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Lactation Information and Discussion <[log in to unmask]>
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Tue, 20 Aug 2002 13:42:24 +1000
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A couple of points.

It sounds from what everyone has contributed so far that the AAP book is
very good AS FAR AS IT GOES. And that is often the problem with
breastfeeding books. What we leave out is as important as what we include.
Misleading by omission of emotionally powerful and damning detail is as
serious as misleading by inaccuracy or untruthfulness, neither or which
seems likely in the AAP book from the reports I have. This is why I have
always taught courses on INFANT feeding, not breastfeeding; why I have
insisted that health professionals ought to deal with infant formula and
bottle feeding as fully and as seriously as we deal with breastmilk. And why
I think IBLCE ought to add knowledge of artificial feeding to its parameters
for safe practice as IBCLCs. After all, it influences decisions about when
to supplement, with what, via  what method, to know the relative risks of
each.

What do I mean by misleading by omission? An example. Consider the positive
spin the companies are making of the (still unproven) gains of adding
LCPUFAs to infant formula. I thought it not a bad idea when they were adding
purified fish oils, because it is only a few decades since parents stopped
giving fish oils for brain development and to prevent rickets in kids, and
over that time we have seen a huge increase in brain-disturbed children. But
industry advertising suggests that this has solved the IQ gap between
breastmilk and infant formula. What parent wouldn't think it a good idea to
add those positive fats.  Now tell those parents that GM organisms including
marine algae (the slime on the pilings) and soil fungi (!!) are churning out
those fats in vast vats on an industrial scale, and that babies were the
first recipients of those "novel foods", before their addition had even been
approved by regulatory authorities, which in the end acted to regularise the
status quo. Add the knowledge that no studies on potential allergenicity and
cross reactivity with freshwater algae or other fungi seem to be in the
published record. Feel different about giving the stuff to a baby? I
certainly do. Put that together with the current epidemic of peanut
sensitivity. In the 1970s I queried the safety of peanut oil in infant
formula. "Oils can't sensitise" they said. Peanut oil is banned from infant
formula now. Will it take 2 generations or three before we have an epidemic
of hypersensitivity to algae and fungi?

All that industry asks of its collaborators is that they say nothing about
emotive (= motivating) truths.  The media is  free to tell scare stories
about breastmilk contamination without health professionals talking about
the more widespread and impossible to resolve concerns about infant formula
contamination. It is not enough to say breastmilk is good. We have to say
plainly that infant formula is seriously risky and inevitably so, and not
just because it distorts immune systems in the index generation and those
that follow. It is an industrial product which carries major risks and every
year kills some children in every country.

Anyway, I will read the AAP book and see what I think about why Ross wants
to be associated with it... As Barbara said, the need to be aware of the
duty to warn of all material risks may be a potent influence. Infant formula
is surely "the tobacco of the 21st century", as Peter Hartmann posited at an
ALCA Vic workshop some years ago.

Secondly, for the record Breastfeeding Matters was initially published in
1984 by Allen & Unwin, and (despite almost zero promotional efforts from a
somewhat ambivalent sales staff) sold enough to classify as a best seller,
largely thanks to positive reviews by male medical writers. That was despite
the ambivalence of some breastfeeding advocates who found it too political
and radical in its approach. I saw no reason to go back to A&U when doing
the fully revised 1998 edition: the book sells through networks. But I have
decided that the new book I am close to finishing, on safer artificial
feeding, should be distributed by a commercial publisher to reach its target
audience. Yet despite the best-seller status of both Food for Thought and
BFM I am finding that the WOMEN commissioning editors in some publishing
firms who read the draft agree that it is an important book on an important
topic, but find the whole detailed and referenced truth too scary and are
unwilling to recommend its publication. It will make mothers feel anxious
about what they must do, say some.  Publishers are supposed to be about
making information available and making a profit, both of which are almost
guaranteed for the new book: but some truths are too close to the bone for
some people to co-operate in making them known.

Maureen Minchin IBCLC
All that it takes for evil to win, is for good decent folks to do nothing...
Joan Baez

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