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

譯者: Wendy Chen 審譯者: Ming Lee

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

你們有聽過，

媽媽哺乳嬰兒提供的是免費餐嗎？

(Laughter)

（笑聲）

Yeah, it's pretty funny,

真的蠻可笑的……

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

只有在你不把 女人付出的時間和精力，

當作一回事的時候，

你才能說嬰兒餐是免費的。

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

任何母親都能告訴你， 這有多耗時間和精力。

to liquify her body --

把自己的身體液化──

to literally dissolve herself --

可以說是把自己溶化掉──

(Laughter)

（笑聲）

as she feeds this precious little cannibal.

來餵這個可愛的食人族寶寶。

(Laughter)

（笑聲）

Milk is why mammals suck.

奶是哺乳動物吸吮的原因。

At Arizona State University,

在亞利桑那州立大學 比較哺乳學實驗室裡，

in the Comparative Lactation Lab,

I decode mothers' milk composition

我剖析母乳的成分，

to understand its complexity

去了解其複雜性，

and how it influences infant development.

以及它如何影響嬰兒的發育。

The most important thing that I've learned

我學到最重要的，

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

是我們缺乏母親和嬰兒之扶助。

And when we fail mothers and babies,

當母親和嬰兒獲得的支持不足時，

we fail everyone who loves mothers and babies:

我們也辜負了 所有愛母親和嬰兒的人。

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

父親們、伴侶們、 祖父母們、阿姨們、

the friends and kin that make our human social networks.

親友們，和我們 社會中的人倫網絡成員。

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

現在是我們該捨棄簡單的解決方案

或簡單的口號，

and grapple with the nuance.

去了解其個中的細微好壞的時候了。

I was very fortunate

我很幸運，

to run smack-dab into that nuance very early,

很早就能意識到這個細微的差異，

during my first interview with a journalist

在我第一次受記者採訪的時候。

when she asked me,

她就問我：

"How long should a mother breastfeed her baby?"

「媽媽應該用母乳 餵養她的寶寶多久呢？」

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

就是這個詞「應該」 ， 讓我思考了很久，

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

因為我永遠不會告訴一個女人 她「應該」用她的身體做什麼。

Babies survive and thrive

寶寶能生存和茁壯成長，

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

是因為母乳是寶寶的 食物、藥物和信號。

For young infants,

對於數周的嬰兒，

mother's milk is a complete diet

母乳是一種全面的營養飲食，

that provides all the building blocks for their bodies,

提供他們身體所要的所有必需物，

that shapes their brain

塑造了嬰兒的大腦，

and fuels all of their activity.

並為其所有的活動提供燃料。

Mother's milk also feeds the microbes

母乳也餵養著那些，

正在嬰兒腸道內繁殖的微生物。

that are colonizing the infant's intestinal tract.

Mothers aren't just eating for two,

母親飲食不只是為兩個人在吃而已，

they're eating for two to the trillions.

同時也是為了數億個微生物在吃。

Milk provides immunofactors that help fight pathogens

乳汁提供有助於 打擊病原體的免疫因數，

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

母乳提供向嬰兒身體 發出信號的激素。

But in recent decades,

但近幾十年來，

we have come to take milk for granted.

我們忽略了乳汁的重要性。

We stopped seeing something in plain sight.

我們對這明顯的事情視若無睹：

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

我們開始視乳汁為標準化、 均質處理、殺菌過、

packaged, powdered, flavored and formulated.

包裝的、粉末狀的、 加添風味、和科學配方的。

We abandoned the milk of human kindness

我們捨棄了人類的母乳，

and turned our priorities elsewhere.

並把我們的重心放在別處了。

At the National Institutes of Health

位於美國國立衛生研究院內，

in Washington DC

在華盛頓特區，

is the National Library of Medicine,

座落著美國國家醫學圖書館。

which contains 25 million articles --

它存放著 2500 萬個文檔──

the brain trust of life science and biomedical research.

是生命科學和生物醫學研究 寶貴資料收藏地。

We can use keywords to search that database,

我們可以使用關鍵字 來搜索該資料庫，

and when we do that,

當我們這樣做時，

we discover nearly a million articles about pregnancy,

我們發現近一百萬篇 關於懷孕的文章，

but far fewer about breast milk and lactation.

