Breast. No Bottle.

To nurse, or not to nurse: that is not a question!

Russia. Breastfeeding failure in a breastfeeding culture

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I thought it would be helpful to look at Russia, a culture similar to Norway in its attitudes towards breastfeeding, yet with vastly different outcomes in breastfeeding support and continuation.

Breastfeeding Failure in a Breastfeeding Culture

First of all keep in mind that accurate statistics of breastfeeding rates from either Czarist Russian Empire, Soviet Union era, or even present day Russian Federation is not readily available. Statistics were either not collected altogether or it is inaccurate because of both false reporting by mothers in order to obtain additional milk products through milk kitchens or by doctors to stretch statistics whichever way looks good to their bosses. The statistics in the chart is rough representation of different sources to give the reader an approximate idea of what is happening on breastfeeding front in Russia. These reports are fairly consistent with on the ground reporting from breastfeeding mothers and advocates.

1. Breastfeeding culture. Just like all of Scandinavia, Russia is a breastfeeding culture where breastfeeding is not a choice but default state of things post birth. Breastfeeding initiation rates closely mimic Norwegian initiation rates approaching 100%. Extensive medical and state propaganda of breastfeeding has been taking place since before the Socialist Revolution of 1917 and after.

2. High breastfeeding failure rate. Russia’s breastfeeding problem closely resembles what Norway faced in the 1960’s – an abrupt decline in breastfeeding during the first 3 months. This is a collossal failure rate of about 60%. It is difficute to say how long Russia has stagnated in the same pattern. My personal estimate would be – several decades.

3. Milk kitchens. Milk kitchens probably were born before the Soviet era. These were government run institutions for collection and processing of donor milk as well as local milk formula production. Donor milk was readily available until 1990’s when issues like HIV and hepatitis became prominent. Milk kitchens distributing supplementary dairy products to infants operate till this day. Mothers may report failure in breastfeeding to authorities to obtain extra food for the families. Informal milk donations also thrived between neighbors and friends.

4. Medical birth model. Since the establishment of the Soviet state in 1917 Russia rapidly introduces the obstetric model of birth management very similar to the US model in mid-twentieth century with the exception of twilight sleep. Birth services has been overwhelmingly demeaning, dehumanizing, and disempowering.

5. Paid maternal leave was introduced immediately upon the formation of the new Soviet state. The leave included both pre-birth leave as well as post-birth leave. The length of leave increased over the course of years with incrementally decreasing pay after 1 year of leave.

6. Breastfeeding legislation. The USSR had very breastfeeding friendly legislation allowing not only leave from work to raise children, but also provisions of flextime, part-time, extensive paid breastfeeding and formula-feeding breaks.

7. State-run creches and daycares. The dream of every American working mother – affordable government sponsored childcare that allows women’s participation in workforce was widely available in the USSR and continues to this day, although on a limited basis.

8. No formula advertising till 1990’s. Not only formula advertising was non-existent, infant formula was also hard to come by in the state rationed economy. The fall of the USSR and the onset of capitalist economy opened floodgates of extremely aggressive formula advertising from every major formula producer from Europe and the US. WHO Code has not been implemented at all and formula manufacturers court healthcare and government officials as well as breastfeeding advocates.

8. Medical maltreatment of breastfeeding. Medical takeover of breastfeeding happened to the detriment of breastfeeding at the end of 19th century. Entry into medical system continues to pose significant threat to breastfeeding and usually causes demise of breastfeeding. Baby-Friendly hospitals do not shy away from routine formula supplementation per maternal reports.

9. Wider gender gap. On one hand the Soviet Revolution advanced women’s rights to unheard in the West levels. Voting rights, independence from spouses, rights to work, right to get education and mandatory schooling for every child went a long way in forwarding women’s causes. On the other hand Russia remains a very patriarchal and authoritative culture with little regard to women’s abilities, knowledge, and experience. While most doctors in Russia have been historically female, they remain a low paid occupation exactly because it is a female occupation. There have been  fairly low government participation levels for women until very recently.

10. Professional support of breastfeeding. Zhanna Tsaregradskaya was at the beginning of breastfeeding Renaissance in Russia. In 1989 she started developing breastfeeding programs for women. Later she adopted some of WHO/UNICEF training and started training paid maternal breastfeeding consultants. The organization has been very successful yet was extensively criticized for its authoritarian approach. Yet it was the authoritative approach that fit so well with Russian culture that thrives on authoritative knowledge.

11. Grassroots breastfeeding movement started fairly late in the game in comparison to the West. In early 2000’s Russian La Leche League Leaders started an online breastfeeding support community Lyalechka that implemented LLL model of work online.

12. Professionalization of breastfeeding support. La Leche League Leaders also influenced the formation and line of work of AKEV, local breastfeeding support organization with primary focus on paid professional support as well as maternal support groups. AKEV became a launchpad for IBCLC in Russia.

As one can see, Russia has had many of the desirable factors going for breastfeeding, yet the empowerment of women was hugely lacking and grassroots movement quickly professionalized to continue the native preference for authoritarian top-down model of breastfeeding promotion. The rising feminist movement in Russia resists prescriptive propaganda of breastfeeding, yet Lyalechka, the mother-to-mother support community in LiveJournal, has been mentioned as the most feminist group online that provides woman-centered support to those seeking breastfeeding help. Median breastfeeding experience of women in Lyalechka is 32 months.

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Written by Medical Nemesis

September 8, 2014 at 02:39

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To nurse, or not to nurse: that is not a question!

Breast. No Bottle.

To nurse, or not to nurse: that is not a question!

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