1
00:00:00,560 --> 00:00:03,719
Have you ever heard the one
about how breastfeeding is free?

2
00:00:05,266 --> 00:00:06,416
(Laughter)

3
00:00:06,440 --> 00:00:08,656
Yeah, it's pretty funny,

4
00:00:08,680 --> 00:00:13,760
because it's only free if we don't value
women's time and energy.

5
00:00:15,120 --> 00:00:19,696
Any mother can tell you
how much time and energy it takes

6
00:00:19,720 --> 00:00:21,656
to liquify her body --

7
00:00:21,680 --> 00:00:24,216
to literally dissolve herself --

8
00:00:24,240 --> 00:00:25,816
(Laughter)

9
00:00:25,840 --> 00:00:28,720
as she feeds this precious
little cannibal.

10
00:00:29,120 --> 00:00:31,336
(Laughter)

11
00:00:31,360 --> 00:00:33,680
Milk is why mammals suck.

12
00:00:35,400 --> 00:00:37,296
At Arizona State University,

13
00:00:37,320 --> 00:00:39,256
in the Comparative Lactation Lab,

14
00:00:39,280 --> 00:00:42,056
I decode mothers' milk composition

15
00:00:42,080 --> 00:00:45,056
to understand its complexity

16
00:00:45,080 --> 00:00:47,480
and how it influences infant development.

17
00:00:48,720 --> 00:00:51,080
The most important thing that I've learned

18
00:00:51,800 --> 00:00:56,920
is that we do not do enough
to support mothers and babies.

19
00:00:57,720 --> 00:00:59,896
And when we fail mothers and babies,

20
00:00:59,920 --> 00:01:03,280
we fail everyone
who loves mothers and babies:

21
00:01:04,080 --> 00:01:07,256
the fathers, the partners,
the grandparents, the aunties,

22
00:01:07,280 --> 00:01:11,360
the friends and kin
that make our human social networks.

23
00:01:12,480 --> 00:01:17,216
It's time that we abandon
simple solutions and simple slogans,

24
00:01:17,240 --> 00:01:18,960
and grapple with the nuance.

25
00:01:20,200 --> 00:01:21,776
I was very fortunate

26
00:01:21,800 --> 00:01:25,456
to run smack-dab
into that nuance very early,

27
00:01:25,480 --> 00:01:27,520
during my first interview
with a journalist

28
00:01:28,560 --> 00:01:29,856
when she asked me,

29
00:01:29,880 --> 00:01:33,160
"How long should a mother
breastfeed her baby?"

30
00:01:36,040 --> 00:01:39,920
And it was that word "should"
that brought me up short,

31
00:01:40,640 --> 00:01:44,960
because I will never tell a woman
what she should do with her body.

32
00:01:46,800 --> 00:01:48,576
Babies survive and thrive

33
00:01:48,600 --> 00:01:53,256
because their mother's milk
is food, medicine and signal.

34
00:01:53,280 --> 00:01:54,496
For young infants,

35
00:01:54,520 --> 00:01:56,456
mother's milk is a complete diet

36
00:01:56,480 --> 00:01:59,056
that provides all the building
blocks for their bodies,

37
00:01:59,080 --> 00:02:00,456
that shapes their brain

38
00:02:00,480 --> 00:02:02,640
and fuels all of their activity.

39
00:02:03,360 --> 00:02:05,776
Mother's milk also feeds the microbes

40
00:02:05,800 --> 00:02:08,240
that are colonizing
the infant's intestinal tract.

41
00:02:08,840 --> 00:02:10,536
Mothers aren't just eating for two,

42
00:02:10,560 --> 00:02:12,720
they're eating for two to the trillions.

43
00:02:14,560 --> 00:02:18,000
Milk provides immunofactors
that help fight pathogens

44
00:02:19,000 --> 00:02:24,000
and mother's milk provides hormones
that signal to the infant's body.

45
00:02:24,800 --> 00:02:26,296
But in recent decades,

46
00:02:26,320 --> 00:02:28,456
we have come to take milk for granted.

47
00:02:28,480 --> 00:02:31,456
We stopped seeing
something in plain sight.

