Founders didn’t even consider the possibility of transgender men giving birth and breastfeeding—yet today, I’m proud that a transgender man is now an accredited LLL Leader here in Canada.
The emphasis on the father’s role in another concept has also met with challenges, as we work with and accredit Leaders from other types of families: those with two mothers or two fathers, those with a single parent, and those with other situations and different types of support systems.
If the medical community and health experts are now advocating the LLL concepts that once seemed radical, does that mean LLL is no longer needed? Is it time to pat ourselves on the back and say, “Job well done, we can close up shop now?” Definitely not. While the vast majority of women in Western countries now want to breastfeed, many of them stop within a few weeks. Because so many new mothers have had breastfeeding problems, the perception among most pregnant parents is that breastfeeding is difficult and likely to go wrong.
And that’s where LLL makes the difference. Our support can dramatically increase the duration of breastfeeding and help parents reach their breastfeeding goals. LLL is where breastfeeding is normal, and parents can share their challenges and the solutions they’ve found. Yes, we are still needed, perhaps even more than in 1956!
What might have happened if those seven women had decided not to found LLL and the rates of breastfeeding had stayed as low as they were in the 1950s? Well,
- Some of you reading this might not have been here: babies who are not breastfeed are 30% more likely to die in the first year. (5)
- We would all be paying higher health care costs because of the higher rates of diabetes, high blood pressure, childhood cancers, pneumonia and respiratory illnesses, heart disease, etc. (6)
- The population would be a bit less intelligent … babies who are not breastfed have IQ scores 7 to 15 points lower (depending on the study). (7)
- More women would suffer from breast cancer, uterine cancer, osteoporosis and other health problems. (8)
- More children would experience abuse and neglect. (9)
No question, LLL has changed the world.
It certainly changed my world. I was born in England the year before that first LLL gathering in Chicago. I’m fortunate that even though she didn’t have LLL support, my mother opted to breastfeed me.
But I am quite certain that without the help, encouragement and wisdom of the LLL Leader and group in my community, I wouldn’t have succeeded in breastfeeding my four children, and I wouldn’t have parented them the way I have. I now have eight grandchildren, all breastfed—again, with the help of LLL.
For me, this celebration of the 60th anniversary is something very personal. Being part of this organization changed my life, changed my children’s lives, and changed my grandchildren’s lives. There are no words to express how very much I appreciate those seven women who decided to share their wisdom with the world.
A highlight of the 60th anniversary celebrations was the creation of a special movie How They Built A Legacy—In Their Own Words, which was showcased at our online conference in April 2017. In the movie Marian Tompson, Mary Ann Kerwin, and the late Mary Ann Cahill talk to New Zealand Leader and journalist Lisa Manning about their journey, their relationships, and their hopes for the future. You can watch the video here: https://vimeo.com/184172160/c186a4b570
REFERENCES
(1) Fomon, S. J. Reflections on infant feeding in the 1970s and 1980s. Am. J. Clin. Nutr. 1987 Suppl. 46:171–82 75.
(2) Anderson, G.C. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst. Rev. 2003: (3) CD003519.
Bystrova, K. Early contact versus separation: effects on mother-infant interaction one year later. Birth2009 Jun:36(2): 97–109.
(3) Boldt, L.J. et al. Infant Attachment Moderates Paths from Early Negativity to Preadolescent Outcomes for Children and Parents Child Dev. 2016 Aug 29.
Kochanska, G., Kim, S. Toward a new understanding of the legacy of early attachments for future antisocial trajectories: evidence from two longitudinal studies. Dev. Psychopathol. 2012 Aug: 24 (3): 783–806.
Beebe, B. et al. The origins of 12-month attachment: a microanalysis of 4-month mother-infant interaction. Attach. Hum. Dev. 2010 Jan:12 (1-2): 3–141.
(4) Gershoff, E. T. et al. Spanking and child outcomes: Old controversies and new meta-analyses. Journal of Family Psychology Jun. 2016; 30(4)453–469.
(5) Chen A, Rogan W.J. Breastfeeding and the risk of postneonatal death in the United States. Pediatr. 2004 May: 113(5): 435–439.
(6) Victora, C. et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet 30 January 2016; 387 (10017): 475–490.
(7) Victora, C., Horta, B.,L. et al. Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil. The Lancet Global Health. April 2015; vol 3, No. 4, e199–e205.
(8) Kendall-Tackett, K. Breastfeeding: What’s in it for Mothers?
(9) Stathearn, L. et al. Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatr. 2009 Feb: 123(2): 483–493.
Kim, P. et al. Breastfeeding, brain activation to own infant cry, and maternal sensitivity. J Child Psychol. Psychiatry 2011 Aug: 52(8): 907–915.
Teresa Pitman has been a La Leche League Leader for 40 years. She is one of the co-authors of the LLLI books The Womanly Art of Breastfeeding and Sweet Sleep and is the author of 16 other books with a 17th book coming out in January 2019 (on starting solids!). She is the mother of four grown children and the grandmother of ten.
