Have you ever heard the one about how breastfeeding is free?
Jeste li ikad čuli kako je dojenje besplatno?
(Laughter)
(Smijeh)
Yeah, it's pretty funny, because it's only free if we don't value women's time and energy. Any mother can tell you how much time and energy it takes to liquify her body -- to literally dissolve herself --
Da, poprilično smiješno, Jer je besplatno samo ako ne cijenimo majčino vrijeme i energiju. Bilo koja majka može reći koliko je vremena i energije potrebno da svoje tiijelo doslovno pretvori u tekućinu
(Laughter)
(Smijeh)
as she feeds this precious little cannibal.
dok hrani svog dragocjenog malog kanibala.
(Laughter)
(Smijeh)
Milk is why mammals suck. At Arizona State University, in the Comparative Lactation Lab, I decode mothers' milk composition to understand its complexity and how it influences infant development. The most important thing that I've learned is that we do not do enough to support mothers and babies. And when we fail mothers and babies, we fail everyone who loves mothers and babies: the fathers, the partners, the grandparents, the aunties, the friends and kin that make our human social networks. It's time that we abandon simple solutions and simple slogans, and grapple with the nuance.
Mliijeko je razlog zašto sisavci sišu. Na Sveučilištu Arizona, u Odjelu za komparativnu laktaciju rastavila sam majčino mlijeko na sastavnice kako bi razumjela njegovu složenost I način na koji utječe na razvitak djeteta. Najvažnija stvar koju sam naučila je da ne činimo dovoljno kako bi poduprli majke i njihovu djecu. A kada zapostavimo majke i njihovu djecu, iznevjerili smo sve koji vole majke i djecu očeve, partnere, djedove i bake, stričeve i tete, prijatelje i rodbinu koji čine društvenu mrežu. Vrijeme je da napustimo jednostavna rješenja i gesla, i pozabavimo s detaljima.
I was very fortunate to run smack-dab into that nuance very early, during my first interview with a journalist when she asked me, "How long should a mother breastfeed her baby?" And it was that word "should" that brought me up short, because I will never tell a woman what she should do with her body.
Imala sam sreće da se podrobno suočim s detaljima dosta rano za vrijeme mog prvog intervjua s novinarkom kada me je pitala „Koliko dugo bi majka trebala dojiti svoje dijete?“ I ta riječ „trebala“ me jako iznenadila Jer nikada ne bih ženi rekla što bi trebala raditi sa svoji tijelom.
Babies survive and thrive because their mother's milk is food, medicine and signal. For young infants, mother's milk is a complete diet that provides all the building blocks for their bodies, that shapes their brain and fuels all of their activity. Mother's milk also feeds the microbes that are colonizing the infant's intestinal tract. Mothers aren't just eating for two, they're eating for two to the trillions. Milk provides immunofactors that help fight pathogens and mother's milk provides hormones that signal to the infant's body.
Novorođenčad preživljavaju i napeduju Jer majčino mlijeko je hrana, lijek i znak. Za dojenčad, majčino mlijeko je prehrana koja osigurava svu gradivnu snagu za njihova tijela, koje kreira njihov mozak i daje snagu za ostale aktivnosti. Majčino mlijeko također hrani mikrobe koje nastanjuju probavu dojenčeta. Majke ne jedu samo za dvoje, već za dva do tri bilijuna. Mlijeko osigurava imunoglobuline koji pomažu u borbi protiv patogena i osigurava hormone koji daju signale dojenčetu.
But in recent decades, we have come to take milk for granted. We stopped seeing something in plain sight. We began to think of milk as standardized, homogenized, pasteurized, packaged, powdered, flavored and formulated. We abandoned the milk of human kindness and turned our priorities elsewhere.
U posljednje vrijeme uzimamo majčino mlijeko zdravo za gotovo. Ne vidimo ono što je očito. Smatramo miljeko kao standardizirano, homogenizirao, pasterizirano, pakirano, u prahu, s okuso i formulom. Odustali smo od ljudskog mlijeka i odredili druge prioritete.
At the National Institutes of Health in Washington DC is the National Library of Medicine, which contains 25 million articles -- the brain trust of life science and biomedical research. We can use keywords to search that database, and when we do that, we discover nearly a million articles about pregnancy, but far fewer about breast milk and lactation. When we zoom in on the number of articles just investigating breast milk, we see that we know much more about coffee, wine and tomatoes.
U Nacionalnom istitutu zdravlja u Washingtonu, u Nacionalnoj medicinskoj knjižnici, koja sadrži preko 25 milijuna članaka - je središte znanosti života i biomedicinskog istraživanja. Možemo koristiti ključne riječi kako bi pretražili bazu podataka, a kada to i napravimo, možemo otkriti skoro milijun članaka o trudnoći, ali mnogo manje o dojenju i laktaciji. Kada se fokusiramo a broj članaka koji se odnose na dojenje, možemo vidjeti da znamo mnogo više o kavi, vinu i rajčicama.