48
00:02:31,480 --> 00:02:36,616
We began to think of milk as standardized,
homogenized, pasteurized,

49
00:02:36,640 --> 00:02:39,600
packaged, powdered,
flavored and formulated.

50
00:02:40,680 --> 00:02:42,856
We abandoned the milk of human kindness

51
00:02:42,880 --> 00:02:44,920
and turned our priorities elsewhere.

52
00:02:46,560 --> 00:02:48,296
At the National Institutes of Health

53
00:02:48,320 --> 00:02:49,936
in Washington DC

54
00:02:49,960 --> 00:02:51,800
is the National Library of Medicine,

55
00:02:52,520 --> 00:02:55,256
which contains 25 million articles --

56
00:02:55,280 --> 00:02:59,520
the brain trust of life science
and biomedical research.

57
00:03:00,080 --> 00:03:03,456
We can use keywords
to search that database,

58
00:03:03,480 --> 00:03:04,736
and when we do that,

59
00:03:04,760 --> 00:03:07,840
we discover nearly a million
articles about pregnancy,

60
00:03:08,640 --> 00:03:12,000
but far fewer about
breast milk and lactation.

61
00:03:12,840 --> 00:03:16,840
When we zoom in on the number of articles
just investigating breast milk,

62
00:03:17,480 --> 00:03:21,976
we see that we know much more
about coffee, wine and tomatoes.

63
00:03:22,000 --> 00:03:23,200
(Laughter)

64
00:03:24,520 --> 00:03:28,216
We know over twice as much
about erectile dysfunction.

65
00:03:28,240 --> 00:03:29,760
(Laughter)

66
00:03:32,240 --> 00:03:34,816
I'm not saying we shouldn't
know about those things --

67
00:03:34,840 --> 00:03:37,536
I'm a scientist, I think
we should know about everything.

68
00:03:37,560 --> 00:03:39,896
But that we know so much less --

69
00:03:39,920 --> 00:03:41,696
(Laughter)

70
00:03:41,720 --> 00:03:43,016
about breast milk --

71
00:03:43,040 --> 00:03:45,816
the first fluid a young mammal
is adapted to consume --

72
00:03:45,840 --> 00:03:47,200
should make us angry.

73
00:03:47,960 --> 00:03:52,456
Globally, nine out of 10 women will
have at least one child in her lifetime.

74
00:03:52,480 --> 00:03:56,936
That means that nearly 130 million
babies are born each year.

75
00:03:56,960 --> 00:04:00,080
These mothers and babies
deserve our best science.

76
00:04:01,080 --> 00:04:04,736
Recent research has shown
that milk doesn't just grow the body,

77
00:04:04,760 --> 00:04:08,000
it fuels behavior
and shapes neurodevelopment.

78
00:04:08,800 --> 00:04:11,816
In 2015, researchers discovered

79
00:04:11,840 --> 00:04:14,816
that the mixture of breast milk
and baby saliva --

80
00:04:14,840 --> 00:04:16,896
specifically, baby saliva --

81
00:04:16,920 --> 00:04:20,736
causes a chemical reaction
that produces hydrogen peroxide

82
00:04:20,760 --> 00:04:22,520
that can kill staph and salmonella.

83
00:04:23,880 --> 00:04:26,056
And from humans and other mammal species,

84
00:04:26,080 --> 00:04:29,496
we're starting to understand
that the biological recipe of milk

85
00:04:29,520 --> 00:04:32,640
can be different when produced
for sons or daughters.

86
00:04:33,560 --> 00:04:37,176
When we reach for donor milk
in the neonatal intensive care unit,

87
00:04:37,200 --> 00:04:39,176
or formula on the store shelf,

88
00:04:39,200 --> 00:04:41,520
it's nearly one-size-fits-all.

89
00:04:41,960 --> 00:04:46,216
We aren't thinking about how sons
and daughters may grow at different rates,

90
00:04:46,240 --> 00:04:47,456
or different ways,

91
00:04:47,480 --> 00:04:49,200
and that milk may be a part of that.

