In many ways, parenting newborns seems instinctual.
We see a little baby, and we want to hold her. Snuggle and kiss her. Even just her smell seems magical.
Many of us think breast-feeding is similar.
"I had that idea before my first child was born," says Brooke Scelza, an evolutionary anthropologist at the University of Los Angeles, California. "I definitely thought, 'Oh, I'm going to figure that out. Like how hard can it be?' "
Although breast-feeding is easy for some women, for many new moms — including Scelza — it's a struggle. "I was shocked at how hard it was," she says.
In a survey a few years ago, 92 percent of women said they had problems in the first few days of breast-feeding. They couldn't get the baby to latch onto the nipple. They had pain. Sore nipples. And they were worried they weren't making enough milk.
"This is just surprising because breast-feeding was a critical function for child survival in the past, and if you couldn't figure it out, your infant was going to be in really big trouble," Scelza says.
It's almost like in the U.S. we've lost the breast-feeding instinct. That Western society has somehow messed it up. Scelza wanted to figure out why: What are we doing wrong?
So a few years ago, she traveled to a place with some of the best breast-feeders in the world.
In the desert of northern Namibia, there's an ethnic group that lives largely isolated from modern cities. They're called Himba, and they live in mud huts and survive off the land.
"They're cattle herders basically," Scelza says. "But they also have gardens where they grow maize, sorghum and pumpkins."
Moms still give birth in the home. And all moms breast-feed.
"I have yet to encounter a woman who could not breast-feed at all," Scelza says. "There are women who have supply issues, who wind up supplementing with goat's milk, which is not uncommon. But there's basically no use of formula or bottles or anything like that."
And Himba women make breast-feeding look easy, Scelza says. They even do it while they're walking around.
"So women will carry the babies with them on their backs, and then if the baby cries, they take the baby out, feed the baby and then put the baby on their back," she says.
Scelza and other anthropologists have come up with several hypotheses for why Himba women and women in other traditional cultures are so successful at breast-feeding.
One idea is that the mom and her newborn have long, uninterrupted contact right after birth. Since women are at home, there are no doctors and nurses whisking the infant away for weighing, fingerprinting or tests. This contact allows the newborn's suckling instincts to kick in, researchers have hypothesized.
"Farmers know that separation of mother and newborn farm animals results in ... an inability on the part of the baby to suckle," anthropologist Meredith Small writes in her book Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent.
"We have only recently become aware that human babies have the same sort of reflexes designed to seal the pact between mother and infant right after birth," Small continues. But if you take the baby away from the mom during the first hour or so, you can "derail the whole process."
The second hypothesis is that Himba women learn how to breast-feed throughout their childhood. Because women see their moms, siblings and friends breast-feed while growing up.
"Breast-feeding in public isn't stigmatized at all," Scelza says.
So by the time they have their own babies, Himba women know what to do and it appears instinctual. Here in the U.S. we hardly ever see mothers breast-feeding. So women never really learn.
Well, turns out both hypotheses aren't quite right.
"I'm telling you that's exactly what I thought was going on until I started to talk to Himba women," Scelza says.
A few years ago, Scelza interviewed 30 Himba women in depth about their experiences breast-feeding, especially in the first few days after birth. And guess what? Himba women are a lot like American women.
"Many of the women that I talked to actually struggled a lot with learning how to breast-feed," she says.
Two-thirds of the women said they had some problems at the beginning, such as pain, fear, troubles getting the baby to latch and concerns about the milk supply — just like American moms.
And their problems went beyond breast-feeding.
"Most women talked about having little knowledge about early infant care, such as how to hold babies or how to be sure they're sleeping safely," Scelza says.
So how do the Himba get over these problems? They have a secret weapon many American women don't, Scelza says: Grandmothers.
"When a woman gives birth, she typically goes home to her mother's compound in the last trimester of pregnancy and stays there for months after the birth," she says.
And then the new mom's mom — the grandma — shows her everything she needs to know about breast-feeding and infant care.
"Their mothers actually sleep in the hut with them after birth and wake up the new mom and say, 'It's time to feed your baby! It's time to feed your baby!" Scelza exclaims.
So it's really not that we've lost the natural instinct for breast-feeding. But instead we no longer have a grandma around 24/7 to be a teacher. We've lost the guidance. We've lost the support.
"As I started to read about this [Himba practice] you can find so many examples of this in so many cultures," Scelza says.
