We would like to see 'strong' wording in support of breastfeeding as
the normal way to feed babies. Many feel the AAP statement was not
strong enough. The way I see it is, they did not have to say anything
at all.  Just the fact that they said something, acknowledged the
information being put out there was wrong, and that informed decisions
should be based on facts is a huge step in the right direction. The
thing is, breastfeeding is a choice.  Women can choose how to use
their bodies. Yes, we want them to choose to let their babies
breastfeed. Babies breastfeed, women allow it.  And women can choose
not to allow it.

 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.  Pick the rights of the baby
over the rights of the mother.  I can think of times I am okay with
that.  Many would not be. Where can that ripple go to?  What about the
mothers who cannot breastfeed?  Does her baby's right to be breastfed
mean she cannot keep her baby? She will have to 'outsource' for
feeding?  Hmm...it can become quite complicated.  I suppose we could
say the breastmilk is the right, not the breastfeeding...but that too
has drawbacks.  At least we could get human milk somewhere though.  No
reason why that could not be the new industry...human milk marketing.
Though it would still not actualy require the mother to breastfeed.
Just market a new product and a new way to choose not to use her own
body to feed her own baby.  And what will the punishment be if women
refuse to allow their babies to breastfeed or be given another woman's
milk? No. It is what it will be:  A choice.

 We can make it about the baby, make it about what a baby needs, so
that a mother wants to do what her baby needs.Of course, that will
mean a huge shift because we already could not care less as a society
about what a baby needs.  There are huge hurdles to making
breastfeeding the accepted and normal way babies are fed.  First we
have to value women as mothers, then value the baby.  We have not got
to the first place, let alone the second.  Making breastfeeding the
preferred choice, the choice that is easy to make, and a choice that
is realistic and possible....well...that will require an entire
cultural shift rewrites the experience of women's roles and choices. A
huge endeavor indeed.  Making breastfeeding the norm  is the first
step, but in the USA we are setting women up to feel like failures in
a society that sees mothering and breastfeeding as 'lesser than'
activities a woman could choose for herself.

Ideally, we word everything about feeding a baby and caring for a baby
in the context of cared for by mothers is normal, being breastfed is
normal, and all substitutes for the normal are substitutes...not equal
alternatives. It will always be a choice the mother has to make, but
we can at least be honest about what the choice really means.

Finally, we do need to acknowledge that not all babies can breastfeed
and not all women can breastfeed.  We can do that while creating the
norm of breastfeeding.  We can acknowledge that while all mothers
would prefer breastfeeding their babies because they all know it
matters, those mothers who are unable to do this have a substitute
that while not as good, does at least provide some level of nutrition
and that is indeed better than starving.  I think that is the part
that is hard.  We don't have human milk readily available and
affordable as an alternative for women who cannot breastfeed. So, the
message is not that breastfeeding is best, your breastmilk in a bottle
is second best, and another woman's breastmilk is third
best....formula coming up last. I am not sure how to balance that act
myself. I sometimes know a baby needs to eat, that the mother is not
able to provide that milk, and her baby needs to eat!  I don't
downplay the importance of her milk, but formula is the reality she is
faced with. I can hold onto it is not about the milk, but in the
meantime some form of alternative must be fed to her baby.

I admit I was pleased with the AAP response. I was even happier with
the ABM response. They responded!  They said it...the choice matters.
It is a choice, they can't change that.  What they can do, and did do,
is say that indeed that choice is important and the science all says
that breastfeeding does indeed make a difference! We can't blame the
AAP or the ABM for the social reality that women are in charge of
their breasts and have the right to choose to not to allow the baby to
breastfeed.  We know that women often do not choose to do what is best
for their babies.  Lets not beat up AAP or ABM for that reality.

Best,
Pam MazzellaDiBosco, IBCLC, RLC

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