但關於母乳和哺乳期的就少多了。

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

當我們再深入查看 關於母乳的專題文章數量時，

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

我們看到，原來我們更了解 咖啡、葡萄酒和番茄。

(Laughter)

（笑聲）

We know over twice as much about erectile dysfunction.

而我們對於勃起功能障礙的了解 更是兩倍之多。

(Laughter)

（笑聲）

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

我不是說，我們不應該 知道這些事情──

我是科學家， 我想我們應該知道一切事物的。

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

But that we know so much less --

但同時我們也知道， 我們懂得也太少了。

(Laughter)

（笑聲）

about breast milk --

但動物的母乳──

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

是新生哺乳動物寶寶 第一口喝到的流體食物──

should make us angry.

這應該讓我們覺得生氣。

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

在全球，10 名女性中有 9 名會在 她一生中至少生一個孩子。

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

這意味著每年有近 1.3 億嬰兒出生。

These mothers and babies deserve our best science.

這些母親和嬰兒 值得我們最好的科學協助。

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

最近的研究更證明， 奶類不僅使身體發育長大，

it fuels behavior and shapes neurodevelopment.

它影響我們的表現， 更領導著神經發展的方向。

In 2015, researchers discovered

在 2015 年，研究人員發現，

that the mixture of breast milk and baby saliva --

母乳和嬰兒唾液的混合物 ，

specifically, baby saliva --

特別是嬰兒之唾液 ，

causes a chemical reaction that produces hydrogen peroxide

能引起化學反應而產生過氧化氫，

that can kill staph and salmonella.

來殺死葡萄球菌和沙門氏菌。

And from humans and other mammal species,

而從人類和其他哺乳動物來看，

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

我們開始明白了， 奶類在成分對於生物的重要性。

can be different when produced for sons or daughters.

母奶分泌的成分 會因嬰兒的性別而改變。

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

當我們為新生兒加護病房 拿取捐贈者奶時，

or formula on the store shelf,

或在架上的嬰兒配方牛奶時，

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

它們都是一體適用的。

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

我們忽略了男嬰或女嬰 會以不同的速度成長，

or different ways,

甚至以不同的方式，

and that milk may be a part of that.

而奶類可能是其中的一部分成因。

Mothers have gotten the message

很多母親已經明白和接受這信息，

and the vast majority of mothers intend to breastfeed,

而大多數的母親 也決定用母乳撫育嬰兒，

but many do not reach their breastfeeding goals.

但還是很多人沒有達到 她們的哺乳目標。

That is not their failure;

這不是她們的失敗，

it's ours.

而是我們的。

Increasingly common medical conditions like obesity, endocrine disorders,

日益普遍的醫療狀況 像肥胖、內分泌失調、

C-section and preterm births

剖腹產和早產嬰兒，

all can disrupt the underlying biology of lactation.

所有這些都可能破壞泌乳之生物學。

And many women do not have knowledgeable clinical support.

許多女人都沒獲得 有經驗人員的臨床支持。

Twenty-five years ago,

二十五年前，

the World Health Organization and UNICEF established criteria

世界衛生組織和兒童基金會制定了，

for hospitals to be considered baby friendly --

「寶寶友好醫院」認證的準則，

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

來提供最有效的方法 幫助母親和嬰兒建立關係，

and infant feeding.

和嬰兒餵養。

Today, only one in five babies in the United States

今天在美國只有五分之一的嬰兒

is born in a baby-friendly hospital.

是出生在寶寶友好醫院。

This is a problem,

這就是個問題，

because mothers can grapple with many problems

因為母親們要面對很多

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

在哺乳期漫長時間中遇到的問題。

They can have struggles with establishing latch,

她們可能遇到嬰兒 不能順利含乳的問題，

with pain,

或感到疼痛，

with milk letdown

或泌乳反射，

and perceptions of milk supply.

及母乳產量的錯誤認知。

These mothers deserve knowledgeable clinical staff

這些母親都該獲得對過程孰悉， 且經驗豐富的臨床人員之協助。

that understand these processes.

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

遇到困難時， 這些母親會打電話給我，

crying with wobbly voices.

顫抖的哭音說：

"It's not working.

