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02.19.11

How Breast Pumps Became a Political Issue

Michelle Obama has officially endorsed breastfeeding, and her Tea Party critics are slamming her for it. But even as they score political points, are they helping her cause?

For decades, breastfeeding has been an inflammatory topic among moms, the relative merits and burdens inspiring books, blogs, and sideways glances. So perhaps it was inevitable that the issue would spark a political firestorm among Mama Grizzlies this week.

It began innocently enough. At an intimate press conference kicking off the second year of her "Let's Move" campaign to fight childhood obesity, First Lady Michelle Obama stressed the importance of early intervention. And in highlighting steps parents can take, she recommended that women breastfeed their babies, because "kids who are breastfed longer have a lower tendency to be obese."

The first lady's comments came shortly after the IRS announced that, after lobbying from lawmakers, breast pumps—which can cost upward of $300—and related supplies could now be paid for with pre-tax Flexible Spending Accounts, or deducted from one's taxes as a medical expense, if one's total out-of-pocket medical costs add up to more than 7.5 percent of her income. Other deductible medical expenses? Contact lenses. Acupuncture. Vasectomies.

Shortly after, Tea Party darling Michele Bachmann slammed the first lady and the IRS on the Laura Ingraham radio show: "I've given birth to five babies, and I've breastfed every single one of these babies," Bachmann said. "To think that government has to go out and buy my breast pump for my babies, I mean, you wanna talk about the nanny state—I think you just got the new definition of the nanny state." Never mind that the government isn't "buying" anything for anyone.

Next, conservative pundit Michelle Malkin, who also breastfed her two kids, chimed in through a blog post and column, attacking the first lady and federal government for telling women how to live their lives, cutely dubbing the initiative "Big Bosom." (Get it?)

And just for good measure, Sarah Palin threw a shot, too. Speaking on Long Island, the former governor of Alaska said, "No wonder Michelle Obama is telling everybody you'd better breastfeed your babies. I'm looking and say, 'Yeah, you better because the price of milk is so high right now.'" Of course, this bad joke doesn't quite track, since babies aren't supposed to drink cow's milk.

Even more curious: Palin, who also breastfed all five of her kids, has spoken out about the challenges of pumping on the campaign trail. "What I've had to do, though, is in the middle of the night, put down the BlackBerries and pick up the breast pump," she told People magazine in 2008. As governor, she even designated October 2007 "Breastfeeding Awareness Month."

One wonders: Would these women have opposed reading if Laura Bush, champion of literacy, had been a Democrat?

For all the mockery and vitriol, Michelle Obama's advocacy for breastfeeding marked a cultural milestone. For years, maternal and child health activists have been working to spread awareness of the health benefits of nursing, and the first lady's endorsement might mark a turning point in this effort. Yes, Angelina Jolie, Gisele Bundchen, and other celeb moms have given their stamp of approval, but no one with the first lady's stature or power has embraced it so publicly.

"Michelle is doing a great service to the country's health and wellbeing, to the field of public health," said Judy Norsigian, executive director of the nonprofit women's health organization Our Bodies, Ourselves. "Her advocacy will get the attention of many women in this country and help to make breastfeeding more acceptable in many households."

And the irony is: Because the first lady's Tea Party critics aren't criticizing the practice of breastfeeding, but in fact helping to further normalize it, they're actually helping Obama and other advocates in spreading awareness.

"Nobody actually disagreed with Obama on the merits of breastfeeding," said Tina Cassidy, a maternal health advocate and author of Birth: The Surprising History of How We Are Born. "The two most vocal opponents had sort of ridiculous, kneejerk responses that were political more than medical. So I think the whole story is great, in that it draws attention to something that we don't typically get to discuss at cocktail parties."

As for the merits: Research suggests they're plentiful, and as such, breastfeeding is strongly recommended by the American Academy of Pediatrics, which teamed up with Obama on the effort. While it can be tough to conduct randomized, controlled studies on breastfeeding, the literature that exists reveals that babies who breastfeed suffer from fewer infections and illnesses including diarrhea and pneumonia, and potentially, fewer cases of asthma and allergies. Mothers who breastfeed may be at less risk for developing breast and ovarian cancer.

