Meggie You bring up an excellent point, and one to which you've clearly already given enormous thought, looking at the question from all sides....You query if your Breastfeeding Advisory Council should have its name changed to the Baby Friendly Initiative Committee, so that it is more inclusive of non-breastfeeding mothers who either can't or choose not to breastfeed and so that the group is not constrained by its focus to protect, promote and support breastfeeding, but can "support _all_ mothers/babies/families with best practices and honoring the choices they make". Whoa! Firstly, let's just look more closely at the last sentence, which I copied directly from your post. There isn't necessarily a correlation between best practice and honoring the choice a mother makes. In other words, if a mother chooses to breastfeed , fine, but if she chooses to formula-feed, what then? We can accept her choice, but is there any obligation on an IBCLC to "honour" a poor choice? When anyone talks about infant feeding choice, they are talking about the _mother's_ perspective, and they rarely actually mention the infant....an interesting phenomenon... Another closely related and terribly important aspect is to realize that this is industry-inspired language (read the ads). Unfortunately it's been co-opted by many respected organizations who should know better, including WHO and UNICEF, maybe as a consequence of the rash of recent public-private partnerships, and as a consequence of economic necessity - who knows? - but I think it's important for us to expose it whenever we find it. If you read anything from the 80s, breastfeeding was heavily promoted, and it was very clear that this was due to the protective effects on infant morbidity/mortality of breastfeeding. But things began to change in the 90s. The term "infant feeding" covers such a multitude of sins, doesn't it? Thus I act on my mistrust of the push to be more "inclusive" by _changing_ the words "infant feeding" to "breastfeeding" in any document I'm given to review. For those of you I've worked with, be warned, I've even done this surreptitiously over many years and without a shred of remorse :-). I believe that it's crucial that we say what we mean and that we continue to keep "breastfeeding" as the main focus. It's interesting to me to reflect that if the mother makes the infant feeding choice, then her counsellor, her advisor, her healthcare provider cannot be held responsible for the consequences, but isn't this a cop-out? As an expert in the physiology of lactation and breastfeeding I know which women can breastfeed but choose not to, and I can distinguish them from the women who really "cannot" and whose babies absolutely need to receive formula - either temporarily while they work to rebuild a mismanaged breastmilk supply, which may or may not have been their fault - or permanently due to insufficient glandular tissue or some other physical cause. Of course I'll provide every support to mothers who absolutely have to use formula. But it's not possible for me to be fooled into blurring the difference between capacity and choice. And I don't have to support infant feeding _choice_ - I 'll go even further to suggest that I have an ethical obligation not to. I'm very fortunate to have lived so long in a place where not to breastfeed was risky, and where mothers were _not_ encouraged in any circumstances to "choose" to formula-feed, but were seen to have an absolute duty to breastfeed their babies and in fact believed that breastfeeding elevated their status as wives and mothers. So I'm not seduced by European/Western human rights language (?jargon) which implies that maternal choice trumps infant health. I also happen to know a fair bit about the health consequences for the baby (the end-user) of the so-called choice to formula-feed. Consequently, even as I can't always persuade a reluctant mother to breastfeed, I feel that I do have an ethical obligation to expose this verbal jargon for what it is (not just semantics, but an effort to hide what is really happening) and to actively protect, promote and support breastfeeding. So I'd honour your uneasiness in the situation you describe Meggie, and I'd celebrate your instincts to resist this kind of messing with the primary focus of your important steering committee. If you possibly can, I think it's really crucial to the continued best health outcomes of the babies you serve that you keep the focus on "breastfeeding." Well done!! Best wishes Pamela Morrison IBCLC Rustington, England (formerly Harare, Zimbabwe) ------------------------- Hi all A discussion has arisen recently in a couple groups I have involved with. We have a large health authority steering committee that is currently called the ‘Breastfeeding Advisory Council’. In the terms of reference, we are responsible for all things breastfeeding related (protection, promotion, support…). Naturally, a key function of the group is too work towards BFI designation for all our facilities (hospital and community). This council is designated as the BFI implementation steering group in the Terms of Reference. We have had a request by some higher up admin leaders to change our name to the 'BFI Committee'. The reason given is that the term ‘breastfeeding’ is limiting the understanding of the group’s focus. There is the perception (by admin) that the current title suggests (to the uninformed) we are not supportive of mothers who for some reason can not or choose not to breastfeed. (this of course in not true, our mandate is very much along the lines of BFI - working to support all mothers/babies/families with best practices and honoring the choices they make or are necessary for medical indications). There was even the suggestion that maybe we should be called the Infant Feeding Committee - because, for similar reasons, our draft policy was changed from the ‘Breastfeeding Policy’ to the ‘Infant Feeding Policy’ even though the content of this high level policy remained the same - basically to work towards BFI. This came as a surprise to me. I am aware that there is some backlash against BFI (thinking that BFI isn’t ‘mother friendly’) so this is the exact opposite thinking. These admins like the term BFI (because who wouldn’t like that we are ‘baby friendly’). The difficulty I have with this is that I have always considered that breastfeeding promotion, prevention and support involved more than just BFI. Sure, if an institution decides to embark on the journey to BFI a lions share of the committee work will be BFI related. And really, for most breastfeeding related work we do we could massage it to fit under the 10 steps. Especially since Step 10 is so broad that any community breastfeeding work can fit under population health. I guess I’m thinking, for example, that our Perinatal Network Steering Committee would have a large amount of their work focused on meeting Accreditation Canada Obstetric Standards, but the committee isn’t called the Accreditation Obstetrics Standards Committee. Breastfeeding Committee for Canada isn’t called the Baby Friendly Initiative Canada, but Breastfeeding Committee for Canada - with a large portion of the work directed to BFI (but not all?). I see BFI a very important tool we can use to advance our work, but not as the defining concept. I’d love to hear your thoughts on this issue. Is it just semantics? Is it important to acknowledge, by title, that ‘yes, the work that we are doing is breastfeeding related’? By eliminating the word ‘breastfeeding’ from our policy title, our committee name etc are we playing it smart? or being disingenuous? Remember, the public doesn’t know the name of our committee - our audience is health care providers. Many thanks - TIA, Meggie --- This email has been checked for viruses by Avast antivirus software. http://www.avast.com *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome