Mississippi Today
Q&A with neonatologist Dr. Christina Glick on the science and stigma of breastfeeding
Note: This Q&A first published in Mississippi Today‘s InformHer newsletter. Subscribe to our free women and girls newsletter to read stories like this monthly.
Dr. Christina Glick is a retired neonatologist who runs Mississippi Lactation Services, one of the only free-standing breastfeeding clinics in the Jackson area. She is an advocate of family-centered care, a system of practice that incorporates the family in therapeutic, management and even diagnostic decision-making, and a proponent of breastfeeding as medicine.
Research around breastfeeding โ which lowers the incidence of numerous diseases, infections and depression in both mother and baby โ has made strides in the last few decades. Still, Glick says she sometimes encounters colleagues who joke that she โquit practicing real medicineโ when she opened her clinic in 2015.
With the highest rate of preterm birth, Mississippi could stand to benefit from increasing its breastfeeding rate โ one of the lowest in the country. Mississippi Today spoke with Glick about the science and stigma of breastfeeding, the multi-billion dollar infant formula industry, and what would be needed to eradicate unnecessary pharmaceutical intervention in baby feeding practices.
Editor’s note: This Q&A has been edited for length and clarity.
Mississippi Today: How did you first get into breastfeeding research and, at the time, did you feel like it was a rather underappreciated or niche area?
Dr. Christina Glick: When I first did my training back in the early โ80s, there was no breastfeeding training in medical school at all. It wasn’t even mentioned. And one of the things we were regularly losing babies from was malnutrition. So, the smallest babies were the hardest ones to be able to feed. And so there was some early work in the late โ80s that breast milk was maybe a solution for some of our malnutrition issues in the tiniest, sickest babies who had chronic lung disease and just weren’t able to get enough nutrition. I got certified as a lactation consultant by the International Board of Certified Lactation Consultants, IBCLC, in the early 2000s. I started working with breastfeeding for my NICU patients at that time, and when I was in private practice I began to do a lot of breastfeeding medicine in the NICU.
When I opened my clinic, I thought โwell I know a lot about breastfeeding and it’s going to be a pretty easy adjustment from intensive care medicine to lactation,’ and it was not โ at all. I found that I knew very little about breastfeeding โ and I’ve breastfed three children of my own. It’s a very confusing thing: you think it’s natural so it’s going to be simple, but it’s a very complex field of work. I have found that it’s absolutely critical to be able to coordinate the teamwork between the provider and the family to be able to successfully advocate for breastfeeding.
It is an extremely underrepresented field, still to this day. It’s getting more and more recognition but I still get people kidding me, โwell, you quit practicing real medicine’ and stuff like that.
MT: Tell us a little bit about the research around breast milk and how breastfeeding has been shown to be mutually beneficial for mother and baby.
CG: There are so many aspects of breastfeeding that are just, seemingly magical. There’s the nutritional part of it โ it’s the perfect food for the baby. So it’s exactly matched to the proteins that babies need. And we’ve found that breastfed babies actually need less volume, less protein, less calories when they’re fed breast milk โ because it’s the perfect food.
Babies that are breastfed, we know, have a lower incidence of some of the diseases that are the most common causes of adult bad outcomes including cardiovascular disease, heart attack and stroke. So breastfed babies have less of that. And we always thought it was a nutritional thing but as we’ve been discovering, the human genome is actually affected by breastfeeding. So the epigenome, which is the part of our genetics that is changeable, is actually impacted greatly by breastfeeding. And so we think now that breastfeeding changes the likelihood of having heart attacks and strokes, based on the changes in the genome, not as a nutritional result โ which I find pretty amazing. The breast milk actually turns off bad genes and turns on good genes.
And as we studied the microbiome, we found that breastfeeding dramatically changes the microbiome and probably has a really big effect on our overall long-term health as well as the epigenome. So breastfed babies have completely different colonies of bacteria in their gut and we think that affects their overall health and their immunological response to infections. So it’s not just the nutritional benefit but also the microbiome that helps fight infections.
MT: Aside from all the benefits for the baby, what are some of the benefits for the mother? Can it help with things like postpartum depression?
CG: Yes. And one of the confusing things about breastfeeding is that the first couple of weeks are usually pretty stressful. We always paint it as a time of bonding and rainbows and unicorns or whatever but establishing breastfeeding in the first couple of weeks can be extremely stressful.
And sometimes the first few weeks are so stressful that people imagine that postpartum depression is increased by breastfeeding โ but the data shows that it’s actually protective. One of the best things that happens with breastfeeding is the hormonal changes that breastfeeding brings on are really unique. So, breastfeeding moms have really high levels of prolactin. And they have huge oxytocin surges which is what stimulates the transfer of milk to the baby. And it turns out that the oxytocin surges are pretty unique in breastfeeding mothers, and those oxytocin surges help reduce the incidence of cardiovascular disease long-term in the mother. So, we see less heart attacks and strokes in mothers who have breastfed for any significant time that is more than a matter of weeks.