(Laughter)
(Smijeh)
We know over twice as much about erectile dysfunction.
Znamo duplo više o erektilnoj disfunkciji.
(Laughter)
(Smijeh)
I'm not saying we shouldn't know about those things -- I'm a scientist, I think we should know about everything. But that we know so much less --
Ne kažem da ne bi trebali znati o takvim stvarima -- Znanstvnica sam, smatram da bi trebali znati o svemu. Ali znamo mnogo manje -
(Laughter)
(Smijeh)
about breast milk -- the first fluid a young mammal is adapted to consume -- should make us angry. Globally, nine out of 10 women will have at least one child in her lifetime. That means that nearly 130 million babies are born each year. These mothers and babies deserve our best science.
o dojenju -- prva tekućina koju je mladi sisvac sposoban konzumirati-- trebalo bi nas razljutiti. U svijetu, devet od deset žena imat će barem jedno dijete u svom životu. Što znači da je skoro 10 milijuna djece rođeno svake godine. Ove majke i djeca Zaslužuju najbolje od znanosti.
Recent research has shown that milk doesn't just grow the body, it fuels behavior and shapes neurodevelopment. In 2015, researchers discovered that the mixture of breast milk and baby saliva -- specifically, baby saliva -- causes a chemical reaction that produces hydrogen peroxide that can kill staph and salmonella. And from humans and other mammal species, we're starting to understand that the biological recipe of milk can be different when produced for sons or daughters. When we reach for donor milk in the neonatal intensive care unit, or formula on the store shelf, it's nearly one-size-fits-all. We aren't thinking about how sons and daughters may grow at different rates, or different ways, and that milk may be a part of that.
posljednja straživanja pokazuju da mlijeko ne pomaže samo rastu tijela, već i oblikovanju ponašanja, te sudjeluje u neurorazvoju. U 2015, istraživači su otkrili da kombinaija majčinog mlijeka i dječje sline - specifično dječe sline- dovodi do kemijske reakcije u kojoj nastaje vodikov peroksid koji ubija stafilokoke i salmonelu. Istražujući ljude i druge sisavce, počinjemo razumijevati kako je biološki mliječni recept drukčiji kada se proizvodi za sinove i kćeri. Kada posegnemo za donorskim mlijekom u neonatalnoj intenzivnoj jedinici, ili formulom iz trgovine, gotovo da svima odgovara. ne razmšljamo o tome kako naši sinovi i kćeri mogu rasti u različitim stopama, ili na drukčiji način, i da mljeko ima utjecaja na to.
Mothers have gotten the message and the vast majority of mothers intend to breastfeed, but many do not reach their breastfeeding goals. That is not their failure; it's ours. Increasingly common medical conditions like obesity, endocrine disorders, C-section and preterm births all can disrupt the underlying biology of lactation. And many women do not have knowledgeable clinical support.
Majke su razumjele tu poruku i velika većina majki namjerava dojiti, ali mnoge ne dođu do tog zaključka. To nije njihova krivica već naša. Sve ćešća pojava medicinskih stanja kao što je pretilost, endokini poremećaji, carski rez i prijevremeni porodi mogu dovesti do promjena u laktaciji. Također mnogo žena nema stručnu kliničku podršku.
Twenty-five years ago, the World Health Organization and UNICEF established criteria for hospitals to be considered baby friendly -- that provide the optimal level of support for mother-infant bonding and infant feeding. Today, only one in five babies in the United States is born in a baby-friendly hospital. This is a problem, because mothers can grapple with many problems in the minutes, hours, days and weeks of lactation. They can have struggles with establishing latch, with pain, with milk letdown and perceptions of milk supply. These mothers deserve knowledgeable clinical staff that understand these processes.
Prije dvadeset pet godina, Svjetska zdravstvena organizacija I UNICEF utvrdili su kriterije za bolnice kako bi bile prilagođene bebama i pružale podršku povezivanju majke i bebe, i hranjenu bebe. danas, samo jedna od pet beba u SAD-u Rođena je u takvoj bolnici. Ovo je problem, jer majke se mogu suočiti s raznim problemima U prvim mintama, satima, danima i tjednima laktacije. mogu voditi borbu s uspostavljanjem laktacije, boli, s gubitkom mlijeka i mliječnim zalihama. ove majke zaslužuju stručnu kliničku podršku koje razumiju ove procese.
Mothers will call me as they're grappling with these struggles, crying with wobbly voices. "It's not working. This is what I'm supposed to naturally be able to do. Why is it not working?" And just because something is evolutionarily ancient doesn't mean that it's easy or that we're instantly good at it. You know what else is evolutionarily ancient?
Majke me zovu dok se bore s ovim problemima, plačući slabašnim glasom. „Ne ide mi. U ovome bi trebala biti po prirodi dobra. Zašto mi ne ide?“ Samo zato što je nešto evolucijski staro ne znači da je lagano i da smo odmah dobri u tome. Znate što je još evolucijski staro?
