I think this issue is of enormous importance. The apathetic, passive approach the AAP has taken to infant feeding in general is appalling. One can certainly see from this lightweight response that infant feeding is clearly viewed as nothing more than a personal decision. It is certainly not viewed as a public health issue, nor as an issue of paramount importance to personal health and well-being.

By contrast, I wonder if anyone has ever heard of any AAP document that argues that mothers should make informed decisions from "credible sources" on the decision to vaccinate their children or not? They have even formed committees to actively battle opposing opinions, to pressure legislators to act to tighten control on exemptions,? and to actively promote their position. By contrast, those peds who actively advocate for breastfeeding receive little support at large and have to temper their language so as to keep other peds on board (not the ABM response).

While I completely disagree with the AAP in every way where vaccines are concerned, and further believe that little the AAP does is not tainted by industry, one has only to look at the contrasting approach to these issues to comprehend a significant cause of breastfeeding failure in the US. In other words, the vaccination of children is so important from an AAP perspective that they will take any and all action to oppose other viewpoints and to force their position on families. Respect for parents who choose not to vaccinate is absent and those parents are often badgered, screamed at, humiliated, threatened with protective services referrals and ultimately "fired" by the pediatrician.? Do peds berate women who artificially feed their babies? Do they "fire" them for doing so? Do they threaten them? I am certainly NOT advocating such behavior--only pointing out how strongly the AAP and individual peds are willing to treat women over an issue they consider important, while weakly defending breastfeeding only when it would embarrass them to do otherwise.

I would say if nothing else, this article has certainly reminded us that we are indeed a highly medicalized, bottle-feeding culture and if we want to see change we have got to do it by very different means. We as LCs need to stop colluding with the medical model, stop trying to be accepted and seen as "professional" when the "professionals" are not on the side of mothers and babies. IMO, we bear significant responsibility for where we are now. We have, as a profession, been so concerned with "evidence-based" practice and proving our value to those to whom we have abdicated power that we have all but forgotten that while we may well be able to place some quantifiable value on human milk, we can never place such a value on mothering at the breast. 

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC



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