Dear all,

As promised earlier this week... I am very proud to be able to tell you that the English version of the lc statement on excessive crying is ready and uploaded www.borstvoeding.com, with warm thanks to Stefan Kleintjes and also to those who were kind enough to help editing my translation. Thanks again, ladies! (Yes, Rachel, I too appreciate this list! ;o))
Here is the link: http://www.borstvoeding.com/files/DutchLCstatementExcessiveCrying.090203.pdf, Statement in reaction to the (draft) guideline 'Dealing with excessive crying in nurslings' (Centrum JGZ / RIVM, Centre for Child Healthcare/National Institute of Public Health and Environment). Version 2007 / version 2008), by Marianne Vanderveen-Kolkena IBCLC and Stephanie Pots MA, IBCLC.

Our statement, together with the statement from the Dutch psychologist organisation and the objections made by the Royal Organisation of Midwives, made the National Institute for Public Health and Environment decide to withdraw the draft guideline we objected against. We are very happy about that. As you can read in the prologue, the National Committe for Unicef, the Netherlands, also endorses our statement.
That means that we were able to join many forces, which is a good base to continue from.
Continue... because we are not done yet: a new guideline is in the making, a multidisciplinary one (as opposed to the previous one, that was initiated mainly by people working in well-baby clinics), which is an improvement, but we are still worried nevertheless, as most likely this study http://www.borstvoeding.com/files/comparison-of-behavior.pdf will again be the starting point.

My colleague Stephanie and I would like to bring a couple of things forward:

*Those of you who are knowledgeable with regard to reading scientific studies... would you please spend some time on analyzing this specific study...? We did that for our statement (fourth paragraph), but we would really like to hear opinions from all over the world. We feel it is a disgrace, that this study should serve as the underpinning for child healthcare guidelines that will have such a big impact (already do! as people have been working with the guideline, despite it being a draft version and employees being 'trained' with sponsorship from ABM-companies... :-s). Anyone who could help towards more or less flawing this study, will greatly aid the cause, being protecting infants from policies that encourage parents letting baby cry it out and 'explain' parents that babies should self-regulate.

*We already received a question from one of our European colleagues on this list to share whatever we have available on this topic. Anyone who feels that our statement might help their own advocacy of co-regulation and comforting crying babies, is welcome to use this English version of our statement. Please credit the authors, when you do. ;o) (And share your results with us, because we are so curious!)

*The problem of how to deal with excessively crying babies is not a Dutch problem. This issue has to be dealt with in many area's where funny people promote harsh sleep training and such. Could you please inform us about how in your country hcp's deal with this problem? What interventions are suggested? What research is used to substantiate the interventions? What are the consequences of promotion of the immature baby's self-regulation for the breastfeeding dyad, as far as you see it in daily practice? Do you have suggestions for effective interventions, without harming the bf relationship?

Our main goal right now is: put pressure on the national institute in order to make them understand that such rigorous interventions should *not* be based on *only one study*. One study is no study, some say, certainly not when even the control group is missing, and especially not a confounded one like this one. Please share your expertise with us and  indulge us with convincing literature and research.
There is a big difference between "not proving harm" and "proving no harm", but so far, the ones in charge don't seem to be impressed by that.
Please provide us with impressive material, so that we can go on with this project and try and steer it in the right direction. Great things have been achieved before, thanks to Lactnet, so why not this time... ;-)
Thank you so much in advance for your involvement and support.

Warmly,

Marianne Vanderveen IBCLC, Netherlands (and author of this piece, that maybe I should translate as welll... http://www.borstvoeding.com/aanverwant/hechting/net-geboren.html)

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