Pam said,  <<I am not sure we really want to go to the place where women do not have rights over their own bodies.  We can't have it both ways...rights over our reproduction and our bodies....and forced to breastfeed against our will. Pick one. >>

 

Pam in this case at least I believe that is a false choice. For health-promoting entities to urge people to engage in particular behaviors does not imply the loss of any right NOT to engage in said behavior.  One of my earlier examples - mammograms - is a case in point.  Women of a certain age are urged to get mammograms. They are not asked to make an informed choice about the matter; they are urged unequivocally to get mammograms.  Some choose not to, this is a given. But the fact that they are urged to get mammograms has not taken away any woman’s right not to have one should she so choose.

 

To tell people to choose between a healthy behavior and an unhealthy one undermines the argument that there is a significant difference between the two choices.  This is why WIC clients will often ask me why WIC gives out formula if indeed it is our policy that breast is best; the fact that we enable their choice not to breastfeed makes them question our position that breastfeeding is superior to formula.  Hence you don’t usually see mixed signals in public health messaging. For example, when people are urged to eat right the two choices, “eat a healthy meal, OR have a Big Mac” are NOT put out there side by side in the food guide pyramids or the press releases.  Failure to acknowledge, in public health messaging, the right to eat that Big Mac anyway is very different from outlawing them, or from depriving people of their right to eat them.

 

So this is not about whether or not women have the right to choose not to breastfeed.  One (and there are others) of the issues here as I see it is the notion that breastfeeding is a public health issue; health/medical authorities should not equivocate in their advocacy, their urgings, their pleas, their flat out “WE FEEL STRONGLY THAT YOU SHOULD DO THIS” messaging. 

 

If women did not have the acknowledged right to choose otherwise, there would be little need to urge them in the first place. It is only when you know that people HAVE a choice that you ask them to pick ONE - one particular one.  The AAP should be asking women, pointedly, to pick breastfeeding. 

 

They also could have and IMO should have, in their response, acknowledged how difficult it is to breastfeed in this country, and taken the golden opportunity that the story presented to urge action on the many obstacles to breastfeeding that women face.  Instead they left it up to the WOMEN to "choose" between A) the status quo, i.e. breastfeeding in spite of the many obstacles to doing so or B) formula. Once again, mammograms are a case in point. Part of the effort to encourage women to have mammograms has included expanding access to them.  

 

This angle of the situation reminds me of something the great Gabrielle Palmer said in The Politics of Breastfeeding. “Health workers’ experience of breastfeeding failure is often greater than their experience of success. They all know the mantra that breast is best, which is as useful as knowing that potatoes are edible without ever learning how to cook them” (pg 53 in my edition).

 

The AAP, in response to a story which listed “modesty, independence, career, sanity” as disadvantages of breastfeeding, and described it as “this generation’s vacuum cleaner-an instrument of misery that mostly just keeps women down” said, essentially, “The evidence is clear that potatoes are very edible”….

 

Regina Maria Roig-Romero, BS, IBCLC, RLC

Sr. Lactation Consultant

Miami-Dade County Health Dept WIC/Nutrition

Breastfeeding Program

 

● 7785 NW 48 Street Suite 300 ● Miami, Florida  33166 ● Phone:  (786) 336-1333 x16219 ● Breastfeeding Helpline: (786) 336-1336 ●  Fax (786) 336-1302

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