Bernice raises some provocative issues.  In her discussion of ideological
problems connected with breastfeeding promotion she hints at one I think is very
crucial.  That is that some women (and their advocates) view the advice to
breastfeed as an attempt to improse biologic "controls" on women's behavior.
This is discomfiting on a level similar to the emotions aroused in the abortion
debate. (No flames please, and I DON'T want to open that debate here -- merely
to make a point about how sensitive an issue attempts to control reproductive
decisions are).  It is my impression that one real danger of our work is being
too closely linked with (either by perception or in reality) to groups or
societal forces which appear to restrict women's choices.  This doesn't mean we
shouldn't continue to advocate for social policies which reward breastfeeding:
work place assistance, lower insurance premiums, recognition for good mothering,
etc.  It also shouldn't affect our public dissemination of factual scientific
evidence of the benefits of bfg and the dangers of formula.  However, we should
remain sensitive to the backlash factor and refrain from the style or tactics of
groups which a fair amount of people view as repressive.

How do we do do our work as scientists without becoming propagandists?  We stay
focused on hammering away at institutional barriers to establishment of bfg.  By
providing consumer information that is as factual and unbiased as possible. By
working ceaselessly for inclusion of bfg into nursing and medical curricula.  By
demanding truth in advertising.  By honing our clinical skills so that we are
very effective at providing the kind of help that will allow each individual
woman to overcome her breastfeeding problems.  By projecting a sense of humor in
our public relations and lightening up a bit -- we do tend to twist off in some
alarming ways when our pet prejudices are tweaked.  And ultimately, we need to
view ourselves as the servants of the mother and the baby (not their masters).
This means respecting choices people make even when they aren't what we'd like.
After all, you can never know all the factors which make people decide things --
esp. when choices are often informed not so much by information as by emotion
(no matter how much we'd like to believe otherwise).

I've learned to take the long view of our work.  I've often discovered that
because I treated a client's choice with respect and kindness, not resorting to
shaming because she didn't do what I said, she has been willing to come back
with a second child and have a much more successful experience.   B.F. Skinner
got painfully honest a long time ago in his book Positive Addictions, admitting
that he believed you can't help someone you really don't like. Speaking just for
myself, if I am trying to control a woman's behavior, it gets in the way of me
really liking her, and her liking me.  It's the suspicion that bfg. might be
some kind of control trip that spooks a lot of  people.

Now if I can just work myself into a more accepting attitude on some of my other
control issues...:)

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
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http://www.jump.net/~bwc/lactnews.html

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