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

翻译人员: 小布 陈 校对人员: Jiawei Ni

Have you ever heard the one about how breastfeeding is free?

你听说过“母乳是免费的”言论吗？

(Laughter)

（笑声）

Yeah, it's pretty funny,

是的，有意思

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

如果我们不算上母亲的时间和精力的话，你可以说母乳是免费的。

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

任何一位母亲都可以告诉你，

她花了多少时间和精力来产奶，

to liquify her body --

to literally dissolve herself --

好不夸张的说，就是溶解了自己，

(Laughter)

（笑声）

as she feeds this precious little cannibal.

当她喂养这个珍贵的小食人族的时候。

(Laughter)

（笑声）

Milk is why mammals suck.

乳汁是哺乳动物会吮吸的原因。

At Arizona State University,

在亚利桑那州立大学

in the Comparative Lactation Lab,

在比较教育学实验室里，

I decode mothers' milk composition

我解码了母乳的组成成分，

to understand its complexity

来理解它的复杂性，

and how it influences infant development.

和它怎样影响婴儿的成长。

The most important thing that I've learned

我学到的最重要的东西，

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

是我们在支持母亲和孩子方面做的还远远不够。

And when we fail mothers and babies,

当我们令母亲和孩子失望的时候，

we fail everyone who loves mothers and babies:

我们会使任何爱着母亲和孩子的人失望：

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

父亲，伴侣，祖父母，姨妈，

the friends and kin that make our human social networks.

朋友，亲戚，这些组成人类社交关系网里的人

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

是时候让我们抛弃简单的方法和简单的口号，

and grapple with the nuance.

来深入研究这细微的区别。

I was very fortunate

我是很幸运的，

to run smack-dab into that nuance very early,

能很早就发现了那些细微区别，

during my first interview with a journalist

是在我第一次的记者采访中。

when she asked me,

当她问我，

"How long should a mother breastfeed her baby?"

“一位母亲应该母乳喂养一个孩子多久？”

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

就是那个词“应该” 刺激到了我，

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

因为我从来不会告诉一位女性，她应该对她的身体做些什么。

Babies survive and thrive

婴儿生存和生长，

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

是因为母乳是他们的食物，药物和信号。

For young infants,

对于小婴儿而言，

mother's milk is a complete diet

母乳是完全的健康食物，

that provides all the building blocks for their bodies,

提供了所有身体需要的养分，

that shapes their brain

促进大脑发育成形，

and fuels all of their activity.

提供他们活动的能量。

Mother's milk also feeds the microbes

母乳同样提供一些微生物，

that are colonizing the infant's intestinal tract.

存储在婴儿的肠道里，

Mothers aren't just eating for two,

母亲不只是为了两个人而吃，

they're eating for two to the trillions.

她们为了两个甚至万亿的“人”而吃。

Milk provides immunofactors that help fight pathogens

母乳提供了免疫因子来抵抗病菌，

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

母乳提供了荷尔蒙向婴儿的身体发出信号。

But in recent decades,

但是最近这些年，

we have come to take milk for granted.

我们理所当然的开始使用牛奶。

We stopped seeing something in plain sight.

我们对显而易见的事情避而不见。

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

我们开始把牛奶分类为标准的，均质的，巴氏消毒的，

packaged, powdered, flavored and formulated.

包装的，奶粉状的，调味的或者配方的。

We abandoned the milk of human kindness

我们放弃了在牛奶中注入人类爱心，

and turned our priorities elsewhere.

而是将首要原则转移到了其他方面。

At the National Institutes of Health

在华盛顿特区的

in Washington DC

国立卫生研究院

is the National Library of Medicine,

是医学的国家图书馆。

which contains 25 million articles --

这里收藏了2500万的文献：

the brain trust of life science and biomedical research.

生命科学和生物研究的智囊团。

We can use keywords to search that database,

我们可以用关键词来搜索数据，

and when we do that,

当我们这么做的时候，

we discover nearly a million articles about pregnancy,

我们发现了将近一百万的文章是关于怀孕的，

but far fewer about breast milk and lactation.