In addition, breastfeeding helps reduce breast cancer. So breastfeeding mothers have a lower risk of developing breast cancer throughout the rest of their lives.
MT: Why do you think Mississippi has one of the lower rates of breastfeeding in the country?
CG: One of the things that gave formula such a strong foothold early on in the โ50s and โ60s was that it was called formula, so it was like the perfect scientific formulation of milk for a baby that was going to make babies healthier than breast milk. And so it became a socioeconomic incentive that well-off people can feed their babies with this new, special formulation of milk. So, it became a status symbol, if you will, that formula-fed babies are better off than breastfed babies. And that lingers in our culture today in America that it’s considered an advantage to be able to formula feed babies.
And one of the things that has happened is that one of the programs that serves lower socioeconomic groups, particularly single women, is the WIC program โ Women, Infants and Children Program โ and that has really translated to a sort of formula chain. There are some lactation consultants who work on supporting breastfeeding, but it’s not a perfect system and it tends to be sort of a knee-jerk to offer women formula instead of breastfeeding. It just seems easier, so if there’s any bump in the road they tend to switch to formula.
Breastfeeding is a cultural thing. If your mother breastfed you and your sisters and your cousins and everyone is breastfeeding their babies, then there is a lot of community support. If you come from a culture where everyone is formula feeding, there’s no one there who really understands. So when you hit problems, the answer is formula.
And unfortunately, the indigent population in Mississippi, and in the country as a whole, is still on the formula highway. There’s not support in our culture by a long history of breastfeeding. So, if you’re in a formula culture, you tend to formula feed and that is the case in Mississippi.
MT: Mississippi also has one of the highest rates of cesarean sections in the U.S. Are these two things, high rate of cesareans and high rate of formula use, connected?
CG: Right, great question. With a cesarean, there are a number of things that interfere with the initiation of breastfeeding. So, one of the big things is that a woman who has a C-section gets a big bolus of fluids, and that translates pretty quickly straight into the baby. So babies born of C-sections have higher water content in their bodies. And when we’re water overloaded what we do is pee it all out pretty quickly. And so babies born by C-section tend to lose weight really quickly. And we have this 10% cutoff, based on a terrible study that said that babies who lose more than 10% of their birth weight are in danger, and immediately supplement them with formula. So, just the weight loss piece of surgical deliveries makes them be at higher risk of formula supplementation recommendation right off the bat.
And then the second thing that happens is that surgical delivery delays the milk coming in. So, there’s breast milk and there’s colostrum. And normally, we transition from colostrum to regular milk by the second or third day, but with surgical deliveries that’s delayed to the fourth or fifth day. And oftentimes when a breastfed baby is only getting colostrum for four or five days, they’re pretty darn hungry by the time the milk comes in. And they’ve lost a lot of weight. So you have a crying, fussing baby who is acting unsatisfied and the natural response is to give the baby supplementation, instead of saying โit’s ok for that baby to cluster feed for 10 or 15 times a day to get that milk.’ And the data is that if you use more than four ounces of formula in a 24-hour period in the first month, it dramatically interferes with sustainability of breastfeeding in the long term.
MT: In your view, do you think more Americans are using formula than need it? What would be needed to shift the paradigm?
CG: Absolutely. That is completely, absolutely true. And one of the unfortunate things that has happened as a result of the move toward formula is the companies who have produced formula are very powerful political forces in this country. So it’s an economic incentive for hospitals and doctors to push formula. And that’s become a real driver in the supplementation of formula in our country. And breastfeeding is not a powerful money-making industry, right? So it’s very hard to fight the pharmaceutical intervention in infant feeding practices in our country.
We would need to strip the pharmaceutical power and make that not a factor anymore โฆ Most mothers are given a sample of formula when they register at the prenatal clinic. So that’s a huge tool to get formula in your front door by sending you free formula. That should be banned. It should be illegal to do that.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Mississippi Election 2024: What will be on Tuesdayโs ballot?
Mississippians will go to the polls on Tuesday, Nov. 5, to elect federal and state judicial posts and some local offices, such as for election commissioners and school board members.
Polls will be open from 7 a.m. to 7 p.m. on Tuesday. To find your polling place, use the secretary of state’s locator, or call your local county circuit clerk.
READ MORE: View the Mississippi sample ballot.
The following is a list of the candidates for federal and judicial posts with brief bios:
President
- Kamala Harris, current vice president and Democratic nominee for president. Her running mate is Tim Walz.
