Dear all:

I once again am feeling the same culture shock I did when I first returned from the "international development world".  For about 20 years I lived in this protected isolated bubble of the international nutrition community where certain research had been read, certain assumptions were given, and certain norms were observed. 

When I gave birth to my son and entered the "developed world" I experienced a huge amount of culture shock.  First at the woefully inadequate assistance I received at the hospital -- with the exception of the nurses from the birthing center who actually came up and helped me after my surgical delivery.  Second when I started doing support groups at one of the hospitals while I was in training.  I actually read the brochure on the counter about infant feeding from one of the formula companies.  It left me sputtering in shock because every sentence was a complete misleading perversion of the real evidence on infant feeding.  Almost every sentence was completely refuted by the evidence I had been reading for at least since 1984.  Yet this information is often readily accepted by other health care practitioners -- at least insofar as they allow these pamphlets to be left out for parents to read.  

Currently the misinformation is infusing the pediatric community in the Lower Manhattan area to the point that I have seen four cases of significant failure to thrive based on the type of misleading information propagated by using bottlefeeding as the norm for breastfeeding mode that we are in.  I am really tired of having to explain why four feeds a day is not enough and why cutting back on the number of feeds "because the baby is burning too many calories if he doesn't sleep 12 hours at night" is likely to make the failure to thrive even worse.

So I feel this amazing amount of cognitive dissonance myself in that the information provided about infant feeding in developing areas is actually MORE evidence based than the information about infant feeding in developed areas of the world.  I don't feel like we can stick our heads in the sand and ignore the misinformation. 

Best, Susan Burger, MHS, PhD, IBCLC

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