但是关于母乳喂养和哺乳期的却非常少。

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

当我们放大这些文章的数量，只搜索母乳喂养时，

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

我们发现更多是关于咖啡，酒和番茄的。

(Laughter)

（笑声）

We know over twice as much about erectile dysfunction.

我们知道的有关勃起障碍的都比这个两倍多。

(Laughter)

（笑声）

I'm not saying we shouldn't know about those things --

我不是说我们不应该了解这些事情，

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

我是一名科学家，我觉得我们应该研究所有东西。

But that we know so much less --

但是我们所知甚少的是，

(Laughter)

（笑声）

about breast milk --

有关母乳喂养方面，

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

年幼的哺乳动物可以摄入的第一种液体，

should make us angry.

这应该让我们感到愤怒。

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

全球来说，九成的女性会在生命中至少有一名孩子。

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

也就意味着每年将近有1.3亿的婴儿出生。

These mothers and babies deserve our best science.

这些母亲和孩子值得我们为他们做最好的科学研究。

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

近期的研究表明，母乳不仅仅是支持身体生长，

it fuels behavior and shapes neurodevelopment.

也影响行为和大脑生长。

In 2015, researchers discovered

2015年，研究人员发现

that the mixture of breast milk and baby saliva --

母乳和婴儿口水的混合物，

specifically, baby saliva --

尤其是婴儿的口水，

causes a chemical reaction that produces hydrogen peroxide

能够发生化学反应，来产生过氧化氢，

that can kill staph and salmonella.

（过氧化氢）可以杀死葡萄球菌和沙门氏菌。

And from humans and other mammal species,

在研究人类和其他哺乳动物时，

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

我们发现人类自然分泌的母乳，

can be different when produced for sons or daughters.

也可能因为（喂养）男孩和女孩而不同。

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

新生儿重症监护室里的捐赠牛奶，

or formula on the store shelf,

和商店货架上的配方奶，

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

那基本上是一个配方供给所有婴儿。

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

我们没有考虑到男孩和女孩成长的不同节奏，

or different ways,

或是不同方式，

and that milk may be a part of that.

（不同的）母乳可能是其中之一的原因。

Mothers have gotten the message

母亲能收到信号，

and the vast majority of mothers intend to breastfeed,

绝大部分的母亲打算母乳喂养，

but many do not reach their breastfeeding goals.

但是很多人达不到她们母乳喂养的目标。

That is not their failure;

这不是她们的失职。

it's ours.

是我们的。

Increasingly common medical conditions like obesity, endocrine disorders,

持续增长的常见身体状况，例如肥胖，内分泌失调

C-section and preterm births

剖腹产和早产，

all can disrupt the underlying biology of lactation.

都可能会干扰到深层生理上的哺乳行为。

And many women do not have knowledgeable clinical support.

很多女性没有得到专业性强的临床医务人员的支持。

Twenty-five years ago,

二十五年前，

the World Health Organization and UNICEF established criteria

世界卫生组织和联合国儿童基金会设立了一系列

for hospitals to be considered baby friendly --

爱婴医院的标准，

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

（爱婴医院）要最大化的帮助支持

建立母婴关系和婴儿喂养。

and infant feeding.

Today, only one in five babies in the United States

现在，在美国只有五分之一的婴儿

is born in a baby-friendly hospital.

是出生在这种爱婴医院里的。

This is a problem,

这是个问题，

because mothers can grapple with many problems

因为母亲在哺乳时，可能在分分钟之内，几小时里，

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

几天内，几周里遇到很多问题。

They can have struggles with establishing latch,

她们可能会在如何控制乳汁，

with pain,

疼痛，

with milk letdown

乳汁分泌，

and perceptions of milk supply.

或者是对母乳供应的看法这些方面遇到问题。

These mothers deserve knowledgeable clinical staff

这些母亲需要熟悉这些过程的

专业性强的临床医务人员。

that understand these processes.

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

母亲们在遇到这些问题的时候，

crying with wobbly voices.

会我打电话，用带着哭腔的声音说：

"It's not working.

“我做不到，

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

这是应该是我天生就能做到的，

Why is it not working?"

