I have read with interest all the comments regarding this topic. A recent experience has caused me to decide that using these terms is a losing battle. We have to totally change  our appoach. We are trying to make a case for something that should be the norm. It is not "superior" or "perfect" or "ideal". It is the average. It is the minimum of what we should do. (Thank you D. Weissinger! You have totally changed my thinking.) It is this thought process that makes women think that if they have bf problems, then it is ok not to breastfeed because, well, if you can't have the "ideal" you can have the "ok". Noone is perfect. 

What my recent experience made me realize is that once we get into the game of adv & disadv's, we think that we have to make lists for both sides. A post a few months ago was from someone who stated that the hospital was telling them they had to make a list of A's and D's for formula. Because there are no documented advantages to formula, we make up things. For example, the following list is from a handout that is given to prenatal women in one of the clinics here in Albuquerque. One of my students critiqued it as a part of her assignment for my class. 

Advantages of bottle feeding: For mom-less time consuming, less painful, allows opportunity to get away from your baby, can go on a strict reducing diet. For family:Allows others to feed your baby, doesn't interfere with sex life, can return to work more easily.  After my shock in reading this, I realized that most of the A's were somebody's opinion rather than science.  

I am going to offer to rewrite this flier. It will contain evidenced based information on breastfeeding--what it is----the normal way to feed, nurture, and mother a human infant. It will include scientific information on how human milk is designed to feed a human infant, the protection it provides from illness etc, and what it provides developmentally.  Then I will discuss what formula is, what it contains, what it does not contain, the impact on the environment, problems that have occurred, and the fact that giving another mammal's milk to humans has not been researched nor is the manufacture of this product monitored or regulated.  No lists side by side, no trying to manufacture A's & D's of each. Just the facts for a women to make a decision. Let's get out of the list making business! Any other suggestions?  When I get this finalized, I will put in on Lactnet for comments. 

And another thing! Carol Bryant( 1992. A strategy for promoting breastfgeeding among economically disadvantaged women and adolescents.NAACOG's Clinical Issues in Perinatal and Women's Health Issues: Breastfeeding 3(4):723-30.) in her focus group research found that women knew that bf was better for their baby, but they didn't bf because of perceived "barriers". We should be spending more time on listening to mothers and helping them overcome their barriers than on teaching A's and D's. 

Carol L'Esperance, RN,MSN, IBCLC

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