While the data isn't conclusive on whether breastfeeding wards off childhood obesity specifically (something Malkin pointed out in her column, calling Obama the "first lady of junk science"), choosing to nurse during the first year of life is one of the few cautionary steps mothers can take, said Joyce Lee, a pediatric endocrinologist and childhood obesity specialist at the University of Michigan. "You can't tell a 9 month old to do more exercise."

And for all their griping about the economy, the Tea Party ladies seem to have conveniently overlooked a well-regarded study in the journal Pediatrics, which revealed that the country could save about $13 billion annually in health care and related costs if 90 percent of American babies were exclusively breastfed for six months. Plus, studies have shown that, by meeting nursing women's needs, employers can lower rates of absenteeism and turnover.

Breastfeeding is now accepted in many circles, yet moms committed to the practice still face obstacles, particularly after the first few months. Relatively few offices are equipped with lactation rooms—and as the rhetorical question goes, if you wouldn't prepare a sandwich for your child in a bathroom, why should you pump your breast milk in one? Breast pumps and other equipment can be pricey. Nursing in public is still often discouraged (as evidenced by a recent incident at the Smithsonian's Hirshhorn Museum and Sculpture Garden, which led "lactivists" to stage a nurse-in weeks later). And current hospital practices, such as separating moms and babies shortly after birth, can make breastfeeding more difficult.

For these and other reasons, the country's breastfeeding rates fall surprisingly short of the Centers for Disease Control's recommendations: Seventy-five percent of U.S. babies start out breastfeeding, but only 13 percent are exclusively breastfed for the recommended six months. The rates among African Americans are even lower.

Indeed, in perhaps another case of Republican race cluelessness (here's looking at you, Haley Barbour), the Mama Grizzlies failed to acknowledge that the first lady's initiative pays special attention to the black community, which is plagued by higher rates of obesity, infant mortality, and other diseases, across socioeconomic lines. Due to an array of factors—including a lingering stigma from black women's days as wet nurses for white women, the outdated notion that breastfeeding is for poor people, and as a result, a lack of cultural, family, and marital support for breastfeeding—breastfeeding has not yet taken off in the African-American community.

"I've been aching and begging and pushing for Michelle Obama to take a stand on breastfeeding for some time now," said Kimberly Seals Allers, editorial director of the Black Maternal Health Project of Women's eNews and founder of MochaManual.com, an online magazine for African-American parents. "It's sad to see that historic moment clouded with political leveraging."

Along with Michelle Obama's stumping and the IRS's new policy, the federal government has taken several steps over the past year to make it easier for women to breastfeed. President Obama's health-care bill requires some employers to give nursing mothers break time and a designated place to pump. Last month, the surgeon general's office issued a "Call to Action to Support Breastfeeding," outlining steps families, clinicians, and employers can take.

And politically opportunistic as they may have been, the Tea Partiers attacks on the first lady's initiative could have been predicted. Back when President Obama's proposed health-care plan dominated political debate, Bachmann often seemed detached from the financial burden of caring for sick children. Meanwhile, Palin jabbed the first lady on her reality-TV show, Sarah Palin's Alaska. Searching her cabinets for S'mores ingredients, she joked: "This is in honor of Michelle Obama, who said the other day we should not have dessert."

Responding to this week's fracas, maternal and child health advocates point out that the government isn't dictating the choices women make, but spreading awareness and improving access. "Breastfeeding is a very personal choice for every woman," the first lady's office told Politics Daily. "We are trying to make it easier for those who choose to do it."

And it seems unlikely that even die-hard Tea Party moms will choose not to breastfeed because of their leaders' remarks. After all, the conservative women provided a sort of accidental endorsement for the practice in sharing their own experiences. Yes, in the battle of Mama Grizzlies versus Big Bosom—coming soon to a cable news network near you!—the latter wins. As big bosoms usually do.

Danielle Friedman is a homepage editor and reporter for The Daily Beast. Previously, she spent five years working as a nonfiction book editor for Hudson Street Press and Plume, two imprints of Penguin Group. She's a graduate of the Columbia University Graduate School of Journalism.