For example, there's a small ethnic group in the Ivory Coast, called Beng. In their community, a woman learns to breast-feed from other moms, anthropologist Alma Gottlieb describes in her book The Afterlife Is Where We Come From.
"During the first few weeks, a newly delivered woman — especially a first-time mother ... has a constant stream of visitors, particularly women," Gottlieb writes. "Most have breast-fed many babies themselves, and they spontaneously share their nursing wisdom. Through them, a new mother is quickly socialized into accepting an almost continual round of breast-feeding suggestions dispensed by more experienced women."
In many Asian cultures, women have traditionally practiced what's called "sitting the month," or zuo yue zi in Mandarin. For 30 days, a woman stays confined in her home and is looked after by grandmothers, in-laws and aunts.
These women cook and help the new mom recover from giving birth. They also teach her how to breast-feed.
"Researchers often write about this period as a time for recuperation," Scelza says. "But I'm increasingly interested in thinking it as critical period of learning for new moms."
So it's no wonder American women struggle with breast-feeding. It would be strange if they didn't. Because women have problems breast-feeding everywhere. Moms have evolved to need help, to be taught.
"I think that there's enormous pressure to succeed with breast-feeding in the U.S. and that you feel like if you can't do it that this is a huge failing as a mother," Scelza says. But Himba women didn't seem to think the problems related to breast-feeding were a big deal.
"When [the baby] had trouble latching, they were just like, 'Yeah, this is part of what you have to learn if you're going to breast-feed," she says. "They didn't stigmatize the failing."
Tell us a tradition about breast-feeding in your culture. Send an email to firstname.lastname@example.org with the subject line "Breastfeeding" and we'll consider it for a possible story on NPR.org.
RACHEL MARTIN, HOST:
Today in Your Health, we're going to learn about the secrets of breast-feeding. Many women want to breast-feed and they try to, but only about half keep it up. It's like we have lost the instinct in some way.
DAVID GREENE, HOST:
And there is a researcher who thinks that she has figured out why and also how to get the instinct back. Here's NPR's Michaeleen Doucleff.
AMARA SCHUMACHER: (Crying).
MICHAELEEN DOUCLEFF, BYLINE: Little Amara Schumacher (ph) is only 5 days old, and she's very hungry. She's lying on her mother's bare chest trying to nurse.
MARELLA ABUNAYAN: There you go. There you go.
DOUCLEFF: But she can't get the hang of it.
ABUNAYAN: I know. I know. It's right there.
DOUCLEFF: Amara's mom, Marella Abunayan (ph), desperately wants to breast-feed, but the baby isn't getting enough milk. She has already lost nearly 10 percent of her body weight. The pediatrician is worried. So is her dad, Scott.
SCOTT SCHUMACHER: The problem is you get to the hospital, I mean, they give you the baby. And they don't really tell you what to do.
DOUCLEFF: So Amara hasn't been nursing correctly, and she damaged Marella's breast.
ABUNAYAN: Oh, my God. She was off to the side of my nipple just, like, chomping on my areola, like, and bruising it. I was like, what did we do to you, you poor thing?
DOUCLEFF: And then that makes it harder and harder.
SCHUMACHER: Yeah, that...
ABUNAYAN: Yeah, I'm in pain. She's starving. It's...
SCHUMACHER: And she's getting frustrated.
DOUCLEFF: And not getting enough food.
SCHUMACHER: We definitely need some help.
DOUCLEFF: Scott and Marella aren't alone. Researchers at UC Davis Medical Center have found that more than 90 percent of new moms have problems breast-feeding at the beginning. A year and a half ago, I was one of them.
(SOUNDBITE OF ARCHIVED RECORDING)
DOUCLEFF: At this point, I'm about 33 days into breast-feeding, and I have to say that (crying) I really want to quit. It's so much harder than I thought it was going to be.
For almost all mammals, breast-feeding is basically an instinct. It's automatic. If you have any doubt of this, just search on YouTube for puppies nursing, and you'll see the instinct in action.
(SOUNDBITE OF YOUTUBE VIDEO)
UNIDENTIFIED MAN: Good girl. There you go.
DOUCLEFF: In one video, a little pit bull puppy with his eyes closed and his body wet crawls to his mom's chest, nuzzles in and starts nursing.
(SOUNDBITE OF YOUTUBE VIDEO)
UNIDENTIFIED MAN: Good girl, Brandy (ph). Go ahead. You're a good girl. You're a good girl, Mom.
