What we don't know about mother's milk | Katie Hinde

Prevodilac: Ivana Krivokuća Lektor: Tijana Mihajlović

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,

Da, prilično je smešno,

because it's only free if we don't value women's time and energy.

jer je besplatno samo ako ne pridajemo vrednost vremenu i energiji žena.

Any mother can tell you how much time and energy it takes

Bilo koja majka vam može reći koliko vremena i energije je potrebno

to liquify her body --

da pretvori svoje telo u tečnost -

to literally dissolve herself --

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.

Sisari sisaju zbog mleka.

At Arizona State University,

Na Državnom univerzitetu Arizone,

in the Comparative Lactation Lab,

u laboratoriji za komparativnu laktaciju,

I decode mothers' milk composition

dekodiram sastav majčinog mleka

to understand its complexity

da bih razumela njegovu složenost

and how it influences infant development.

i način na koji utiče na razvoj bebe.

The most important thing that I've learned

Najvažnije što sam naučila

is that we do not do enough to support mothers and babies.

je da ne činimo dovoljno da bismo podržali majke i bebe.

And when we fail mothers and babies,

A kada izneverimo majke i bebe,

we fail everyone who loves mothers and babies:

izneveravamo sve koji vole majke i bebe:

the fathers, the partners, the grandparents, the aunties,

očeve, partnere, babe i dede, tetke,

the friends and kin that make our human social networks.

prijatelje i rodbinu koji sačinjavaju naše ljudske društvene mreže.

It's time that we abandon simple solutions and simple slogans,

Vreme je da napustimo jednostavna rešenja i slogane

and grapple with the nuance.

i da se pozabavimo nijansama.

I was very fortunate

Imala sam mnogo sreće

to run smack-dab into that nuance very early,

da rano uletim baš u te nijanse,

during my first interview with a journalist

tokom svog prvog intervjua sa novinarkom

when she asked me,

kada me je pitala:

"How long should a mother breastfeed her baby?"

„Koliko dugo majka treba da doji svoju bebu?“

And it was that word "should" that brought me up short,

Upravo me je ta reč „treba“ naterala da zastanem,

because I will never tell a woman what she should do with her body.

jer nikada neću reći ženi šta treba da radi sa svojim telom.

Babies survive and thrive

Bebe preživljavaju i razvijaju se

because their mother's milk is food, medicine and signal.

jer je mleko njihove majke hrana, lek i signal.

For young infants,

Za bebe, majčino mleko predstavlja kompletnu ishranu

mother's milk is a complete diet

that provides all the building blocks for their bodies,

koja obezbeđuje sve bitne elemente za njihovo telo,

that shapes their brain

koja oblikuje njihov mozak

and fuels all of their activity.

i snabdeva energiju za sve njihove aktivnosti.

Mother's milk also feeds the microbes

Majčino mleko takođe hrani mikrobe

that are colonizing the infant's intestinal tract.

koji stvaraju kolonije u crevnom traktu bebe.

Mothers aren't just eating for two,

Majke ne jedu samo za dvoje,

they're eating for two to the trillions.

već jedu za između dvoje i nekoliko biliona.

Milk provides immunofactors that help fight pathogens

Mleko obezbeđuje imuno-faktore koji pomažu u borbi protiv patogena,

and mother's milk provides hormones that signal to the infant's body.

a majčino mleko snabdeva i hormone koji daju signal za telo bebe.

But in recent decades,

Međutim, poslednjih decenija,

we have come to take milk for granted.

počeli smo da uzimamo mleko zdravo za gotovo.

We stopped seeing something in plain sight.

Prestali smo da vidimo nešto što nam je ispred nosa.

We began to think of milk as standardized, homogenized, pasteurized,

Počeli smo da razmišljamo o mleku

kao standardizovanom, homogenizovanom, pasterizovanom,

packaged, powdered, flavored and formulated.

upakovanom, u prahu, sa ukusom i formulom.

We abandoned the milk of human kindness

Odustali smo od mleka ljudske dobrote

and turned our priorities elsewhere.

i preusmerili svoje prioritete.

At the National Institutes of Health

Na Nacionalnim institutima za zdravlje

in Washington DC

u Vašingtonu

is the National Library of Medicine,

nalazi se Nacionalna biblioteka medicine

which contains 25 million articles --

koja sadrži 25 miliona članaka -

the brain trust of life science and biomedical research.

stručni fond nauka o životu i biomedicinskih istraživanja.

We can use keywords to search that database,

Možemo koristiti ključne reči da bismo pretražili tu bazu podataka,

and when we do that,

a kada to uradimo,

we discover nearly a million articles about pregnancy,

otkrivamo blizu milion članaka o trudnoći,

but far fewer about breast milk and lactation.

ali daleko manje o majčinom mleku i laktaciji.

When we zoom in on the number of articles just investigating breast milk,

Kada se fokusiramo na broj članaka koji izučavaju samo majčino mleko,

we see that we know much more about coffee, wine and tomatoes.

