Madras High Court judge's absurd extempore on breastfeeding ignores what is best for the mother

By Nisha Susan

The last place you expect to hear hipster parenting views is in the Madras High Court. But here is what happened in the last week of December. Justice N Kirubakaran was ruling in a case which required him to decide whether a young doctor, Dr U Ishwarya, was ineligible for her post-graduate course on account of taking six months’ maternity leave during her two-year probationary service. The judge ruled she was indeed eligible, but he did not stop there. The court went on to ask the Union government to consider passing a law to make breastfeeding mandatory, and declaring it to be a fundamental right for a newborn child to be breastfed for at least six months.

Tarika, a 34-year-old first-time mother in Bangalore, read the news and reacted with a mixture of terror and giggles. She has barely recovered from the tyrannical ways of her extremely fancy paediatrician who demanded that she feed her twin premature babies only with breast milk, and since they were at the early stages finding it a little hard to suck, feed them with a metal-beaked spoon. For four months, she periodically asked whether she could occasionally feed the babies with a bottle (pumped breast milk, not formula, mind you) and the doctor scolded her to “not even think about a bottle”.

Representational image. Reuters

Representational image. Reuters

So back she went to sleeplessness and exhaustion since each baby had to be fed every 2.5 hours and each took half an hour to drink. And when she was not actively feeding the twins, she was pumping breast milk for later use. She was doing nothing else. Her husband would come home from work and take over for a couple of hours but she was up every night and all day. Then one day in the doctor’s waiting room, she found herself in conversation with two other women who had got the same diktat and had met it with considerably more scepticism. One of them told her that her mother had laughed at her and told her that the baby needed a sane and healthy mother more than a 100 percent breast milk diet. The other reported that she had 60 days maternity leave and was looking forward to returning to work. Both women were disobeying the doctor, at first lying to him and then slowly growing bolder in discomfiting him with the truth. They were feeding their babies that shocking thing: baby formula.

The American obsession with ‘breast is best’ has firmly come to our shores. It is slowly taking over high-end maternity hospitals and the rolling accents of paediatricians and ‘lactation consultants’ heavily peddling the improved immunity, higher IQ and all-round awesomeness of babies who are exclusively breast-fed. And it is in this atmosphere that the Madras High Court has now issued a 36-page order asking the Union government to mull a law that would make breastfeeding mandatory.

None of the breast-is-best talk considers what may be best for the mother, and even the judge who ruled favourably for the young doctor is likely to have felt the weight of her hallowed maternity over the broader rights of working women. To quote Jennifer Senior, the author of All Joy and No Fun: The Paradox of Modern Parenthood, “our expectations of mothers seem to have increased as our attitudes toward women in the workplace have liberalized.”

Indian courtrooms are the last home of dazzling, high-flown prose and this order was no different, especially early on where we read in the order that “delivery gives birth not only to a child, but also a mother as well” and that “there is no substitute for mother's milk in the world and even the so-called ‘divine nectar’ could not be equal to mother's milk.”

For a large part, the order looks at legal precedents for Dr Ishwarya’s situation and pronounces that “nature does not discriminate whether the woman is an approved probationer or an unapproved probationer with regard to the child birth”. To this end, the judge urges the Centre to increase maternity leave for its employees from 180 to 270 days, push state governments to swiftly match this and suggests actually penalizing officers who dither about granting maternity leave. I am grateful to see that he urges the government to work harder to reduce maternal mortality in India. He suggests maternity insurance for government employees, a fantastic suggestion in a country where it’s next to impossible to get medical insurance coverage for pregnancy.

Wonderfully, he also suggests the establishing of crèches for government employees. Again, I feel grateful to the judge and wish more people and our Parliament-avoiding government would put their money into crèches for all classes of working parents. As research among the urban poor in India shows, children are severely malnutritioned nowadays because their parents have to go to work, leaving even babies as young as one to their own nutritional devices, aka biscuits and instant noodles. Communal childcare has been shown to improve this situation hugely. To quote an American: It takes a village.

As Leila Slimani, the author of the runaway hit French novel The Perfect Nanny says in an interview, “I think that to put the idea in people’s heads that to entrust your children to someone other than yourself is something bad—it’s a tool to alienate women, because it always ends with ‘O.K., then, it’s the woman who stays at home.” And in these times when it’s difficult to summon moral arguments to keep women away from the workplace, comes the argument of the priceless nectar of breast milk. It is the children of the poorest working parents who are most likely to get the least care, unable to access free or subsidised childcare. But even well-to-do working mothers have little chance of seeking paid childcare without encountering some shaming. These days, the shaming even comes from perfect strangers who ask whether your baby is being formula-fed because “you don’t have enough yourself”, or the more familiar letting-you-know that you are a selfish monster. (In hipster circles, it comes with the question whether you are combining this gross negligence with the wrecking of the environment, aka using disposable diapers.)

The bulk of Justice Kirubakaran’s suggestions for the government are towards the fervent proselytization of breastfeeding. Apart from practical considerations, such as more rooms in public places for breastfeeding, he also suggests that women government employees should breastfeed exclusively during maternity leave. (In this guileless way, the court also suggests that women government employees sign an undertaking to not to have more than two children.) Justice Kirubakaran would like the government to spend more on promoting breastfeeding, rope in celebrities and create ads to promote it, and also perhaps ban ads for substitute baby foods. The judge quotes, among other things, a recent study done at the University of California, Los Angeles which found that one third of beneficial gut bacteria in infants comes directly from mother's milk.

Mothers may variously find that breastfeeding is rewarding, emotional, tiring, astounding or forgettable but it is not clear whether breast milk is so significantly superior.

Author and journalist Hanna Rosin’s careful review of the vast scientific literature on the benefits of breastfeeding (while breastfeeding her third child) concluded that, “We have clear indications that breast-feeding helps prevent an extra incident of gastrointestinal illness in some kids—an unpleasant few days of diarrhea or vomiting, but rarely life-threatening in developed countries. We have murky correlations with a whole bunch of long-term conditions. [And] The evidence on IQs is intriguing but not all that compelling, and at best suggests a small advantage, perhaps five points.” In developing countries, the lack of clean water or facilities to sterilize equipment for formula feeding could, in fact, be life-threatening, just as the lack of clean water could be for anybody and not just newborn infants. But are a baby’s chances to survive improved by its mother being driven round the bend by sleeplessness, ill health and poverty?

More than one recent study on the post-birth earnings of American women shows that mothers who breastfeed for six months or longer suffer more severe and more prolonged earning losses than do mothers who breastfeed for shorter durations or not at all. Other research shows that the average American man earns a pay bump of more than 6 percent when he becomes a father, and that American women's earnings decrease by 4 percent for every child they have. ‘Father’ is not a word that appears anywhere in the judge’s order.

Why not make it obligatory for women, the judge asks, to breastfeed “as has been done by UAE Government by having mandatory breast feeding clause in the new UAE Child Rights law?” Sure, why not? That Bangalore pediatrician would certainly be thrilled. When in this dystopian world women are required by law to breastfeed their babies, is our government going to take charge of feeding the mothers? The judge has asked various ministries at the Centre to respond to his questions via video-conference by 22 January.

For once in my life, I feel the pain of the Union government as it tries to do the impossible: respond politely to someone’s unsolicited parenting advice.

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Published Date: Jan 08, 2018 17:38 PM | Updated Date: Jan 08, 2018 17:41 PM

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