「做不到啊，

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

這是母性自然該能做的，

Why is it not working?"

為什麼不行呢？」

And just because something is evolutionarily ancient

雖然這些是自古進化而來的事，

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

但不意味我們一定也能。

You know what else is evolutionarily ancient?

你知道還有什麼 是上古以來就有的嗎？

(Laughter)

（笑聲）

Sex.

性交配。

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

也沒有人期望我們 從一開始就很擅長的。

(Laughter)

（笑聲）

Clinicians best deliver quality equitable care

臨床醫生能提供最佳的護理。

when they have continuing education

他們要繼續接受教育

about how to best support lactation and breastfeeding.

學習如何有效支持哺乳期 和母乳餵養。

And in order to have that continuing education,

為了繼續推動這種教育，

we need to anchor it to cutting-edge research

我們必需同時在生命和社會科學，

in both the life sciences and the social sciences,

都注入尖端的研究基礎，

because we need to recognize

因為我們需要察覺到，

that too often

很多時候，

historical traumas and implicit biases

歷史的創傷和隱性偏見，

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

常常存在於新手媽媽， 和她們的臨床醫生之間。

The body is political.

人體是政治化的。

If our breastfeeding support is not intersectional,

如果對於母乳喂養的支持 不能彼此產生互動的話，

it's not good enough.

就代表它還不夠好。

And for moms who have to return for work,

而對急著返回工作的媽媽，

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

因為像美國這樣的國家 是不提供帶薪育嬰假的，

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

媽媽可能在生育後幾天就回家。

How do we optimize mother and infant health

我們怎能優化母親和嬰兒健康，

just by messaging about breast milk to moms

如果只是傳遞 母乳好處的訊息給媽媽，

without providing the institutional support

而沒有體制上的支援，

that facilitates that mother-infant bonding

那種促進母乳餵養嬰兒的支持 ，

to support breastfeeding?

我們怎麼可能成功呢?

The answer is: we can't.

答案是：我們是無法成功的。

I'm talking to you, legislators,

我是在向立法委員 和你們的選民呼籲，

and the voters who elect them.

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

還有老闆們、工會們

and workers, and shareholders.

員工們和股東們。

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

我們對社區公共衛生 負有成敗的責任，

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

我們都要扮好各自的角色 來促使它成功。

Breast milk is a part of improving human health.

母乳是改善人類健康之一環。

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

在新生兒加護病房， 當嬰兒早產或生病受傷時，

milk or bioactive constituents in milk can be critically important.

母乳和其中的生物活性成分 是至關重要的。

Environments or ecologies,

在生活、生態環境，

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

或社區中有高風險傳染病時，

breast milk can be incredibly protective.

母乳可以發揮令人難以置信的保護。

Where there are emergencies like storms and earthquakes,

發生緊急情況像颱風和地震，

when the electricity goes out,

當電力供應停止時，

when safe water is not available,

當飲用水沒有時，

breast milk can keep babies fed and hydrated.

母乳仍可以餵養嬰兒和提供水份。

And in the context of humanitarian crises,

而且在人道危機的情況下，

like Syrian mothers fleeing war zones,

像母親逃離敘利亞戰區之時候，

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

只要一滴的母乳，

就能讓嬰兒在面臨生死一刻時， 還擁有一線生機。

But understanding breast milk is not just about messaging to mothers

但是要讓人了解母乳撫育的觀念，

不能只靠提供 母親或決策者訊息而已。

and policy makers.

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

還要去了解母乳的重要成分是什麼，

so that we can deliver better formulas

這樣才能提供更佳的嬰兒配方奶粉，

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

給那些不能、或不願意親餵的媽媽。

We can all do a better job

我們大家都可以做得更好，

of supporting the diversity of moms raising their babies

來支持媽媽們來養育她們的寶寶，

in a diversity of ways.

以多元化的方式。

As women around the world struggle

當世界各地的婦女，

to achieve political, social and economic equality,

為實現政治、 社會和經濟平等奮鬥時，

we must reimagine motherhood

我們必須重新思考母親的身分；

as not the central, core aspect of womanhood,

這不是女性扮演的唯一核心角色，

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

而是女性如此偉大的 一個潛在原因。

It's time.

現在該是時候了。

(Applause)

（掌聲）