Breaking a l-o-n-g silence here, just to say I'm alive and well, my house is cleaner than it's been in nearly 20 years, and our second and last child gets married next weekend.  But also to say a new word hit me while I was mopping the hall floor (ooh, these floors are so clean!).

Iatrocentric - believing that the world centers around medicine, or doctors, or hospitals, as in "The Ten Steps to Successful Breastfeeding are iatrocentric".

I've always thought Step Ten - "Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic" - should really be Step 0 - "Foster the establishment of breastfeeding support groups and refer mothers to them during pregnancy or before."

But it hit me that it's been put last because hospitals (or, more correctly, WHO and UNICEF trying to work from a hospital perspective) see breastfeeding as beginning with *them*.  It doesn't, of course.  It begins with a child's own breastfeeding experience, or with her feeding her doll, or with her observing the mothers around her.  By the time she hits the hospital in labor, her attitudes toward infant feeding are pretty much a done deal.  But the hospital's iatrocentric view prevents it from working pre-conception to help shift a woman's - or a culture's - perspective from bottle-feeding to breastfeeding.  And so it relies on that pitifully neglected last step.

For years I've urged doing the last step first, and now I can explain why in a nutshell, thanks to roving thoughts as I mop:  Iatrocentric breastfeeding may sound good, but it isn't how the real world works.

Diane Wiessinger, MS, IBCLC, nearly invisible but slowly getting shoveled out in Ithaca, NY  USA
www.wiessinger.baka.com

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