DOUCLEFF: It's easy. It's beautiful. And it's exactly the opposite of what happens with so many moms in the U.S. Brooke Scelza is an evolutionary anthropologist at UCLA. She says women have a huge number of problems breast-feeding. They have pain, infections, low supply of milk and about half can't get the baby to latch onto the nipple.
BROOKE SCELZA: Which is surprising - right? - because this is a really critical function for child survival. And if you can't figure this out, your infant is going to be in really big trouble.
DOUCLEFF: It's almost like in the U.S. we've lost the breast-feeding instinct, that Western society has messed it up somehow. Scelza wanted to figure out why, what we've lost, what are we doing wrong.
So a few years ago, she traveled to a place with some of the best breast-feeders in the world. In northern Namibia, along the coast of Western Africa, there's a rocky desert where a tribe still lives a lot like they did hundreds of years ago. They're called Himba.
SCELZA: They're cattle herders, basically, but they also have gardens where they grow maize and pumpkins and things like that.
DOUCLEFF: Moms still give birth in the home in mud huts, and all moms breast-feed.
SCELZA: There's basically no use of formula or bottles or anything like that in this community.
DOUCLEFF: She also says Himba women make breast-feeding look easy. They even do it while they're walking around.
SCELZA: So women will carry the babies with them on their backs, and the baby cries, they take the baby out, feed the baby, put the baby to sleep.
DOUCLEFF: Scelza and many researchers have thought this might be the reason why Himba are so successful at breast-feeding. They see it all the time while they're growing up.
SCELZA: It's not stigmatized at all.
DOUCLEFF: They see their moms do it, their friends, their siblings. But in the U.S., we hardly ever see mothers breast-feeding, so we never learn. Turns out, that idea is completely wrong.
SCELZA: Yeah, well, I'm telling you, that's exactly what I thought was going on until I started to talk to people.
DOUCLEFF: Scelza interviewed dozens of Himba women, and guess what?
SCELZA: Many of the women that I talked to actually struggled a lot with learning how to breast-feed.
DOUCLEFF: Many women had all the problems American women have - pain, sore nipples, they can't get the baby to latch. So how do Himba women get over these problems? Scelza says they have a secret weapon that many American women don't.
DOUCLEFF: Grandmas - that's right, the new mom's mom.
SCELZA: When a Himba woman gives birth, she - typically, she goes home to her mother's compound, and she stays there for months after the birth.
DOUCLEFF: And the grandma shows her everything she needs to know about breast-feeding.
SCELZA: What to do, when to do it, how to get the baby to latch, how to hold the baby - so really giving them a lot of direct guidance.
DOUCLEFF: So what our culture has lost is having a grandma around 24/7 to be a teacher, a guide. But there is a way of getting this help back, at least partially. In fact, many health insurers will pay for the next best thing to a Himba grandma.
SCHUMACHER: Hey, how's it going?
CAROLEEN CAHAVE: Hi, Scott.
DOUCLEFF: Back in San Francisco, that's just what Marella and Scott have done.
SCHUMACHER: Good, good.
DOUCLEFF: They've hired Caroleen Cahave (ph), a certified lactation consultant. She's come to their home to teach Marella all the tricks of breast-feeding...
DOUCLEFF: ...Like using a pump to help the milk start flowing, massaging the breast and putting pillows underneath the baby to get her in the right position.
CAHAVE: If you want to help her and get her a little bit more on this side, that's OK. There you go. Perfect. Perfect.
DOUCLEFF: And then Cahave does something that's almost unbelievable. She shows Marella a trick that's exactly what Himba women do to get newborns to latch.
CAHAVE: You can kind of scissor - yeah, scissor is great. Perfect.
DOUCLEFF: She uses her two fingers to make a scissor motion around her breast to help Amara latch on.
DOUCLEFF: Then almost like magic, Amara opens her mouth...
CAHAVE: In your mouth.
ABUNAYAN: Oh, my God.
DOUCLEFF: ...Starts nursing.
CAHAVE: She's doing it.
ABUNAYAN: Yeah (laughter).
DOUCLEFF: Once she got the hang of it, Amara quickly gained weight. And a few weeks later, Marella was a breast-feeding pro, even nursing while carrying Amara in a sling, just like a Himba woman. And for those of you wondering, I also got help with a lactation consultant and made it through.
Michaeleen Doucleff, NPR News.
(SOUNDBITE OF ARLISS PARKER'S, "TAKEN TO ANTRIM") Transcript provided by NPR, Copyright NPR.