Rachel,

you say you would not accept money and have the logo of the mother support
organisation on this (now corrected) pump poster, but are considering it for
the midwives' association.

I have thought about this because I am the co-author of a leaflet
on masititis.  I recently spoke on the topic at a study evening and had the
most complicated time deciding whether I could speak.  One pump company
sponsored another of the speakers (a midwife who has left her hospital job
to become a consultant for the company), and had a stall, and the organiser
invited the other main electric pump co to have a stand as well, for
balance.  I agreed to speak only after very careful thought and assurance
that my fee did not come from the companies.

After my talk someone asked 'so, what you are saying is that for infective
mastitis you use antibiotic therapy and pump?' and I was able to say, 'no,
what I am saying is that you use antibiotics and EXPRESS'.  Had I been paid
by the companies completely and / or linked with one of them (my
organisation does not have an agreement to act as agents for either company,
which the other three mother support orgs in the UK do) I would have felt
unable to make that point so clearly and have it understood.

Now, midwives are OFTEN the people who introduce a mother to a pump,
especially in situations of need (as opposed to 'social hire').  Sometimes
women, in these exact same situations of need might be just as well off, or
better off, with hand expression.  If the midwife is in an association with
a pump company, via her professional organisation, it colours the whole
decision -- maybe at the level only of the assumptions of how beneficial
pumps can be.

I assume that in Norway, as in the UK, the health service is from the state.
Women in these countries deserve to have the independence of their health
care preserved and defended so that the information and therapy they receive
is based on their need.  It makes me so angry and sad that throughout my
working life as a breastfeeding supporter I constantly see women exposed to
information from commercial entities.  Overwhelmingly this is from companies
with some interest in infant feeding -- pump companies are included in this,
as they have a financial interest in how women are feeding their babies --
and I also include companies which make colic remedies and the like (they
have an interest in women, for example, breastfeeding with sub-optimal
positioning to increase the chances of 'colic').  There should be one place
where, when you are a new mother, emerging vulnerably from the shell of your
old self, you can be wrapped in tender care and not bombarded with the
self-interest of others.

I know this will sound utopian.  But if there is no one standing here,
holding on to this vision of things, there will be no balance to those
sliding away into other positions and defending the use of money from one
part of the baby feeding industry as it is better than another sector
(resonances of Sears' self explanation).

I would love to see some qualitative research looking at the impact of pumps
on the way wmoen view their own breastfeeding experience.  My hunch is that
it might impact on how women are placed on the continuum between expereicing
breastfeeding as a relationship and viewing it as a method of getting a
nutritional product into their baby.  So far, we have fairly uncritical
acceptance of the intervention of pumps with attention to only a limited few
outcomes.

****NB  I am absolutely not saying there is no place for pumps, just
that we can become very blase about them and accept them as a part of normal
breastfeeding for women and also normal 'wallpaper' in our professional
journals as an uncontroversial and totally benign tool of our trade.*****

Magda Sachs
Breastfeeding Supporter, BfN, UK

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