- Donald Trump, former president and current Republican nominee. His running mate is J.D. Vance.
- Robert Kennedy Jr. remains on the ballot in Mississippi even though he has endorsed Trump. His running mate is Nicole Shanahan.
- Jill Stein is the Green Party candidate. Her running mate is Rudolph Ware.
- Five other candidates will be on the Mississippi ballot for president. For a complete list of presidential candidates, see the sample ballot.
U.S. Senate
- Ty Pinkins is the Democratic nominee. He is a Rolling Fork native and attorney, representing, among other clients, those alleging unfair working conditions. He served 21 years in the U.S. Army, including combat stints, other overseas deployment and posts in the White House,
- Roger Wicker is the Republican incumbent senator. He resides in Tupelo and has served in the U.S. Senate since late 2007 after first being appointed to fill a vacancy by then-Gov. Haley Barbour. He was elected to the post in 2008. He previously served in the U.S. House and as a state senator. He is an attorney and served in the United States Air Force.
House District 1
- Dianne Black is the Democratic nominee. She is a small business owner in Olive Branch in DeSoto County.
- Trent Kelly is the Republican incumbent. He was elected to the post in a special election in 2015. He previously served as a district attorney and before then as a prosecuting attorney for the city of Tupelo. He is a major general in the Mississippi Army National Guard.
House District 2
- Bennie Thompson is the Democratic incumbent. He was first elected to the post in 1993. Before then, he served as a Hinds County supervisor and as alderman and then as mayor of Bolton.
- Ronald Eller is the Republican nominee. He grew up in West Virginia and moved to central Mississippi after retiring from the military. He is a physician assistant and business owner.
House District 3
- Michael Guest is the Republican incumbent and is unopposed.
House District 4
- Mike Ezell is the Republican incumbent first being elected in 2022. He previously served as Jackson County sheriff.
- Craig Raybon is the Democratic nominee. Raybon is from Gulfport and began a nonprofit โfocused on helping out the community as a whole.โ
Central District Supreme Court
- Jenifer Branning currently serves as a member of the state Senate from Neshoba County.
- Byron Carter is a Hinds County attorney and previously served as a law clerk for Supreme Court Justice Armis Hawkins.
- James Kitchens is the incumbent. He has served on the state’s highest court since 2008.
- Ceola James previously served on the Court of Appeals.
- Abby Gale Robinson is a Jackson attorney. She previously was a commercial builder.
Southern District Supreme Court
- Dawn Beam is the incumbent, having been first appointed in 2016 by then-Gov. Phil Bryant and later winning election to the post. She is a former chancellor for the Hattiesburg area.
- David Sullivan is an attorney in Harrison County and has been a municipal judge in D’Iberville since 2019. His father, Michael, previously served on the state Supreme Court.
Northern District Supreme Court seats
- Robert Chamberlin of DeSoto County is unopposed.
- James Maxwell of Lafayette County is unopposed.
Court of Appeals 5th District seat
- Ian Baker is an assistant district attorney in Harrison County.
- Jennifer Schloegel is a Chancery Court judge for Harrison, Hancock and Stone counties.
- Amy St. Pe is a Municipal Court judge in Gautier.
Court of Appeals District 2
- Incumbent Latrice Westbrooks is unopposed.
Court of Appeals District 3
- Incumbent Jack Wilson is unopposed.ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1750
Nov. 4, 1750
Jean Baptiste Point DuSable, the โFather of Chicago,โ was born.
A man of African descent, he became the first known settler in the area that became the city of Chicago. He married a Potawatomi woman, Kitiwaha (Catherine), and they had two children.
According to records, the property included a log cabin with two barns, a horse-drawn mill, a bakehouse, a poultry house, a dairy, a smokehouse, a fenced garden and an orchard. At his trading post, DuSable served Native Americans, British and French explorers and spoke a number of languages.
โHe was actually arrested by the British for being thought of as an American Patriot sympathizer,โ Julius Jones, curator at the Chicago History Museum told WLS, but DuSable beat those charges.
In Chicago today, a school, street, museum, harbor, park and bridge bear his name. The place where he settled near the mouth of the Chicago River is now a National Historic Landmark, part of the city’s Pioneer Court.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Podcast: Mississippiโs top election official discusses Tuesdayโs election
Secretary of State Michael Watson talks with Mississippi Today’s Geoff Pender, Bobby Harrison and Taylor Vance ahead of Tuesday’s election. He urges voters to remember sacrifices many have made to protect Americans’ voting rights and get to the polls, and he weighs in on whether a recent court ruling on absentee vote counting will impact this year’s elections.
READ MORE: As lawmakers look to cut taxes, Mississippi mayors and county leaders outline infrastructure needs
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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