Canadians have grown accustomed to the sight of breastfeeding moms at coffee shops, libraries and shopping malls. But what about in an indoor pool?
When a mother was asked to stop breastfeeding her 20-month-old daughter in a Newmarket, Ont., swimming pool last month, the case sparked an uproar that pitted breastfeeding advocates against those who can't get past the ick factor in that setting.
The mother, Cinira Longuinho, is asking the Ontario Human Rights Commission to investigate whether her right to breastfeed was violated. The pool owner, Ellie Karkouti, says she was concerned for the baby's health and the health of other swimmers.
Some jurisdictions in Canada have pool safety regulations that group breast milk and baby vomit among the body fluids that can cause a pool to be shut down for cleaning.
In Newmarket, there is no municipal policy banning mothers from breastfeeding in pools, town spokeswoman Wanda Bennett says.
Women are encouraged to breastfeed anywhere they like, she said.
Trying to keep breastfeeding women out of pools, whether backed up by policy or not, may stem from the fact that pools are wet environments and thus widely considered a breeding ground for bacteria, says Allison McGeer, director of infection control at Toronto's Mount Sinai Hospital. But Dr. McGeer and other health experts say there is no cause for concern for the breastfed child or the swimmers.
Breastfeeding in a pool doesn't increase children's exposure to bacteria, since they've presumably already been submerged in the water, Dr. McGeer says. Healthy toddlers encounter bacteria everywhere they go and in their food, she adds. "You are counting on the chlorination of our public pools, there's no doubt about it. That's important."
And the chlorine itself isn't much of a concern, says Madeleine Harned, a lactation consultant at BC Children's Hospital who said she would not advise mothers in her care against breastfeeding in a pool. "There's chlorine in tap water."
Gideon Koren, director of the Motherisk program at the Hospital for Sick Children in Toronto, says any arguments about a baby's welfare used to ban a woman from breastfeeding in a pool are based on "pseudoscience." And, "when people use pseudoscience to make scientific arguments, it becomes very suspicious. It's very aggressive nonsense."
As for the fear that the breast milk itself may contaminate pool water, Dr. McGeer dismisses the idea. Unlike urine and excrement, breast milk is sterile. "A little bit of breast milk getting into the pool is not an issue," she says.
And baby spit-up is no different from the saliva that routinely gets in the pool, according to Dr. McGeer. While a baby vomiting in a pool may be gross - "I can see us not wanting to see it," she says - it's not infectious. It has little bacterial growth in it, she says.
When it comes to blood-borne illnesses that may be carried by the mother, Dr. McGeer says HIV-positive mothers are discouraged from breastfeeding and a mom with hepatitis B would only be infectious if her breasts were cracked and bleeding into the breast milk. In that case, regulations prohibiting swimming with open sores would presumably apply.
Instead, experts say, this case highlights a lingering difficulty with public breastfeeding.
"When push comes to shove, we still have trouble with breasts in public. We know we shouldn't, but we do," Dr. McGeer says.