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Have you ever heard the one[br]about how breastfeeding is free?

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(Laughter)

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Yeah, it's pretty funny,

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because it's only free if we don't value[br]women's time and energy.

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Any mother can tell you[br]how much time and energy it takes

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to liquify her body --

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to literally dissolve herself --

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(Laughter)

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as she feeds this precious[br]little cannibal.

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(Laughter)

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Milk is why mammals suck.

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At Arizona State University,

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in the Comparative Lactation Lab,

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I decode mothers' milk composition

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to understand its complexity

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and how it influences infant development.

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The most important thing that I've learned

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is that we do not do enough[br]to support mothers and babies.

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And when we fail mothers and babies,

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we fail everyone[br]who loves mothers and babies:

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the fathers, the partners,[br]the grandparents, the aunties,

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the friends and kin[br]that make our human social networks.

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It's time that we abandon[br]simple solutions and simple slogans,

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and grapple with the nuance.

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I was very fortunate

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to run smack-dab[br]into that nuance very early,

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during my first interview[br]with a journalist

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when she asked me,

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"How long should a mother[br]breastfeed her baby?"

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And it was that word "should"[br]that brought me up short,

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because I will never tell a woman[br]what she should do with her body.

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Babies survive and thrive

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because their mother's milk[br]is food, medicine and signal.

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For young infants,

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mother's milk is a complete diet

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that provides all the building[br]blocks for their bodies,

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that shapes their brain

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and fuels all of their activity.

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Mother's milk also feeds the microbes

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that are colonizing[br]the infant's intestinal tract.

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Mothers aren't just eating for two,

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they're eating for two to the trillions.

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Milk provides immunofactors[br]that help fight pathogens

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and mother's milk provides hormones[br]that signal to the infant's body.

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But in recent decades,

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we have come to take milk for granted.

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We stopped seeing[br]something in plain sight.

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We began to think of milk as standardized,[br]homogenized, pasteurized,

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packaged, powdered,[br]flavored and formulated.

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We abandoned the milk of human kindness

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and turned our priorities elsewhere.

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At the National Institutes of Health

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in Washington DC

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is the National Library of Medicine,

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which contains 25 million articles --

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the brain trust of life science[br]and biomedical research.

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We can use keywords[br]to search that database,

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and when we do that,

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we discover nearly a million[br]articles about pregnancy,

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but far fewer about[br]breast milk and lactation.

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When we zoom in on the number of articles[br]just investigating breast milk,

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we see that we know much more[br]about coffee, wine and tomatoes.

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(Laughter)

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We know over twice as much[br]about erectile dysfunction.

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(Laughter)

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I'm not saying we shouldn't[br]know about those things --

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I'm a scientist, I think[br]we should know about everything.

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But that we know so much less --

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(Laughter)

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about breast milk --

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the first fluid a young mammal[br]is adapted to consume --

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should make us angry.

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Globally, nine out of 10 women will[br]have at least one child in her lifetime.

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That means that nearly 130 million[br]babies are born each year.

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These mothers and babies[br]deserve our best science.

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Recent research has shown[br]that milk doesn't just grow the body,

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it fuels behavior[br]and shapes neurodevelopment.

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In 2015, researchers discovered

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that the mixture of breast milk[br]and baby saliva --

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specifically, baby saliva --

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causes a chemical reaction[br]that produces hydrogen peroxide

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that can kill staph and salmonella.

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And from humans and other mammal species,

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we're starting to understand[br]that the biological recipe of milk

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can be different when produced[br]for sons or daughters.

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When we reach for donor milk[br]in the neonatal intensive care unit,

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or formula on the store shelf,

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it's nearly one-size-fits-all.

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We aren't thinking about how sons[br]and daughters may grow at different rates,

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or different ways,

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and that milk may be a part of that.

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Mothers have gotten the message

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and the vast majority of mothers[br]intend to breastfeed,

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but many do not reach[br]their breastfeeding goals.

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That is not their failure;

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it's ours.

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Increasingly common medical conditions[br]like obesity, endocrine disorders,

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C-section and preterm births

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all can disrupt the underlying[br]biology of lactation.

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And many women do not have[br]knowledgeable clinical support.

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Twenty-five years ago,

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the World Health Organization[br]and UNICEF established criteria

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for hospitals to be[br]considered baby friendly --

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that provide the optimal level[br]of support for mother-infant bonding

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and infant feeding.

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Today, only one in five babies[br]in the United States

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is born in a baby-friendly hospital.

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This is a problem,

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because mothers can grapple[br]with many problems

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in the minutes, hours, days[br]and weeks of lactation.

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They can have struggles[br]with establishing latch,

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with pain,

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with milk letdown

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and perceptions of milk supply.

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These mothers deserve[br]knowledgeable clinical staff

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that understand these processes.

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Mothers will call me as they're[br]grappling with these struggles,

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crying with wobbly voices.

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"It's not working.

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This is what I'm supposed[br]to naturally be able to do.

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Why is it not working?"

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And just because something[br]is evolutionarily ancient

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doesn't mean that it's easy[br]or that we're instantly good at it.

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You know what else[br]is evolutionarily ancient?

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(Laughter)

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Sex.

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And nobody expects us[br]to start out being good at it.

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(Laughter)

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Clinicians best deliver[br]quality equitable care

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when they have continuing education

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about how to best support[br]lactation and breastfeeding.

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And in order to have[br]that continuing education,

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we need to anchor it[br]to cutting-edge research

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in both the life sciences[br]and the social sciences,

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because we need to recognize

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that too often

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historical traumas and implicit biases

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sit in the space between[br]a new mother and her clinician.

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The body is political.

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If our breastfeeding support[br]is not intersectional,

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it's not good enough.

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And for moms who have to return for work,

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because countries like the United States[br]do not provide paid parental leave,

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they can have to go back in as short[br]as just a few days after giving birth.

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How do we optimize[br]mother and infant health

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just by messaging[br]about breast milk to moms

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without providing[br]the institutional support

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that facilitates[br]that mother-infant bonding

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to support breastfeeding?

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The answer is: we can't.

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I'm talking to you, legislators,

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and the voters who elect them.

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I'm talking to you, job creators[br]and collective bargaining units,

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and workers, and shareholders.

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We all have a stake[br]in the public health of our community,

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and we all have a role[br]to play in achieving it.

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Breast milk is a part[br]of improving human health.

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In the NICU, when infants are born[br]early or sick or injured,

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milk or bioactive constituents in milk[br]can be critically important.

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Environments or ecologies,

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or communities where there's[br]high risk of infectious disease,

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breast milk can be incredibly protective.

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Where there are emergencies[br]like storms and earthquakes,

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when the electricity goes out,

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when safe water is not available,

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breast milk can keep babies[br]fed and hydrated.

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And in the context of humanitarian crises,

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like Syrian mothers fleeing war zones,

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the smallest drops can buffer babies[br]from the biggest global challenges.

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But understanding breast milk[br]is not just about messaging to mothers

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and policy makers.

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It's also about understanding[br]what is important in breast milk

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so that we can deliver better formulas

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to moms who cannot or do not[br]breastfeed for whatever reason.

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We can all do a better job

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of supporting the diversity[br]of moms raising their babies

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in a diversity of ways.

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As women around the world struggle

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to achieve political,[br]social and economic equality,

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we must reimagine motherhood

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as not the central,[br]core aspect of womanhood,

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but one of the many potential facets[br]of what makes women awesome.

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It's time.

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(Applause)