(Laughter)
(Smijeh)
Sex. And nobody expects us to start out being good at it.
Seks. I nitko ne očekuje od nas da u startu budemo dobri u tome.
(Laughter)
(Smijeh)
Clinicians best deliver quality equitable care when they have continuing education about how to best support lactation and breastfeeding. And in order to have that continuing education, we need to anchor it to cutting-edge research in both the life sciences and the social sciences, because we need to recognize that too often historical traumas and implicit biases sit in the space between a new mother and her clinician. The body is political. If our breastfeeding support is not intersectional, it's not good enough. And for moms who have to return for work, because countries like the United States do not provide paid parental leave, they can have to go back in as short as just a few days after giving birth.
Klinčari nabolje osiguravaju kvalitetnu njegu kada imaju kontinuiranu edukaciju o tome kako najbolje osigurati lakatciju i dojenje. A kako bi postojalo kontinuirano educiranje mora se temeljiti na najnovijim istraživanjima I u znanosti o životu, i u društvenim znanostima, jer moramo prepoznati da prečesto povijesne traume i predrasude stoje u prostoru između mlade majke i liječnika. Tijelo je nastrojeno politčki. Ako podrška dojenju nije opće prihvaćena, to nije dovoljno dobro. Neke majke se moraju vratiti na posao, jer zemlje kao što je SAD ne osiguravaju plaćen porodiljni dopust, već se moraju vratiti u kratkom periodu samo nekoliko dana nakon poroda.
How do we optimize mother and infant health just by messaging about breast milk to moms without providing the institutional support that facilitates that mother-infant bonding to support breastfeeding? The answer is: we can't. I'm talking to you, legislators, and the voters who elect them. I'm talking to you, job creators and collective bargaining units, and workers, and shareholders. We all have a stake in the public health of our community, and we all have a role to play in achieving it. Breast milk is a part of improving human health. In the NICU, when infants are born early or sick or injured, milk or bioactive constituents in milk can be critically important. Environments or ecologies, or communities where there's high risk of infectious disease, breast milk can be incredibly protective. Where there are emergencies like storms and earthquakes, when the electricity goes out, when safe water is not available, breast milk can keep babies fed and hydrated. And in the context of humanitarian crises, like Syrian mothers fleeing war zones, the smallest drops can buffer babies from the biggest global challenges.
Kako ćemo optimizirati zdravlje majke i djeteta samo kroz poruke majkama o dojenju bez pružanja institucijske potpore koja podupire tu vezu majke i bebe i podržava dojenje? Odgovor je: ne možemo. Govorim zakonodavcima I glasačima koji ih izaberu. Govorim stvarateljima radnih mjesta i kolektivnim pregovaračkim jedinicama Radnicima i dioničarima. Svi imamo udio u kreiranju općeg zdravlja zajednice, i svi imamo ulogu koju igrao kako bi to postigli. Dojeno miljeko je dio poboljšanja ljudskog zdravlja. Na intenzivnoj kada su novorođenčad već bolesna ili ozljeđena, mlijeko i njegove bioaktivne sastavnice imaju kritičnu ulogu. U okolinama, okolišima ili zajednicama gdje postoji veliki rizik od infektivne bolesti, dojeno mlijeko može djelovati zaštitnički. Kada postoje nesreće kao što su oluje i potresi, kada nestane struje, kada nije dostupna pitka voda, dojeno mlijeko drži dojenčad uhranjenima i hidratiziranima. U kontekst humanitarnih kriza, kao što su sirijske majke izbjeglice, i najmanje kapi mogu odmaknuti djecu od velikih globalnih izazova.
But understanding breast milk is not just about messaging to mothers and policy makers. It's also about understanding what is important in breast milk so that we can deliver better formulas to moms who cannot or do not breastfeed for whatever reason. We can all do a better job of supporting the diversity of moms raising their babies in a diversity of ways.
Poznavanje dojenog mlijeka nije samo poruka majkama i političarma. Radi se o razumjevanu što je važno u majčinom mlijeku kak bi mogli napviti što bolje formule za majke koje ne mogu il zbog bilo kojeg razloga ne doje. Svi možemo biti bolji u podržavanju različitih majki i različitih načina odgoja njihove djece.
As women around the world struggle to achieve political, social and economic equality, we must reimagine motherhood as not the central, core aspect of womanhood, but one of the many potential facets of what makes women awesome.
Žene u cijelome svijetu bore se kako bi postigle političku, društvenu i ekonomsku jednakost trebamo zamisliti majčinstvo ne samo kao centralni, sržni aspekt ženstvenosti, ceć i kao jedan od mnogih potencijala koji čine žene čudesnima.
It's time.
Vrijeme je.
(Applause)
(Aplauz)