Abstract
So That's What They're For: Breastfeeding Basics by Janet Tamaro. Published 1998 by Adams Media Corporation in Holbrook, MA. As childbirth educators continue the effort to find ways to educate women on the benefits of breastfeeding, it is increasingly difficult to find literature that appeals to teenagers and nonmedical personnel. Many texts are written at such a high level of language and complexity that they are inappropriate to recommend for the teenage girl or the educated woman who has no desire to become bogged down by the pathophysiology of the breast and the plethora of research that has been conducted. In her book So That's What They're For: Breastfeeding Basics (1998), Janet Tamaro achieves a balance between information, practical suggestions, anecdotes, and a good helping of humor to guide the pregnant or new mother through the decision and practice of breastfeeding.
In the introduction, Tamaro addresses an emotion many women may have about the decision to breastfeed: “You are not a bad person if you are ambivalent, think it may be embarrassing, strange, even icky. Even if you've been dying to have a baby, you may not be dying to breastfeed. That's normal too” (p. 13). She also notes the first of many myths that women often hear: “The biggest myth about breastfeeding is that it's easy from the start” (p. 13). Tamaro's conversational style of writing immediately relaxes the reader, providing an advantage over those books that read like a college text.
The body of the book is composed of 15 chapters divided into three sections. Section 1, titled “The Learning Curve,” has three chapters discussing the history of breastfeeding and the debate over breast versus bottle-feeding and examining why the number of breastfeeding mothers is not higher. Each chapter is divided into smaller paragraphs with bold-faced headings, making flipping through the book and picking out topics of interest or for reference very easy.
Chapter 1 focuses on the evolution of breastfeeding, the swing toward the use of formula, and the current trend back toward breastfeeding. Tamaro addresses common statements that women—especially teenagers—may have heard, such as “… my friends say it hurts, why didn't my mother breastfeed and everybody uses bottles” (p. 20). Another section focuses on the attitudes of physicians toward breastfeeding. Tamaro cites a study by the Journal of the American Medical Association in which 55% of the physicians most likely to care for a woman postnatally in the hospital setting admitted they did not know enough about breastfeeding (p. 22).
… 55% of the physicians most likely to care for a woman postnatally in the hospital setting admitted they did not know enough about breastfeeding.
The second chapter focuses on the debate over breast milk and formula (artificial baby milk). Tamaro begins by citing 29 facts that emphasize why breastfeeding is the best choice. She discusses the influence that formula manufacturers can have over new mothers by the use and distribution of free samples in the hospital setting and the physician's office, as well as by the advertising of formula on items such as thermometers and even on posters that promote breastfeeding. Tamaro makes a poignant statement on the breast-versus-bottle decision: “People need to understand that when they're deciding between breast milk and formula, they're not deciding between Coke and Pepsi …. They're choosing between a live, pure substance and a dead substance made with the cheapest oils available” (p. 26). She also points out that the United States is not enforcing a World Health Organization code that prohibits the advertising of formula and the distribution of free samples, despite the fact that the U.S. signed an agreement to uphold this code.
“People need to understand that when they're deciding between breast milk and formula, they're not deciding between Coke and Pepsi…. They're choosing between a live, pure substance and a dead substance made with the cheapest oils available.”—Janet Tamaro
In chapter 3, titled “If It's So Great Why Doesn't Everybody Do It?”, Tamaro discusses reasons why the number of breastfeeding mothers is not higher. She states, “We live in a culture that isn't always supportive of breastfeeding mothers, and you'll run into pressure from a lot of women who bottle-feed and think you should too” (p. 41). She cites seven common excuses that are often used as “reasons” not to breastfeed, such as “… my friends say it hurts, I can't make enough milk, formula is practically the same as breast milk, and I wasn't breastfed and I turned out okay” (p. 44). By addressing all the negatives a woman may hear about breastfeeding in an objective fashion and providing factual, logical responses, Tamaro enables the reader to address any fears and work toward an informed decision.
The second part of the book, “Mine Didn't Come with a Manual,” covers getting ready to breastfeed, starting to breastfeed, dealing with the first days and weeks, sleeping, and addressing possible problems the mother may encounter. The chapter on preparation discusses tips on finding a pediatrician, myths about the need for breast preparation, buying bras and clothing, and what to expect at the hospital and how to make the stay more pleasant. Tamaro notes five hospital breastfeeding tips that can be invaluable for the new breastfeeding mother: “No pacifiers, no bottles, baby rooms-in with you at the hospital, feed on demand, and call for help if you need it” (p. 71). Simple tips and statements such as these are what make Tamaro's book so endearing. Her aim is not to be intellectually stimulating, but to speak to all women who need clear, easy-to-understand information that they can relate to when making the important decision about breast or bottle-feeding. Real-life stories of her own experiences and those of others interspersed throughout the book reassure the reader that any thoughts and feelings she has, whether positive or negative, are normal and she is not alone.
