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

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(Laugther)

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Yeah, it's pretty funny,

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

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Any mother can tell you
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
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 influcences 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
to support mothers and babies.

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And when we fail mothers and babies,

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we fail everyone who loves
mothers and babies:

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the fathers, the partners,
the grandparents, the aunties,

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the friends and kin that make
our human social networks.

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It's time that we abandon 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 into
that nuance very early,

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during my first interview
with a journalist

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when she asked me,

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"How long should a mother
breastfeed her baby?"

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

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

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Babies survive and thrive

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because their mother's milk
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
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 the infant's
intenstinal 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
that help fight pathogens,

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and mother's milk provides hormones
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
something in plain sight.

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We began to think of milk as standardized,
homogonenized, pasturized,

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packaged, powdered, 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
in Washinton 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
and biomedical research.

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We can use key words
to search that database,

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and when we do that,

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we discover nearly a million
articles about pregnancy,

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but far fewer about
breast milk and lactation.

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

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

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(Laughter)

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We know over twice as much
about erectile dysfunction.

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(Laughter)

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

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I'm a scientist,

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I think 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
is adapted to consume --

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should make us angry.

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Globally, nine out of 10 women will
have at least once child in her lifetime.

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

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These mothers and babies
deserve our best science.

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

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it fuels behavior and shapes
neurodevelopment.

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In 2015, researchers discovered

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that the mixture of breast milk
and baby saliva --

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specifically, baby saliva --

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causes a chemical reaction
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
that the biological recipe of milk

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can be different when produced
for sons or daughters.

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When we reach for donor milk
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
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
intend to breastfeed,

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but many do not reach
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
like obesity, endocrine disorders,

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C-section and pre-term births

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all can disrupt the underlying
biology of lactation.

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And many women do not have
knowledgable clinical support.

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25 years ago,

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the World Health Organization
and Unicef established criteria

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for hospitals to be
considered baby friendly --

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

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and infant feeding.

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Today, only one-in-five babies
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
with many problems

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in the minutes, hours, days
and weeks of lactation.

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They can have struggles
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
knowledgable clinical staff

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that understand these processes.

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Mothers will call me as they're
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 to
naturally be able to do,

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why is it not working?"

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And just because something
is evolutionarliy ancient

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

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You know what else
is evolutionarily ancient?

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(Laughter)

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Sex.

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

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(Laughter)

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Clinicians best deliver
quality equitable care

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when they have continuing education
about how to best support lactation

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and breastfeeding.

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In order to have
that continuing education,

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we need to anchor it
to cutting-edge research

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in both the life sciences
and the social sciences,

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because we need to recognize

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that too often historical traumas
and implicit biases

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

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The body is political.

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If our breastfeeding support
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
do not provide paid parental leave,

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

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How do we optimize mother
and infant health

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just by messaging about
breast milk to moms

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without providing
the institutional support

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that facilitates
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, legistlators,

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and the voters who elect them.

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

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and workers,

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and shareholders.

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

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

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Breast milk is a part
of improving human health.

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

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milk or bioactive constituents in milk
can be critically important.

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Environments or ecologies,

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

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breast milk can be incredibly protective.

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Where there are emergencies
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
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
from the biggest global challenges.

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But understanding breast milk is not
just about messaging to mothers

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and policy makers.

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It's also about understanding
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
breastfeed for whatever reason.

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We can all do a better job

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of supporting the diversity
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, social
and economic equality,

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we must reimagine motherhood

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as not the central,
core aspect of womanhood,

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but one of the many potential facets
of what make women awesome.

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It's time.

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(Applause)