为什么现在做不到？”

And just because something is evolutionarily ancient

仅仅因为有些事情在进化中是相当古老的，

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

并不意味着这是简单的，或者说我们立刻就能驾驭的。

You know what else is evolutionarily ancient?

你知道还有什么是在进化中是相当古老的吗？

(Laughter)

（笑声）

Sex.

性。

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

没有人期待我们生来就擅长这个。

(Laughter)

（笑声）

Clinicians best deliver quality equitable care

临床医生能够为产妇提供最好的护理，

when they have continuing education

在他们持续接受

about how to best support lactation and breastfeeding.

一些关于如何最佳支持母乳和母乳喂养方面教育的时候

And in order to have that continuing education,

为了能使这种教育继续，

we need to anchor it to cutting-edge research

我们需要继续最先进的研究，

in both the life sciences and the social sciences,

在生命科学和社会科学方面。

because we need to recognize

因为我们需要认识到，

that too often

很常见的情况，

historical traumas and implicit biases

历史创伤和潜在偏见，

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

存在于一个新手妈妈和她的医务护理中。

The body is political.

身体是敏感的。

If our breastfeeding support is not intersectional,

如果我们对母乳喂养的支持不是相互交叉的，

it's not good enough.

那就做的不够好。

And for moms who have to return for work,

还有那些需要回到工作中去的母亲们，

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

因为像美国这样的国家，不提供带薪产假，

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

公司可以让你生产完之后几天之内，就尽快回到岗位。

How do we optimize mother and infant health

我们如何使母亲和婴儿健康最大化，

just by messaging about breast milk to moms

仅仅通过向母亲传达关于母乳喂养的信号，

without providing the institutional support

而没有提供制度支持

that facilitates that mother-infant bonding

来促进母亲和婴儿之间的关系

to support breastfeeding?

来支持母乳喂养呢？

The answer is: we can't.

答案是：我们做不到。

I'm talking to you, legislators,

我在对你们说，立法人，

and the voters who elect them.

还有那些为他们投票的人。

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

我在对你们说，提供岗位的老板，和有独立交涉权的工会单位，

and workers, and shareholders.

工人和股票持有人。

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

公共健康跟我们每个人的利益相关，

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

我们都在达成目标中担任一份角色，

Breast milk is a part of improving human health.

母乳喂养是改善人类健康的一部分。

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

在新生儿监护病房，当婴儿早产或者生病或者受伤时，

milk or bioactive constituents in milk can be critically important.

母乳或者母乳里的微生物成分可能是非常重要的。

Environments or ecologies,

环境，生态

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

社区，那些疾病易感染区，

breast milk can be incredibly protective.

母乳是非常起保护作用的。

Where there are emergencies like storms and earthquakes,

当有紧急情况发生时，比如说风暴来临或者发生地震，

when the electricity goes out,

当断电的时候，

when safe water is not available,

当缺少安全饮用水的时候，

breast milk can keep babies fed and hydrated.

母乳可以使婴儿有饭吃，不脱水，

And in the context of humanitarian crises,

在人道主义危机的情况下，

like Syrian mothers fleeing war zones,

像叙利亚的母亲们逃出战争区，

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

一小滴的母乳可以帮助婴儿面对最大的全球挑战。

But understanding breast milk is not just about messaging to mothers

但是对母乳的了解不仅仅是传达信息

给母亲们和政策制定人，

and policy makers.

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

同样也要认识到母乳中什么最重要，

so that we can deliver better formulas

因此我们可以来研究更好的配方，

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

提供给那些因为某种原因不能够或者没法母乳喂养的母亲们。

We can all do a better job

我们可以都做的更好一些

of supporting the diversity of moms raising their babies

来支持不同的母亲用不同的方式

in a diversity of ways.

来养育她们的孩子。

As women around the world struggle

当世界上的女性争取

to achieve political, social and economic equality,

政治、社会、经济平等时，

we must reimagine motherhood

我们必须重新考虑母亲的角色

as not the central, core aspect of womanhood,

不只关注中心，女性所有角色的最中心方面，

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

而是关注能凸显女性光辉的很多潜质中的这一点。

It's time.

是时候了。

(Applause)

（掌声）