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 --

Ne kažem da ne treba da stičemo znanja o tim stvarima -

I'm a scientist, I think we should know about everything.

ja sam naučnik i mislim da treba da saznamo sve,

But that we know so much less --

ali to što znamo toliko manje -

(Laughter)

(Smeh)

about breast milk --

o majčinom mleku -

the first fluid a young mammal is adapted to consume --

prvoj tečnosti za čiju je konzumaciju mladi sisar prilagođen -

should make us angry.

trebalo bi da nas naljuti.

Globally, nine out of 10 women will have at least one child in her lifetime.

Na globalnom nivou, devet od 10 žena će imati najmanje jedno dete u životu.

That means that nearly 130 million babies are born each year.

To znači da se svake godine rodi približno 130 miliona beba.

These mothers and babies deserve our best science.

Te majke i bebe zaslužuju najbolje od naše nauke.

Recent research has shown that milk doesn't just grow the body,

Skorija istraživanja su pokazala da ne samo da mleko obezbeđuje rast tela,

it fuels behavior and shapes neurodevelopment.

već, takođe, pokreće ponašanje i oblikuje razvoj nervnog sistema.

In 2015, researchers discovered

Godine 2015, istraživači su otkrili

that the mixture of breast milk and baby saliva --

da mešavina majčinog mleka i bebine pljuvačke -

specifically, baby saliva --

konkretno, bebine pljuvačke -

causes a chemical reaction that produces hydrogen peroxide

uzrokuje hemijsku reakciju koja proizvodi hidrogen peroksid

that can kill staph and salmonella.

koji može ubiti stafilokoke i salmonelu.

And from humans and other mammal species,

Od ljudi i drugih vrsta sisara,

we're starting to understand that the biological recipe of milk

počinjemo da razumemo da biološki recept mleka

can be different when produced for sons or daughters.

može biti različit kada se proizvodi za sinove ili ćerke.

When we reach for donor milk in the neonatal intensive care unit,

Kada posegnemo za mlekom donatora na intenzivnoj nezi novorođenčadi

or formula on the store shelf,

ili za formulom sa police u prodavnici,

it's nearly one-size-fits-all.

gotovo da je po principu „jedna veličina odgovara svima“.

We aren't thinking about how sons and daughters may grow at different rates,

Ne razmišljamo o tome kako se sinovi i ćerke mogu razvijati različitom brzinom

or different ways,

ili na različite načine,

and that milk may be a part of that.

a da mleko može biti deo toga.

Mothers have gotten the message

Majke su primile poruku

and the vast majority of mothers intend to breastfeed,

i velika većina majki namerava da doji,

but many do not reach their breastfeeding goals.

ali mnoge ne ostvare svoje ciljeve u vezi sa dojenjem.

That is not their failure;

To nije njihov neuspeh,

it's ours.

već naš.

Increasingly common medical conditions like obesity, endocrine disorders,

Sve više uobičajena medicinska stanja poput gojaznosti, endokrinih poremećaja,

C-section and preterm births

carskog reza i prevremenog rođenja

all can disrupt the underlying biology of lactation.

mogu poremetiti biologiju koja je u osnovi laktacije.

And many women do not have knowledgeable clinical support.

Mnoge žene nemaju stručnu kliničku podršku.

Twenty-five years ago,

Pre 25 godina,

the World Health Organization and UNICEF established criteria

Svetska zdravstvena organizacija i UNICEF ustanovili su kriterijume

for hospitals to be considered baby friendly --

potrebne da bi se bolnice smatrale naklonjenim bebama -

that provide the optimal level of support for mother-infant bonding

da obezbeđuju optimalni nivo podrške za vezivanje majke i bebe

and infant feeding.

i hranjenje bebe.

Today, only one in five babies in the United States

Danas se samo jedna od pet beba u Sjedinjenim Državama

is born in a baby-friendly hospital.

rodi u bolnici naklonjenoj bebama.

Ovo predstavlja problem,

This is a problem,

because mothers can grapple with many problems

jer se majke mogu suočavati sa mnogim problemima

in the minutes, hours, days and weeks of lactation.

prvih minuta, sati, dana i nedelja laktacije.

They can have struggles with establishing latch,

Mogu se mučiti sa pravilnim hvatanjem dojke,

with pain,

sa bolom,

nedostatkom mleka

with milk letdown

and perceptions of milk supply.

i percepcijom o zalihama mleka.

These mothers deserve knowledgeable clinical staff

Ove majke zaslužuju stručno kliničko osoblje

that understand these processes.

koje razume ove procese.

Mothers will call me as they're grappling with these struggles,

Majke me pozovu dok se muče sa ovim problemima,

crying with wobbly voices.

uplakane i sa drhtavim glasom.

"It's not working.

„Ne ide.

This is what I'm supposed to naturally be able to do.

Trebalo bi da sam prirodno u stanju da ovo radim.

Why is it not working?"

Zašto ne ide?“

And just because something is evolutionarily ancient

Samo zato što je nešto evoluciono staro

doesn't mean that it's easy or that we're instantly good at it.

ne znači da je lako i da nam odmah dobro ide.

You know what else is evolutionarily ancient?

Znate li šta je još evoluciono staro?

(Laughter)

(Smeh)

Sex.

