Breastfeeding and Mothering in Denmark
State College, PA USA
From: New Beginnings, Vol. 29 No. 5-6, 2009, pp. 56-59
Ninety-nine percent of mothers in Scandinavia breastfeed their babies. I recently visited Denmark to find out more about this phenomenal statistic and this remarkable country. Denmark, the smallest country in Scandinavia, has a land area of only 16,621 square miles, equivalent to a very small state in the US, and a population of roughly five and a half million, about the same as the state of Maryland. With a strong policy of protecting natural resources, Denmark is one of the greenest countries in the world. The public transportation is outstanding and there are bike lanes on nearly every street. The toilets offer the choice of flushing with an entire tank or half a tank. Danes turn the lights out when they leave a room. They would not want to waste precious resources; water and electricity are expensive. So is coffee. A cup of coffee or tea costs about four US dollars.
While participating in a Rotary Group Study Exchange program, I wanted to learn about the Danish health care system and I was very interested to know about the unusually high rate of women who breastfeed their babies in Denmark. The Rotary clubs in Denmark arranged for me to meet with a wide variety of people so that I could ask specific questions about the health care system, infant mortality, and breastfeeding.
Many people in Denmark were curious why I was so interested in their health care system and breastfeeding. I shared with them that the US spends 16 percent of its Gross Domestic Product (GDP) on health care, compared to Denmark's eight percent; that we lose over six of every 1,000 babies in the first year of life, compared to four of every 1,000 in Denmark; and that only about 70 percent of mothers in the US initiate breastfeeding, compared to 99 percent of mothers in Scandinavia. This usually enlivened our conversation, and as I listened to the Danes tell me about their everyday life and views on the health care system, I fell in love with Denmark.
The Danish people are very proud of their health care system and were delighted to share information with me. Many of them mentioned that it was important to them that everyone in their country has access to health care. Everyone is treated the same in the public system and everyone has equal care. All those I spoke with wanted to know if I would send my findings to President Obama; I assured them that I would.
When talking about the amazingly high breastfeeding initiation rate, one mother, who is now 61 years old, said:
"When you get pregnant and go to see your midwife, you get a lot of papers and information on how important it is to breastfeed your child. All mothers know that it is important for the baby and that it is the easiest and cheapest way to feed your baby. It is very expensive to buy all that formula and bottles."
It is clearly culturally acceptable for women to nurse their children in Denmark. Mothers are educated about the benefits of breastfeeding before they give birth and are provided with excellent health care. During a typical pregnancy, a woman sees both a midwife and a doctor. As long as the labor and delivery are normal, a midwife will be there to support the mother and deliver the child. If there are any problems, a doctor will intervene. The Danes love their health care system and it provides them with the opportunity to go to a doctor or midwife as frequently as needed, without any additional cost. Danes pay for health care through taxes; currently the average income tax is about 50 percent, considerably higher than the US tax rate of about 30 percent.
In several hospitals I had the chance to talk at length with many different health care providers, including a pediatrician, emergency medicine physician, anesthesiologist, several nurses, midwives, and a midwifery student. All of the people I spoke with in the hospitals were enthusiastic about breastfeeding. Most of these providers were women, and most of them were mothers who had successfully breastfed their own children. (I should note here that the student studying to be a midwife was also excited to show me the scooter she used to scoot around the hospital on errands.)
After a baby is born, mothers and fathers are given additional education on breastfeeding and the health of the mother and baby, both in the hospital and at home. The health care system has a program in place for health nurses to visit new mothers in their homes and provide them with needed support. In the town of Solrød I had the chance to spend time with two health nurses that make such home visits.
The first visit of the day was to a group of mothers in the small rural village of Havdrup in the region of Solrød. Each had a two-month-old baby. Most of the mothers could walk to this "moms' group," even though we were in a farming area, as the farms are situated in such a way that the village homes are close together. This is typical for most rural towns and villages. Denmark as a country has excellent land use and development planning, as well as transportation. In addition to driving, there are many other transportation options in most areas -- walking, biking, trains, and buses.
Lise, the health education nurse, coordinated this first moms' group for the new mothers. She asked one of the mothers to host the first gathering in her home; after this, the moms will decide the meeting times and places. The mothers enjoyed meeting one another and having a chance to ask questions. I observed much active listening on Lise's part and she did an excellent job of giving encouragement. The mothers asked Lise to weigh their babies and some asked her questions privately. This gathering reminded me very much of a La Leche League meeting. Many Danish mothers that I spoke with said that the friends made through such moms' groups became some of their closest lifelong friends.
I then had the chance to make a home visit with lead nurse, Dawn. She informed me that Solrød has 21,000 residents and roughly 250 births per year. They have eight nurses on staff who do home visits to support the mothers and babies.
Hannah's baby was asleep when we arrived at her home and Hannah was very thankful that we were coming to check on them. She had a list of questions ready, and Dawn was able to give her much-needed support. The Danes realize that mothering is one of the toughest jobs of all, and by providing these home visits, they try to provide mothers with the tools needed to be successful.
Many health care providers, administrators, and consumers whom I interviewed spoke of the importance of mothers being able to take time off from their outside employment. Most women stop working outside the home four weeks before their due date, giving them time to prepare for the birth of their baby. Many people mentioned how critical it is for mothers and babies to spend time together. All women in Denmark have six months of paid maternity leave, most take an additional six months off after that, and sometimes the fathers use some of their parental leave. For most people it is a priority to have their children spend their first year of life at home; these long maternity leaves clearly play an important role in the initiation and duration of breastfeeding.
I found two LLL Leader Applicants in Denmark and enjoyed speaking with them one afternoon. I was interested in their views and they asked me a lot of questions about how LLL operates. They were very positive about breastfeeding in general, but less enthusiastic about the Danish visiting health nurse program than I was, noting that sometimes the nurses are not prepared to answer specific questions about special situations. The formal education of health care professionals does not include breastfeeding as a separate topic, and perhaps that is a need that's not been met, as is also true in the US. There are not yet any LLL Leaders in Denmark, and I encouraged them to continue with their training. Once they are accredited as Leaders and can offer meetings, they will provide a forum for mothers to discuss important issues related to breastfeeding and be able to give unique support to mothers in Denmark beyond what is currently supplied by health care providers.
In such a small country in which precious commodities are well conserved, the residents seem to understand that good parenting, including breastfeeding, is an essential resource worthy of protection and support.