Nina - I agree completely.  I just wish the word 'choice' could be 
completely eliminated from these documents.  Of course women are free 
to disregard the recommendations, just as they are free to disregard 
clear advice to use seat belts or disregard recommendations for 
immunization.  But that doesn't absolve healthworkers from the 
responsibility/duty to be clear about what the recommendation 
_is_.  In particular, as you say, to distil the available evidence 
and then give the best advice.

The same nebulous/ambiguous wording is used in the WHO HIV and infant 
feeding recommendations too.  No wonder we are all so confused!  And 
no wonder these kinds of guidelines are so easily exploited to sell 
more of the other stuff.

And Jay, just read your message before I hit Send - thanks for 
telling it like it is!!

Pamela Morrison IBCLC
Rustington, England
---------------------------------------
This is not about forcing women to breastfeed against their will.  It is
about making recommendations; taking a position on an issue that has
important health ramifications for infants and their mothers.  No one can
force me to breastfeed my baby but they can inform me that breastfeeding is
so important that the all of the important authorities concerned with the
health of infants recommend it.
In order to make informed choices, we need professional organisations to
distil the available evidence and then to make recommendation about what are
the best choices to make.  This is at the core of the practice of public
health messaging.
We don't hear the AAP encouraging mothers to make an informed choice about
whether they will smoke.  We don't hear the AAP encouraging mothers to make
an informed choice about what position they will place their babies in to
sleep.  On these and a great many public health issues for which there is an
overwhelming body of evidence in favour of one behaviour rather than
another, the AAP and several other bodies with an interest in health
promotion, take a position.  They recommend not smoking and placing babies
to sleep on their backs.
The AAP (and the ABM) have a responsibility as public health advocates to
recommend that infants, with very few exceptions, be breastfed.  That is
what the weight of research evidence says they should be recommending.
That is why it is important for these bodies to get off the fence and take a
position.

             ***********************************************

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