Chris Mulford's Intervention at the NGO Panel
Response from the floor to NGO Panel presented during
ILO Maternity Protection Committee session
June 1, 2000
I am Chris Mulford. My NGO is ILCA, the International Lactation Consultant
Association. We are health care professionals who specialize in
breastfeeding. ILCA has over 4000 members in 38 countries. I would like to
clear up some misunderstandings about breastfeeding that I heard during the
debate last June.
The ILO Maternity Protection Conventions of 1919 and 1952 covered all three
phases of maternity: pregnancy, childbirth, and lactation (or breastfeeding).
But in the present debate, there is confusion about whether the lactation
phase of maternity is still considered part of childbearing---or does it
belong to childrearing? The answer is, that it is both. A woman begins
lactation during her pregnancy, and milk production always follows after
birth. But a woman can sustain lactation in only two ways---either by
breastfeeding, which is a kind of child feeding and care that is unique to
mothers, or by milk expression, which is a kind of self-care that is
important for the health of her breasts as well as a way to obtain milk for
her child. There have always been mothers who chose to suppress their
lactation and have their baby fed another way, even in ancient times. But
any woman who does exercise her human right to breastfeed can continue to
supply milk for her child only if she regularly gives milk, either by
breastfeeding or by milk expression. During the period of exclusive
breastfeeding (about the first 6 months), she needs to do this on average
every three hours, or eight times in 24 hours.
Last year the employers asked, then how can it benefit a breastfeeding woman
to combine her two 30-minute breastfeeding breaks and take them at the
beginning or end of her workday? The answer is this. Once lactation is well
established, a mother has some flexibility in milk production. As babies
mature, many sleep longer than two to three hours at a time during the night,
and they make up for that long period with no breastfeeding, by breastfeeding
more in the daytime. Likewise, a woman in a large city like Metro-Manila or
Buenos Aires, who works so far from home that she cannot visit her baby for
breastfeeding during the work day, might choose to take a long stretch
without breastfeeding breaks during her work-time, perhaps expressing milk on
her lunch break, and then breastfeed almost non-stop before and after work,
while she is home. Many clever babies adapt to their mother's work schedule
in this way---we call it "reverse cycle feeding"---by sleeping more while she
is away and maximizing their time at the breast while she is accessible.
This example brings up another point about breastfeeding. It changes over
time. At first a mother who returns to work has a period of adjustment while
she and her baby get used to the separation. She needs the most support
then, and her need continues through the period of exclusive breastfeeding.
Then as her baby begins to eat other foods, she may have more flexibility.
This flexibility does not always mean more breaks---sometimes it means that
she needs fewer breaks. There must be room for individual variation.
Breastfeeding is most efficient when the baby can be cared for at or near the
workplace. That is because the baby does the best job of getting milk from
the breast. Instead of the mother having to express her milk, her
breastfeeding baby does all the work of milk expression while at the same
time, the mother is doing the job of feeding her baby AND she is getting a
rest. Thus a workplace crèche can increase the productivity of the
mother-child unit!
A paid breastfeeding break is really a kind of mini-maternity leave, an
entitlement that enables a lactating woman to interrupt her work in order to
sustain the physiological process of milk production, either by breastfeeding
her baby or by expressing milk, just the way her maternity leave enables her
to interrupt her job to give birth and then to recover from that very intense
physical work. Since breastfeeding breaks take up only twice 30 minutes per
working day, or one hour out of eight working hours, then the cost for the
breastfeeding breaks from eight days of work is the same as the cost of one
day of paid maternity leave. But look at how much more productive the woman
can be for her employer over eight days at work with breastfeeding breaks,
compared to one day of maternity leave! Both are good investments in health
of mother and child.
My final point concerns the issue of non-discrimination. Some nations have
raised the question of how long a lactating woman at work should be protected
against job discrimination on the grounds of being a lactating woman. Surely
a woman has the right to such protection for as long as she is lactating! A
woman's right not to be fired because she breastfeeds does not suddenly end
when her child reaches some arbitrary age. There are two distinct principles
here: one is her entitlement to take the break time she needs in order to
sustain lactation. The other principle concerns her inalienable human right
to breastfeed. That right cannot be taken away from her. I hope this will
be remembered when Article 8 is debated by the committee.
Thank you for this opportunity to speak.
International Lactation Consultant Association
4101 Lake Boone Trail, Suite 201, Raleigh, NC
27607 USA
Tel 1-919-787-5181 Fax 1-919-787-4916
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