Thinking like an economist, about breastfeeding in Japan

Our start-of-class essays invite students to begin “thinking like an economist” by describing a familiar thing as a three-part story: (a) your own decisions, (b) the decisions of other people with whom you interact, and (c) the rules or technologies that guide interactions. The first step requires only introspection, about our own goals and limitations, and the degree to which we’ve done the best we can given our constraints. The second requires empathy, to see other peoples’ actions as choices that they’ve made under conditions that differ from yours. The third step is hardest of all, requiring imagination about how societal outcomes might differ if we lived under different rules or with different technologies. Here’s the start-of-class essay from Natsuko Seki, an MNSP student from Japan:

For the first six months of my son’s life, I wanted to feed him breastmilk exclusively, following WHO recommendations to raise him up healthy. For this exercise I would like to share my experience when I traveled to the US.

My choice

Last January, I went to Boston for ten days to attend in-person classes required to complete my master’s degree. I had to choose whether I brought my four-month-old boy to Boston or left him in Japan. To achieve my breastfeeding goal, the former choice seemed preferable, but I was scared to break his stable sleeping cycle by exposing him to a huge time gap. Since this cycle was critical for me and my husband to stay in good health, I decided to leave him in Japan and tried my best to freeze as much milk as possible for my absent days. During the residency classes, I also pumped every four hours or so to keep my breast producing milk. In the end, my son had to be fed some infant formula along with my breastmilk for a period of about one month, because the frozen milks were not enough and my ability to produce milk declined while we were separated. However, his sleep cycle was kept.

Other people’s choice

My family -Since my husband was working, it was impossible for him to either come to Boston with our son or look after him alone in Japan. Therefore, we asked my mother to help us. She respected my needs and didn’t say her desires clearly, but I knew that going to Boston with us would be harder for her because she doesn’t speak English, so she took care of my son in Japan while I was away. In fact she was pleased this rare opportunity to interact with her grandson because she lives far away and doesn’t get to see him very often.

Infant milk companies – The Japanese birthrate is low so the infant formula market is not so big, and it is not easy for them to have high sales. Their efforts to sell more start even before infants are born — they distribute samples in the hospital, and that actually worked with me. I selected the brand for my son’s supplemental milk from the samples I received at the hospital.

Societal rules

The Japanese Ministry of Health, Labor and Welfare has guidelines for infant and young child feeding that call for appropriate supports, including the use of infant milk if necessary, to help mothers meet children’s needs. In Japan, where there are many concerns about postpartum depression and repeated cases of breastmilk being sold and bought on the internet, exclusive breastfeeding may not the most prioritized measure to protect mother and child’s health. In other countries, a greater focus on just exclusive breastfeeding may be needed, but the Japanese government’s stance allows companies to distribute milk samples at the hospital and that had an influence on my choice.