Have you ever heard the one about how breastfeeding is free?
Da li ste nekad čuli ono kako je dojenje besplatno?
(Laughter)
(Smeh)
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, prilično je smešno, jer je besplatno samo ako ne pridajemo vrednost vremenu i energiji žena. Bilo koja majka vam može reći koliko vremena i energije je potrebno da pretvori svoje telo u tečnost - bukvalno da se rastvori -
(Laughter)
(Smeh)
as she feeds this precious little cannibal.
dok hrani svog dragocenog malog kanibala.
(Laughter)
(Smeh)
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.
Sisari sisaju zbog mleka. Na Državnom univerzitetu Arizone, u laboratoriji za komparativnu laktaciju, dekodiram sastav majčinog mleka da bih razumela njegovu složenost i način na koji utiče na razvoj bebe. Najvažnije što sam naučila je da ne činimo dovoljno da bismo podržali majke i bebe. A kada izneverimo majke i bebe, izneveravamo sve koji vole majke i bebe: očeve, partnere, babe i dede, tetke, prijatelje i rodbinu koji sačinjavaju naše ljudske društvene mreže. Vreme je da napustimo jednostavna rešenja i slogane i da se pozabavimo nijansama.
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 mnogo sreće da rano uletim baš u te nijanse, tokom svog prvog intervjua sa novinarkom kada me je pitala: „Koliko dugo majka treba da doji svoju bebu?“ Upravo me je ta reč „treba“ naterala da zastanem, jer nikada neću reći ženi šta treba da radi sa svojim telom.
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.
Bebe preživljavaju i razvijaju se jer je mleko njihove majke hrana, lek i signal. Za bebe, majčino mleko predstavlja kompletnu ishranu koja obezbeđuje sve bitne elemente za njihovo telo, koja oblikuje njihov mozak i snabdeva energiju za sve njihove aktivnosti. Majčino mleko takođe hrani mikrobe koji stvaraju kolonije u crevnom traktu bebe. Majke ne jedu samo za dvoje, već jedu za između dvoje i nekoliko biliona. Mleko obezbeđuje imuno-faktore koji pomažu u borbi protiv patogena, a majčino mleko snabdeva i hormone koji daju signal za telo bebe.
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.
Međutim, poslednjih decenija, počeli smo da uzimamo mleko zdravo za gotovo. Prestali smo da vidimo nešto što nam je ispred nosa. Počeli smo da razmišljamo o mleku kao standardizovanom, homogenizovanom, pasterizovanom, upakovanom, u prahu, sa ukusom i formulom. Odustali smo od mleka ljudske dobrote i preusmerili svoje 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.
Na Nacionalnim institutima za zdravlje u Vašingtonu nalazi se Nacionalna biblioteka medicine koja sadrži 25 miliona članaka - stručni fond nauka o životu i biomedicinskih istraživanja. Možemo koristiti ključne reči da bismo pretražili tu bazu podataka, a kada to uradimo, otkrivamo blizu milion članaka o trudnoći, ali daleko manje o majčinom mleku i laktaciji. Kada se fokusiramo na broj članaka koji izučavaju samo majčino mleko, uviđamo da mnogo više znamo o kafi, vinu i paradajzu.
(Laughter)
(Smeh)
We know over twice as much about erectile dysfunction.
Znamo dvostruko više o erektilnoj disfunkciji.
(Laughter)
(Smeh)
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 treba da stičemo znanja o tim stvarima - ja sam naučnik i mislim da treba da saznamo sve, ali to što znamo toliko manje -
(Laughter)
(Smeh)
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 majčinom mleku - prvoj tečnosti za čiju je konzumaciju mladi sisar prilagođen - trebalo bi da nas naljuti. Na globalnom nivou, devet od 10 žena će imati najmanje jedno dete u životu. To znači da se svake godine rodi približno 130 miliona beba. Te majke i bebe zaslužuju najbolje od naše nauke.
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.
Skorija istraživanja su pokazala da ne samo da mleko obezbeđuje rast tela, već, takođe, pokreće ponašanje i oblikuje razvoj nervnog sistema. Godine 2015, istraživači su otkrili da mešavina majčinog mleka i bebine pljuvačke - konkretno, bebine pljuvačke - uzrokuje hemijsku reakciju koja proizvodi hidrogen peroksid koji može ubiti stafilokoke i salmonelu. Od ljudi i drugih vrsta sisara, počinjemo da razumemo da biološki recept mleka može biti različit kada se proizvodi za sinove ili ćerke. Kada posegnemo za mlekom donatora na intenzivnoj nezi novorođenčadi ili za formulom sa police u prodavnici, gotovo da je po principu „jedna veličina odgovara svima“. Ne razmišljamo o tome kako se sinovi i ćerke mogu razvijati različitom brzinom ili na različite načine, a da mleko može biti deo toga.
