Judy
Thanks for sending that in. See, this is why I have a very jaundiced
view of Cochrane Reviews..... I always read them with high hopes that
we can use their unbiased, professional opinion, carefully conducted
by an expert to help show that breastfeeding makes a difference to
the health of babies, that babies need more breastmilk rather than
less, that mothers need more help or something.... But I'm
consistently disappointed by them! They always seem to show that
breastfeeding is not important, or that a tool/technique that I find
valuable is not useful. Now they've trashed pumps. I think it's the
way they ask the questions, to include certain research and exclude
other research, often by quantity rather than quality. If it wasn't a
Cochrane Review, we'd call this cherry-picking... It's got to the
point now that I'm downright suspicious of them..... not good, right?
One of the first times I had the temerity to disagree with the
conclusions of a Cochrane Review was when it concerned HIV,
breastfeeding, antiretroviral therapy etc. It didn't have a good
outcome for breastfeeding, but because I'd been obsessive about the
topic for some time, I could see what had been missed out, and what
had been counted to arrive at a parrticular conclusion. The overall
outcome was to endorse the very fashionable or popular view being
promoted in other circles at the time - abandon breastfeeding as
being too risky. This meant that this particular Cochrane Review
seemed to have a political element at odds with some of the later
(albeit smaller) research studies, which I found surprising and -
later - downright unethical. As I say, I think it's that the
questions asked can be used to influence the results in a particular way.
Regarding the pump review, what it might take would be one of our
colleagues expert in helping mothers provide milk for sick/pre-term
babies to review the review and point out where the flaws are. While
this review identifies many factors other than pumping which are
helpful to maximize/increase milk-production in cases where babies
are not fed direct at the breast, we all also know that some pumps
are more effective than others, and we know why! We also accept that
manual expression is great, and that we can teach it, but that
doesn't mean that new mothers should not have access to efficient and
effective tools which will save them time and maximize breast
drainage to maintain breastmilk synthesis. Someone probably needs to
say in a very technical way why that's so and perhaps show at the
same time that this seems to be a biased review.
Pamela Morrison IBCLC (not offering in Rustington, England!)
--------------------------------------------------
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0013778/ Anyone finding
that this review is being used to justify denial of coverage for a
rental, since 'it reports that all pumps produce the same results?'
thanks,
Judy
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