Seks.

And nobody expects us to start out being good at it.

I niko ne očekuje da nam na početku dobro ide.

(Laughter)

(Smeh)

Clinicians best deliver quality equitable care

Kliničari najbolje pružaju kvalitetnu i ravnopravnu negu

when they have continuing education

kada nastave da se obrazuju

about how to best support lactation and breastfeeding.

u vezi sa time kako da najbolje podrže laktaciju i dojenje.

And in order to have that continuing education,

A da bismo imali to obrazovanje,

we need to anchor it to cutting-edge research

moramo ga zasnovati na savremenim istraživanjima

in both the life sciences and the social sciences,

kako iz nauka o životu tako i iz društvenih nauka,

because we need to recognize

jer je potrebno da prepoznamo

that too often

da previše učestalo

historical traumas and implicit biases

istorijske traume i implicitne predrasude

sit in the space between a new mother and her clinician.

stoje između novopečene majke i njenog kliničara.

The body is political.

Telo je politizovano.

If our breastfeeding support is not intersectional,

Ako podrška koju pružamo dojenju nije intersekcionalna,

it's not good enough.

nedovoljna je.

And for moms who have to return for work,

A za majke koje moraju da se vrate na posao,

because countries like the United States do not provide paid parental leave,

jer zemlje poput Sjedinjenih Država ne pružaju plaćeno roditeljsko odsustvo,

they can have to go back in as short as just a few days after giving birth.

možda će morati da se vrate čak svega nekoliko dana nakon porođaja.

How do we optimize mother and infant health

Kako da obezbedimo najbolje moguće zdravlje za majku i bebu

just by messaging about breast milk to moms

samo upućivanjem poruke majkama o majčinom mleku,

without providing the institutional support

bez pružanja institucionalne podrške

that facilitates that mother-infant bonding

koja olakšava vezivanje majke i bebe

to support breastfeeding?

da bi se potpomoglo dojenje?

The answer is: we can't.

Odgovor je - ne možemo.

I'm talking to you, legislators,

Obraćam se vama, zakonodavcima,

and the voters who elect them.

i glasačima koji su ih izabrali.

I'm talking to you, job creators and collective bargaining units,

Obraćam se vama, koji stvarate radna mesta i zastupate sindikate,

and workers, and shareholders.

radnicima i akcionarima.

We all have a stake in the public health of our community,

Svi mi imamo udela u javnom zdravlju naše zajednice,

and we all have a role to play in achieving it.

i svi igramo ulogu u njegovom dostizanju.

Breast milk is a part of improving human health.

Majčino mleko je deo poboljšanja ljudskog zdravlja.

In the NICU, when infants are born early or sick or injured,

Na Intenzivnoj jedinici neonatologije,

gde se bebe rađaju prevremeno, bolesne ili sa povredama,

milk or bioactive constituents in milk can be critically important.

mleko ili bioaktivni sastojci u mleku mogu biti od kritičnog značaja.

Environments or ecologies,

Za životnu sredinu, ekologiju,

or communities where there's high risk of infectious disease,

ili zajednice u kojima postoji visok rizik od infektivnih bolesti,

breast milk can be incredibly protective.

majčino mleko može biti neverovatna zaštita.

Where there are emergencies like storms and earthquakes,

Tamo gde nastanu vanredne situacije poput oluja i zemljotresa,

when the electricity goes out,

kada nestane struje,

when safe water is not available,

kada čista voda nije dostupna,

breast milk can keep babies fed and hydrated.

majčino mleko može da obezbedi da bebe budu site i hidrirane.

And in the context of humanitarian crises,

A u kontekstu humanitarne krize,

like Syrian mothers fleeing war zones,

kao u slučaju sirijskih majki koje beže iz ratnih zona,

the smallest drops can buffer babies from the biggest global challenges.

najmanje kapi mogu da umanje uticaj najvećih globalnih izazova na bebe.

But understanding breast milk is not just about messaging to mothers

Međutim, razumevanje majčinog mleka

ne podrazumeva samo upućivanje poruka majkama i političkim akterima.

and policy makers.

It's also about understanding what is important in breast milk

Takođe se radi o razumevanju onoga što je važno kod majčinog mleka

so that we can deliver better formulas

da bismo obezbedili bolje formule

to moms who cannot or do not breastfeed for whatever reason.

majkama koje ne mogu da doje ili to ne čine iz bilo kog razloga.

We can all do a better job

Svi možemo da bolje poradimo

of supporting the diversity of moms raising their babies

na podršci različitih majki koje podižu svoje bebe

in a diversity of ways.

na najrazličitije načine.

As women around the world struggle

Dok se žene širom sveta bore

to achieve political, social and economic equality,

da steknu političku, društvenu i ekonomsku jednakost,

we must reimagine motherhood

moramo da iznova osmislimo majčinstvo

as not the central, core aspect of womanhood,

ne kao središnji i suštinski aspekt ženstvenosti,

but one of the many potential facets of what makes women awesome.

već kao jednu od mnogo mogućih strana onoga što čini žene fenomenalnim.

It's time.

Vreme je.

(Applause)

(Aplauz)