92
00:04:50,200 --> 00:04:52,136
Mothers have gotten the message

93
00:04:52,160 --> 00:04:55,576
and the vast majority of mothers
intend to breastfeed,

94
00:04:55,600 --> 00:04:58,440
but many do not reach
their breastfeeding goals.

95
00:04:59,520 --> 00:05:01,616
That is not their failure;

96
00:05:01,640 --> 00:05:03,080
it's ours.

97
00:05:03,760 --> 00:05:08,336
Increasingly common medical conditions
like obesity, endocrine disorders,

98
00:05:08,360 --> 00:05:09,976
C-section and preterm births

99
00:05:10,000 --> 00:05:12,600
all can disrupt the underlying
biology of lactation.

100
00:05:13,280 --> 00:05:17,000
And many women do not have
knowledgeable clinical support.

101
00:05:17,520 --> 00:05:18,896
Twenty-five years ago,

102
00:05:18,920 --> 00:05:22,776
the World Health Organization
and UNICEF established criteria

103
00:05:22,800 --> 00:05:25,376
for hospitals to be
considered baby friendly --

104
00:05:25,400 --> 00:05:29,216
that provide the optimal level
of support for mother-infant bonding

105
00:05:29,240 --> 00:05:30,560
and infant feeding.

106
00:05:31,480 --> 00:05:34,856
Today, only one in five babies
in the United States

107
00:05:34,880 --> 00:05:37,040
is born in a baby-friendly hospital.

108
00:05:39,200 --> 00:05:40,456
This is a problem,

109
00:05:40,480 --> 00:05:43,336
because mothers can grapple
with many problems

110
00:05:43,360 --> 00:05:47,416
in the minutes, hours, days
and weeks of lactation.

111
00:05:47,440 --> 00:05:49,936
They can have struggles
with establishing latch,

112
00:05:49,960 --> 00:05:51,176
with pain,

113
00:05:51,200 --> 00:05:52,416
with milk letdown

114
00:05:52,440 --> 00:05:53,920
and perceptions of milk supply.

115
00:05:55,000 --> 00:05:59,496
These mothers deserve
knowledgeable clinical staff

116
00:05:59,520 --> 00:06:01,720
that understand these processes.

117
00:06:02,480 --> 00:06:06,000
Mothers will call me as they're
grappling with these struggles,

118
00:06:06,880 --> 00:06:09,280
crying with wobbly voices.

119
00:06:11,400 --> 00:06:12,600
"It's not working.

120
00:06:13,240 --> 00:06:15,896
This is what I'm supposed
to naturally be able to do.

121
00:06:15,920 --> 00:06:17,160
Why is it not working?"

122
00:06:18,240 --> 00:06:21,080
And just because something
is evolutionarily ancient

123
00:06:21,840 --> 00:06:24,800
doesn't mean that it's easy
or that we're instantly good at it.

124
00:06:25,560 --> 00:06:28,216
You know what else
is evolutionarily ancient?

125
00:06:28,240 --> 00:06:30,520
(Laughter)

126
00:06:32,200 --> 00:06:33,496
Sex.

127
00:06:33,520 --> 00:06:36,456
And nobody expects us
to start out being good at it.

128
00:06:36,480 --> 00:06:38,640
(Laughter)

129
00:06:39,480 --> 00:06:44,016
Clinicians best deliver
quality equitable care

130
00:06:44,040 --> 00:06:46,056
when they have continuing education

131
00:06:46,080 --> 00:06:49,200
about how to best support
lactation and breastfeeding.

132
00:06:49,840 --> 00:06:52,056
And in order to have
that continuing education,

133
00:06:52,080 --> 00:06:54,216
we need to anchor it
to cutting-edge research

134
00:06:54,240 --> 00:06:57,736
in both the life sciences
and the social sciences,

135
00:06:57,760 --> 00:06:59,456
because we need to recognize

136
00:06:59,480 --> 00:07:00,760
that too often

137
00:07:01,640 --> 00:07:05,056
historical traumas and implicit biases

138
00:07:05,080 --> 00:07:08,600
sit in the space between
a new mother and her clinician.

