Nancy Wight wrote, "The breast is an organ of the human body. How
can breastfeeding not be a medical issue?".
Hear, hear Nancy! I'm a bit late responding, but I've been thinking
along the same lines. The health of mother or baby affects
breastfeeding/lactation and breastfeeding/lactation affects the
health of both mother and baby. It's a health (medical) issue.
Furthermore, no matter how much eulogizing there is about the value
of home birth and unmedicated deliveries, and women's wisdom,
accompanied by lamenting that if we just let Nature take it's course
and stopped interfering, both birth and breastfeeding would proceed
well - or certainly better without all our interventions, I would ask
everyone to take a look at the stats for the least developed areas of
the world. What is the maternal mortality rate where most births
take place at home? What is the infant mortality rate where most
babies are breastfed? The very worst breastfeeding/lactation
problems, the worst abscesses, the worst (horrendous) cases of
failure to thrive that I have worked with, have been with African
mothers and babies for whom breastfeeding was culturally normal, well
supported within their families, and everyone had the firm
expectation that it would go well.
Conversely, my experience is that although birth interventions do
negatively affect initiation of breastfeeding, they hardly ever
prevent it to the extent that I read about on LACTNET. This begs the
question of whether the main "problem" is not bad births, and
nipple-confusion, and over-medicalization, but lack of appropriate
support for breastfeeding (poor hospital practices and inadequately
trained healthcare providers who are able to dispense out-of- date,
non-evidence-based medical "advice").
Where are the government regulating agencies who should be DOING
something about this?? I've just seen a map of the world showing
shaded areas for breastfeeding rates. Amazingly, the industrialized
countries (W & N Europe, N America, Canada, Australia) are blank
because these countries are somehow not required to report their
stats on breastfeeding initiation to the international health
agencies. How can this be? Why are the world's health watchdogs
turning a blind eye to this omission, instead of requiring reports
from all countries, as necessary health indicators? My guess is that
it's because bottle-feeding is so much a part of the culture of
countries that set international standards that it pleases everyone
NOT to characterize breastfeeding as a medical matter. But I think
it is. I think the use of formula should be rationalized from a
medical perspective. And I think we should all speak with one voice
about this.
Pamela Morrison IBCLC
Rustington, England
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