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 primile poruku i velika većina majki namerava da doji, ali mnoge ne ostvare svoje ciljeve u vezi sa dojenjem. To nije njihov neuspeh, već naš. Sve više uobičajena medicinska stanja poput gojaznosti, endokrinih poremećaja, carskog reza i prevremenog rođenja mogu poremetiti biologiju koja je u osnovi laktacije. Mnoge žene nemaju 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.
Pre 25 godina, Svetska zdravstvena organizacija i UNICEF ustanovili su kriterijume potrebne da bi se bolnice smatrale naklonjenim bebama - da obezbeđuju optimalni nivo podrške za vezivanje majke i bebe i hranjenje bebe. Danas se samo jedna od pet beba u Sjedinjenim Državama rodi u bolnici naklonjenoj bebama. Ovo predstavlja problem, jer se majke mogu suočavati sa mnogim problemima prvih minuta, sati, dana i nedelja laktacije. Mogu se mučiti sa pravilnim hvatanjem dojke, sa bolom, nedostatkom mleka i percepcijom o zalihama mleka. Ove majke zaslužuju stručno kliničko osoblje koje razume 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 pozovu dok se muče sa ovim problemima, uplakane i sa drhtavim glasom. „Ne ide. Trebalo bi da sam prirodno u stanju da ovo radim. Zašto ne ide?“ Samo zato što je nešto evoluciono staro ne znači da je lako i da nam odmah dobro ide. Znate li šta je još evoluciono staro?
(Laughter)
(Smeh)
Sex. And nobody expects us to start out being good at it.
Seks. I niko ne očekuje da nam na početku dobro ide.
(Laughter)
(Smeh)
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.
Kliničari najbolje pružaju kvalitetnu i ravnopravnu negu kada nastave da se obrazuju u vezi sa time kako da najbolje podrže laktaciju i dojenje. A da bismo imali to obrazovanje, moramo ga zasnovati na savremenim istraživanjima kako iz nauka o životu tako i iz društvenih nauka, jer je potrebno da prepoznamo da previše učestalo istorijske traume i implicitne predrasude stoje između novopečene majke i njenog kliničara. Telo je politizovano. Ako podrška koju pružamo dojenju nije intersekcionalna, nedovoljna je. A za majke koje moraju da se vrate na posao, jer zemlje poput Sjedinjenih Država ne pružaju plaćeno roditeljsko odsustvo, možda će morati da se vrate čak svega nekoliko dana nakon porođaja.
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 da obezbedimo najbolje moguće zdravlje za majku i bebu samo upućivanjem poruke majkama o majčinom mleku, bez pružanja institucionalne podrške koja olakšava vezivanje majke i bebe da bi se potpomoglo dojenje? Odgovor je - ne možemo. Obraćam se vama, zakonodavcima, i glasačima koji su ih izabrali. Obraćam se vama, koji stvarate radna mesta i zastupate sindikate, radnicima i akcionarima. Svi mi imamo udela u javnom zdravlju naše zajednice, i svi igramo ulogu u njegovom dostizanju. Majčino mleko je deo poboljšanja ljudskog zdravlja. Na Intenzivnoj jedinici neonatologije, gde se bebe rađaju prevremeno, bolesne ili sa povredama, mleko ili bioaktivni sastojci u mleku mogu biti od kritičnog značaja. Za životnu sredinu, ekologiju, ili zajednice u kojima postoji visok rizik od infektivnih bolesti, majčino mleko može biti neverovatna zaštita. Tamo gde nastanu vanredne situacije poput oluja i zemljotresa, kada nestane struje, kada čista voda nije dostupna, majčino mleko može da obezbedi da bebe budu site i hidrirane. A u kontekstu humanitarne krize, kao u slučaju sirijskih majki koje beže iz ratnih zona, najmanje kapi mogu da umanje uticaj najvećih globalnih izazova na bebe.
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.
Međutim, razumevanje majčinog mleka ne podrazumeva samo upućivanje poruka majkama i političkim akterima. Takođe se radi o razumevanju onoga što je važno kod majčinog mleka da bismo obezbedili bolje formule majkama koje ne mogu da doje ili to ne čine iz bilo kog razloga. Svi možemo da bolje poradimo na podršci različitih majki koje podižu svoje bebe na najrazličitije načine.
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.
Dok se žene širom sveta bore da steknu političku, društvenu i ekonomsku jednakost, moramo da iznova osmislimo majčinstvo ne kao središnji i suštinski aspekt ženstvenosti, već kao jednu od mnogo mogućih strana onoga što čini žene fenomenalnim.
It's time.
Vreme je.
(Applause)
(Aplauz)