139
00:07:09,680 --> 00:07:11,280
The body is political.

140
00:07:12,760 --> 00:07:16,456
If our breastfeeding support
is not intersectional,

141
00:07:16,480 --> 00:07:18,360
it's not good enough.

142
00:07:19,120 --> 00:07:22,096
And for moms who have to return for work,

143
00:07:22,120 --> 00:07:27,136
because countries like the United States
do not provide paid parental leave,

144
00:07:27,160 --> 00:07:31,320
they can have to go back in as short
as just a few days after giving birth.

145
00:07:32,400 --> 00:07:35,736
How do we optimize
mother and infant health

146
00:07:35,760 --> 00:07:39,096
just by messaging
about breast milk to moms

147
00:07:39,120 --> 00:07:41,896
without providing
the institutional support

148
00:07:41,920 --> 00:07:44,576
that facilitates
that mother-infant bonding

149
00:07:44,600 --> 00:07:46,040
to support breastfeeding?

150
00:07:46,680 --> 00:07:48,680
The answer is: we can't.

151
00:07:51,000 --> 00:07:53,456
I'm talking to you, legislators,

152
00:07:53,480 --> 00:07:55,416
and the voters who elect them.

153
00:07:55,440 --> 00:08:00,136
I'm talking to you, job creators
and collective bargaining units,

154
00:08:00,160 --> 00:08:02,320
and workers, and shareholders.

155
00:08:03,360 --> 00:08:07,296
We all have a stake
in the public health of our community,

156
00:08:07,320 --> 00:08:10,280
and we all have a role
to play in achieving it.

157
00:08:11,200 --> 00:08:14,280
Breast milk is a part
of improving human health.

158
00:08:15,000 --> 00:08:19,016
In the NICU, when infants are born
early or sick or injured,

159
00:08:19,040 --> 00:08:22,760
milk or bioactive constituents in milk
can be critically important.

160
00:08:23,360 --> 00:08:24,776
Environments or ecologies,

161
00:08:24,800 --> 00:08:28,016
or communities where there's
high risk of infectious disease,

162
00:08:28,040 --> 00:08:30,496
breast milk can be incredibly protective.

163
00:08:30,520 --> 00:08:34,135
Where there are emergencies
like storms and earthquakes,

164
00:08:34,159 --> 00:08:35,655
when the electricity goes out,

165
00:08:35,679 --> 00:08:37,655
when safe water is not available,

166
00:08:37,679 --> 00:08:40,480
breast milk can keep babies
fed and hydrated.

167
00:08:42,360 --> 00:08:45,056
And in the context of humanitarian crises,

168
00:08:45,080 --> 00:08:47,280
like Syrian mothers fleeing war zones,

169
00:08:48,240 --> 00:08:53,760
the smallest drops can buffer babies
from the biggest global challenges.

170
00:08:55,480 --> 00:09:00,216
But understanding breast milk
is not just about messaging to mothers

171
00:09:00,240 --> 00:09:01,760
and policy makers.

172
00:09:02,080 --> 00:09:05,176
It's also about understanding
what is important in breast milk

173
00:09:05,200 --> 00:09:07,976
so that we can deliver better formulas

174
00:09:08,000 --> 00:09:11,800
to moms who cannot or do not
breastfeed for whatever reason.

175
00:09:12,440 --> 00:09:14,256
We can all do a better job

176
00:09:14,280 --> 00:09:17,576
of supporting the diversity
of moms raising their babies

177
00:09:17,600 --> 00:09:19,320
in a diversity of ways.

178
00:09:20,680 --> 00:09:22,536
As women around the world struggle

179
00:09:22,560 --> 00:09:26,216
to achieve political,
social and economic equality,

180
00:09:26,240 --> 00:09:28,776
we must reimagine motherhood

181
00:09:28,800 --> 00:09:34,016
as not the central,
core aspect of womanhood,

182
00:09:34,040 --> 00:09:38,520
but one of the many potential facets
of what makes women awesome.

183
00:09:39,080 --> 00:09:40,280
It's time.

184
00:09:41,040 --> 00:09:46,443
(Applause)