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Associate Professor of Sociology, University of Virginia 

Ensuring Breastfeeding for Baby, in Saudi Arabia and America

Bryce J. Christensen and Nicole M. King

The medical science on the matter is too strong for progressives to deny the immense benefits that breastfeeding gives babies. So when the issue comes up, they claim to support the practice—so long as it doesn’t seriously interfere with women’s out-of-home careers. But two new studies—one from Saudi Arabia, one from the United States—make it amply clear that keeping Mom at home is the best way to ensure that babies receive the incalculable benefits of breastfeeding.

Breastfeeding matters a good deal to these researchers, who hail from the University of Tabuk in Saudi Arabia, and from the Universities of Maryland and Minnesota and from the Cleveland Clinic in America. The Saudi scholar identifies “the stage of life beginning at birth and lasting until an infant reaches two years of age . . . as the ‘critical window’ in terms of encouraging optimal health, growth and cognitive development,” making it imperative that “mothers in both developing and developed countries . . . exclusively breastfeed their infants for the first 6 months of their lives, and then ensure that they receive adequately safe and nutritious solid foods alongside continued breastfeeding until they reach the age of 2 years or more.” The American scholars similarly stress that “breastfeeding has established benefits for both maternal and child health” and deplore the fact that “The U.S. continues to have one of the lowest breastfeeding rates in the industrialized world,” with “only 49% [of American mothers] report[ing] feeding any human milk to their infants at six months.”

To be sure, the Saudi study actually focuses not on breastfeeding per se but rather on “complementary feeding” of infants—the introduction into infants’ diets of foods other than breast milk. But such complementary feeding is an issue because—as the Egyptian study explains—“early introduction of complementary foods (i.e., before the infant reaches six months of age) may have the effect of replacing breast milk and halting breastfeeding altogether at too early a stage.” Who, the author of the Egyptian study wants to know, are the mothers most and least likely to start premature complementary feeding?

For the authors of the American study, breastfeeding does define the primary focus of investigation. What these authors seek to identify is the set of characteristics and circumstances found among the employed mothers most and least likely to initiate breastfeeding and then to persist in breastfeeding for at least six months.

To answer his research questions, the Saudi researcher parses data collected in 2015 in the Saudi city of Tabuk from 632 randomly selected mothers with children between the ages of 4-24 months.  To answer their largely parallel research questions, the American researchers pore over data collected from 817 Minnesota women ages 18 and older who were hospitalized for childbirth and then tracked for six months thereafter.

But in spite of slightly different focuses, the Saudi researcher and the American researchers end up at the same place: as soon as a mother leaves home for paid employment, she puts her baby’s nutrition at risk.  That is, she is decidedly more likely to prematurely introduce non-breast-milk foods  (according to the Egyptian study) and is significantly less likely to continue breastfeeding (according to the American study). 

More specifically, the Egyptian researcher calculates that mothers who were employed within six months of giving birth are more than six times more likely to start complementary feeding during this period than are peer mothers who remain in the home (Odds Ratio of 6.39).  The American researchers calculate that “the hazard for breastfeeding cessation” ran half again higher among mothers who returned to out-of-home employment during the first six months after childbirth than among women who did not return to employment during this period (Hazard Ratio of 1.46). In other words, the employed mothers most likely to breastfeed for six months are those who do not act like employed mothers—they are those employed mothers who simply did not go back to work at all during the study period.

Also deserving mention from the American study is the finding that unmarried employed mothers who initiate breastfeeding are almost 40% more likely than married employed peers to cease breastfeeding before their child is six months (Hazard Ratio of 1.39). Needless to say, in the conservative Islamic country of Saudi Arabia, researchers have little reason to track this differential.

Because out-of-home employment for women now defines a non-negotiable desideratum for progressive academics, the finding that such employment jeopardizes healthy breastfeeding poses a problem for both the Saudi scholar and his American colleagues. But the Saudi and the Americans solve that problem the way progressives always solve problems: by turning to a statist and corporatist formula.  

The Saudi scholar interprets his justification for three statist-corporatist conclusions: First, “improved education is . . . needed to improve awareness of the advantages of exclusive breastfeeding.” Second, “public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early.” Third, “programs which can support working mothers must be implemented.”

The American researchers are headed in the same statist-corporatist direction when they argue that their findings indicate the need for “work policies that support longer duration of breastfeeding” in a social world where “a substantial amount of employed women return to work in the first three months postpartum.” The American researchers’ intransigent commitment to this kind of statist-corporatist nostrum is especially astonishing given that in the data for their own study, “having an employer that provides paid leave was not associated with breastfeeding initiation and the longest paid leave available to a woman given her employer’s policy benefits was not associated with breastfeeding cessation during the 6 months after childbirth” (emphasis added).

Apparently, neither the Saudi researcher nor his American colleagues dare to draw the obvious conclusion from their findings: moving mothers of young children out of the home for paid employment has been a mistake endangering those children’s health. Neither the Saudi nor the Americans dare to suggest that what will safeguard young children’s health most fully would be helping their mothers to stay in the home. (Of course, mothers will find it difficult to stay at home unless they are married, but the American researchers skate around this issue as well.) How strange that plain speaking about home truths has grown impossible for academics in both Saudi Arabia and the United States!

(Riyadh A. Alzaheb, “Factors Associated with the Early Introduction of Complementary Feeding in Saudi Arabia,” International Journal of Environmental Research and Public Health 13.7 [2016]: 702, Web; Rada K. Dagher et al., “Determinants of Breastfeeding Initiation and Cessation among Employed Mothers: A Prospective Cohort Study,” BMC Pregnancy and Childbirth 16 [2016]; 194, Web.)