Real-life stories of her own experiences and those of others interspersed throughout the book reassure the reader that any thoughts and feelings she has, whether positive or negative, are normal and she is not alone.
Chapter 5, which Tamaro titles “Inserting Breast A into Mouth B,” covers the actual physiology and mechanics of putting the baby to breast. Along with clear, simple diagrams of the breast, she uses the analogy of the internal plumbing and water supply in a house to describe the production and delivery of breast milk. “Let's say you want water. Some of the water is stored in pipes, some of it comes from a larger water supply. You signal the pipes that you want water when you turn on the faucet. Water pressure will push the water through the pipes, and you'll keep getting water until you signal that you've got enough by turning off the faucet” (p. 84). Tamaro's ability to take a complex biological process and turn it into a simple analogy is further evidence of why this book is especially appropriate for the teenage mother and the woman who is not, or has no desire to be, intimately familiar with the anatomy and physiology of the human body. This chapter also discusses positioning and latching-on and provides diagrams of correct mouth positioning and how to hold the breast correctly during feeding.
The remaining six chapters in part 2 cover common obstacles from the first few days through the first 6 weeks, getting enough sleep, and problems that may arise (e.g., sore nipples, plugged milk ducts, and mastitis). Tamaro also discusses breastfeeding in relation to the infant with problems such as prematurity, cleft palate, or Down's syndrome, and conditions of the mother such as HIV, hepatitis, epilepsy, and diabetes, as well as their impact on breastfeeding. While these last discussions are short, this length is appropriate for the style of the book, and many other texts are available for the reader to explore for greater depth of these topics.
Another important, often rarely discussed issue Tamaro covers in this section is breastfeeding an adopted infant. She cites successful and unsuccessful breastfeeding experiences of adoptive mothers, an overview of lactation induction, and the use of the Supplemental Nutrition System. While this discussion is not in-depth, it provides practical information and does not dismiss the issue as impossible.
Part 3 is composed of six chapters that cover pumping, working, weaning, and toddler nursing. Tamaro does a thorough job of discussing diet and the implications for breastfeeding, the pumping and storage of breast milk, the emotions and practicalities of the breastfeeding mother returning to work, the introduction of solid foods, and the weaning process.
Two of the latter chapters cover topics often labeled as taboo: sex while breastfeeding and toddler nursing. Chapter 13 provides the reader with a humorous, but practical, look at the nursing couple's sex life. She begins by citing the many terms by which the breasts are known in different countries, and goes on to discuss worries and possible solutions for sexual concerns of the breastfeeding couple. Once again, Tamaro's easy writing style and no-nonsense narrative put the reader at ease with a topic that can be of great importance to new parents, but something which they may be afraid to address with anyone else, including their health care providers.
Toddler nursing, the second “taboo” topic, is discussed honestly and openly. Tamaro addresses concerns about what the increasingly verbal toddler will name the breast, biting and pinching, nursing while pregnant, and how to handle the often-horrified reactions of those who see a nursing toddler. Her discussion makes the reader realize that societal pressure has an enormous impact on the weaning of a child.
The book concludes with appendices that provide the reader with a wealth of information and contacts. Tamaro lists organizations and phone numbers ranging from La Leche League and breast pump manufacturers to milk banks, drug information hotlines, and breast implant resources. The typeface is easily readable and the heavyweight vellum is more reminiscent of a novel than an informative text. The book's cover price of $10.95 makes it easily affordable for the consumer and a resource that would be invaluable in any practitioner's office or childbirth educator's library.
The major weakness of the book is the reference section. While it has over 180 citations, none of these is specifically referenced within the body of the text, which makes finding a specific article (e.g., the poll conducted by the Journal of the American Medical Association) both annoying and time consuming. However, this is the only major complaint in an otherwise outstanding text and is not necessarily a deficit for the target audience.
The readability and sheer fun of reading this book can perhaps be explained in Tamaro's own words from the preface: “The reason the book is funny is because reality is almost always stranger and funnier than fiction. As you will soon see, though parenting is exhausting, it is also the most amusing chapter of life” (p. 7). Janet Tamaro has produced a humorous, informative, concise, affordable, fun-to-read book on the joys and trials of breastfeeding. Her wit and use of real-life stories and examples paired with factual, hands-on information has resulted in a book that will undoubtedly encourage and promote breastfeeding.
“The reason the book is funny is because reality is almost always stranger and funnier than fiction.”—Janet Tamaro