Thank you, Jeanette, Heather, Kellie, and others for voicing your thoughts and 
concerns about my ideas on long term breastfeeding management and the 
roles each of us play in supporting mothers and babies.  I’d like to note that is 
long response is not entirely directed at you, but does address a number of 
things that have come up in the last few days.

I am sorry I was not able to continue this discussion sooner…I am actually 
away on holiday and am using a borrowed computer.  I will be honest and tell 
you that I lost a lot of sleep last night, as I worried that my words may have 
offended people on this list.  That is certainly not my intent!

I do not mind people thinking of me as a radical…but I DO mind them thinking 
of me as a wacko!

First I would like to primarily address Jeanette’s concerns over what I have 
said about PHN’s.  First and foremost, I must again preface my further 
comments by reminding everyone that I am specifically addressing what works 
and what does not work in MY community, province and nation.  Not in yours.

Second, using PHN’s as my example was just that:  An *example*.  I could 
just have easily said RN, LPN, MD, CLC, CLE, etc., etc., etc…but, I chose PHN 
because I am addressing the lack of exclusive to six months breastfeeding 
rates in MY community…and…largely, breastfeeding support in MY community 
is handled by the PHN’s *even if they have only taken one breastfeeding 
course* and have VERY LITTLE actual practice in terms of breastfeeding 
consultancy hours.  I believe that it is largely because of this, and because 
breastfeeding support is NOT a specialty but rather just woven into everything 
else that a professional may do as they work with women and babies, that the 
barriers to breastfeeding for longer durations simply cannot be addressed with 
childbearing women in my community.

I have continued to follow these threads, even though I have not been able 
to respond each time.  Many people are now responding with their own 
personal stories and again comparing role models vs. medical or professional 
help and assistance.  Ladies and gentlemen...this is NOT the issue!  Both of 
these things work…all methods are valid!  

The issue that I am addressing, the problem that I see, is that NIETHER 
method is enough.  If it were, EVERY WOMAN would follow the WHO’s 
recommendations and EVERY baby would be breastfed (okay, okay…I know 
that there are some exceptions, but please tell me you understand the gist of 
my words…).  I am not talking about the women we ARE reaching…I’m talking 
about those that we DON’T.  (Sorry…I don’t mean to shout, but I’m getting a 
little frustrated by this process as it seems I am often misquoted or mis-
referenced or simply misunderstood).

If you would like to discuss this further, or if you are interested in seeing the 
diagrams I have drafted which explain this situation within my community, 
please contact me off list (this invitation is open to everyone on Lactnet).

Now that I have that clarified, I would also like to mention that this type of 
disagreement, or misunderstanding, often occurs when isolated statements 
are taken out of the context of an entire discussion.  I am not sure if you 
have read all these threads from the beginning, but if you are interested in 
this topic, then I urge you to do so.  

I think it is unfair of anyone to be upset with me or to feel that I am unfairly 
representing them and what they do, by isolating ONE statement out of 
dozens of others.  In order to understand what I believe, why I believe it, and 
why I may have chosen to use specific examples, the entire discussion needs 
to be followed.  If you are interested in doing so, you might wish to look for 
threads titled: “Imagine if…”; “Canadian LC’s…need stats!”; Flossing with the 
Dentist” (and related ones); and “One LC for every childbearing woman”.  
There might be a few more, but that is all I can remember at this time.

To sum up, I want to reiterate that it was not ever my intent to attack PHN’s 
or any other group of professionals who work with breastfeeding mothers.   I 
was not in anyway meaning to minimize the work done for breastfeeding 
mothers and babies by group of professionals.  What you do, what all of us 
do, is valid and necessary, and I am very glad that you, and all of us, are 
working in these capacities.

However, once again, let me state what I believe is obvious:  What we all, in 
all our different capacities, are doing now is not enough.  At least not in my 
community where exclusive breastfeeding rates drop 10% for every infant 
month of age.  This means that in my community – which literally has the 
HIGHEST breastfeeding rates (93% initiation) in all of Canada – only 3 of every 
10 babies are still exclusively breastfed at six months.  If your community, 
province or state, or country can boast stats that are higher than that, I 
commend you.

We have all worked hard, and we continue to work tirelessly…however, 
SOMETHING needs to be done in order to bring those stats up to the next 
level.  

That is my message.  Nothing more.

Blessings!

Karyn-grace Clarke, IBCLC, LLLL
Gabriola Island, BC, Canada

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