Hi Susan,
I don't see this as having anything to do with an elitist attitude and there
are certainly no parallels to what Paula does with the mums whose babies are
in her unit. When a challenge has presented itself you empower the mother
with appropriate support and knowledge to overcome that challenge. What I
don't understand is why when we have literally bucketloads of research
showing us that breastfeeding self efficacy/confidence is strongly
associated with breastfeeding success why it could be considered that
suggesting to or telling a mother that because of X reason that she might
not make enough milk (however nicely it is framed) is OK. Doing so can only
decrease her chance of successfully breastfeeding and as I have mentioned
before we don't have a crystal ball to say who is going to have problems.
Of course you give women the tools to recognise when things are not going
well and what they can then do but that should be standard care for all
women.
I've mentioned in a few posts how common it is for women to have perceived
insufficient milk supply and asked why if preparing women for the
possibility of problems is so important why we don't just tell every mum
that she may not make enough milk or believe that she is not making enough
milk? No one has answered me. (BTW, has research on the incidence of PIMS
been carried out in the US or UK? I would be interested to know the figures)
I think that Rachael's point made earlier about hostile hospital
environments is very pertinent also. There is so much more to successful
breastfeeding than the mother's physiology.
Karleen Gribble
Australia


----- Original Message ----- 
From: "Susan Burger" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, July 21, 2007 12:01 PM
Subject: Non elitist attitudes & the real message I take away from Paula
Meier's work


Dear all:

I'm thinking about what Paula Meier does with her low income mothers.  She
did not adopt
an elitist attitude towards these women.  She had faith that these women
could comprehend
science and do scientific tests themselves.  Really, all a centrifuge is, is
a big fancy salad
spinner with a fancier degree of machine tooling.  I do not believe the
instruments she used
with these women were as important as the fact that she trusted these women
to care
enough to learn how to use these instruments to help their babies.  The
trust she had in
them (not necessarily the centrifuge for assessing milk fat content or the
scale for test
weighing their babies) was the greatest gift she gave them.  Faith that they
did not need to
be protected from the knowledge that not giving breast milk was a risk and
faith that they
did not need to be protected from learning a little bit of math and science
becuase someone
else thought it would be too complicated for them to understand.

I would say any conversation we have with mothers, we should take the higher
road of
assuming they are competent and can handle appropriate discussions of risk.

Best, Susan Burger

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