Karleen

Congratulations on writing another fine article!  Although I'm aware 
of the storm of protest over use of the word "devastating", I, for 
one, approve your courage in telling it like it is when defending the 
use of human milk over formula.

Actually, the truth is, I'm a little nervous about our collective 
concern about the need to be 100% politically correct, and dare I say 
it, even apologist when we write and speak and advocate publicly for 
breastfeeding/breastmilk-feeding.  I think there's a world of 
difference in the approach we should take on the one hand with 
individual mothers struggling with the decision to abandon 
breastfeeding, or those who for whatever reason (the 0.1%) who 
physically "cannot" lactate, and on the other hand the opportunities 
we have in the public arena (ie generally) to 
speak/write/strategize/advocate about how to protect, promote and 
support breastfeeding.

The former require, IMHO, exquisite empathy, sensitivity, caring and 
tact, for humane reasons, and in recognition that the individual 
mother does the best she possibly can in her particular, unique 
circumstances, for her own individual baby.  I do believe that the 
original wisdom of working with one mother at a time, and meeting her 
where she's at, can't be improved upon. We could even apply the rule 
to one healthworker at a time, or one policy-maker at a time.

However, public, generalized statements about the importance of 
breastfeeding, and the "devastating" differences between 
breastfeeding and _not_ breastfeeding (formula) need to unambiguously 
clear, so that no-one is in any doubt - this is a time to speak 
up.  I don't think that, in writings which will be in the public 
domain, or in pronouncements which will be repeated or aired or 
printed over and over, it is helpful to be so tactful that it becomes 
difficult for the average reader/woman in the street to become 
confused about our message.  I find it achingly disappointing to see 
a TV interview with someone who is one of our known big names put 
forward a publicly and deliberately "moderate" point of view in order 
not to offend those who so loudly defend mothers' rights to 
bottle-feed.   It adds to the general misunderstanding that 
formula-feeding really doesn't matter, so why are some of us making 
such a fuss about it?  And of course the media love it.  And so do 
the very militant formula-feeders.

Years ago, when breastfeeding was under serious threat because of the 
move to provide replacement feeding to the babies of HIV+ mothers on 
a global scale, a UNICEF person said to me "But you people are only 
speaking in whispers".  And sure enough, formula-feeding was so 
heavily supported and actively promoted for about a decade, with 
truly "devastating" consequences that I wonder now whether 
breastfeeding rates will ever revert to what they were before this 
initiative was first dreamed up.  Some of us attempted to engage with 
those who seemed to be ringing the changes and deliberately 
maintained a carefully moderate stance so as not to be labelled 
fanatics.  It didn't help.  Thousands of babies died.  If we don't 
speak up - who will?

Sure, as I've recently discovered, today's mom's lists and blogs can 
be merciless and very public in distorting our words and intentions 
out of all proportion, so it's vital for us to be accurate and 
scientific.  But do we write and speak for them, or for the health of 
babies now and in the future?  In telling it like it is, I think 
we're allowed to use the occasionally negative descriptive word to 
emphasize a point. In fact, it might be high time we did.  The truth 
is that physiologically, nutritionally and psychologically 
breastfeeding really _does_ matter, and it might be our very 
restraint that perpetuates the myth that it doesn't.  So words like 
"devastating" are good!  We shouldn't be intimidated into muting our advocacy.

Pamela Morrison IBCLC
Rustington, England

   

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