Americans are expected to spend nearly $16 billion this year on Mother’s Day celebrations. It’s an impressive outpouring of appreciation – and it’s also an aberration. The other 364 days of the year, American mothers are on their own, with profound consequences for public health.

As an obstetrician, I see these consequences every day. When mom and baby leave the hospital Dad goes back to work, and older children get pulled from day care to save money. Saddled with responsibility for housework, older children and baby-care, mothers fight for even a few minutes to nurture their infants.

Three-quarters of American mothers start out breastfeeding, but more than half wean early, unable to reach the goals they set for themselves. It’s not difficult to understand why – stress interferes with the hard-wired brain circuitry responsible for mothering and nurturing babies.

In a classic experiment in 1948, researchers measured how much milk a baby took during a feeding when mom was relaxed, and then when she was stressed. They dipped her feet in ice water; they asked her complicated math problems and shocked her if she got them wrong; and they pulled on her big toe until it hurt. Each time, the baby got less milk.

The authors concluded that mothers who are stressed or in pain have trouble making milk. Their babies become frustrated and cry, making the mothers more stressed and setting up a vicious cycle. Effectively, the American new mother has her feet firmly planted in ice water. It’s no wonder that one in five mothers gives up on breastfeeding in the first month.

This early weaning is a major public health problem. In normal human biology, mother and baby remain linked in the first months after birth. A breastfeeding mother burns 500 calories a day to make milk for her baby, helping lose pregnancy pounds. The hormone oxytocin that’s produced with holding, snuggling, and feeding lowers her blood pressure and heart rate and calms her response to stress.

When this link it broken, the effects appear to last for decades. We’ve now found evidence in large studies involving hundreds of thousands of women that shortened breastfeeding is associated with higher maternal risk of heart attacks, high blood pressure and diabetes. When our culture plants a new mother’s feet in ice water, we are setting her up for a lifetime of health risks.

We’re also putting her baby at risk. The scientific evidence is clear: babies who are not breastfed face higher risks of ear infections, pneumonia and diarrhea, as well as obesity, childhood leukemia, and SIDS. We all share the burden of the resulting increase in healthcare costs, as well as the environmental impact of manufacturing, distributing, and disposing of millions of cans of infant formula.

In contrast to modern America, many traditional cultures celebrate and protect mothers and babies in these crucial first few months. Consider the rural Philippines: after a birth, a mother does not work for two months. Her own mother tends to mom and baby and does all the housework for eight weeks, while neighbors plow the family’s fields.

What might such a tradition look like in modern America? We could start with paid parental leave. The US shares with Swaziland, Lesotho, and Papua New Guinea the dubious distinction of being the only countries without it. Paid leave would allow mothers to spend those first months nurturing their infants, rather than cobbling together a few weeks of sick leave and disability to make ends meet.

Back at work, mothers need protection from discrimination. Currently, the Civil Rights Act forbids discrimination against women due to pregnancy or childbirth, but makes no mention of breastfeeding. It’s time to guarantee women the right to breastfeed their babies.

And then there’s what we could all do, every day, to support moms and babies. At baby showers and religious ceremonies, we lavish families with embroidered onesies and engraved baby rattles, yet we leave too many new mothers home alone, trying to squeeze in a few minutes of nurturing between loads of laundry, dirty dishes and jealous older siblings.

So in honor of your mother – and all the mothers in your life – find some time this week to take a new big sibling to the playground, fold a load of laundry, or drop off a casserole for the newly-expanded family in your neighborhood.
And then, call your legislator and explain that it’s time to outlaw discrimination and guarantee paid family leave in the United States.  Our future depends on it.