Tina, your PhD work sounds very timely.  I hope you will include in your
policy suggestions a mention of the increased morbidity in artificially fed
children.  If children are eligible for medical assistance (they used to be
but I don't know what still remains of the 'safety net' any more) it saves
the state money to ensure that they are breastfed.  The International Labor
Organization also has guidelines for protecting the breastfeeding mother in
the workplace; Chris Mulford has posted on these numerous times in the past
so an archive check for her name might be useful if you haven't done so
already.

I think there definitely is a downside to medicalizing breastfeeding, and
especially as long as most health care professionals are so ignorant about
the practicalities of BF; look at the sorry state of childbirth if you want
to see what medicalizing a normal bodily function can do, not to mention the
medicalization of menopause (Lancet and NEJM both have very recent articles
showing the serious risks of long term HRT - why am I unsurprised?)

It always seems to be the features of women's bodies that set us apart from
men's, that get medicalized, as though gender differences are due to some
medical problem, without which we would all be 'normal' (male) people.
'Female' is practically a diagnosis in itself.  In a world run according to
feminist ideology, the unique features of all genders would be equally
valued and equally considered in legislation, architecture, design of
medical and other research, etc.  Imagine what a different world that would
be - you might not have to spend all your coffee breaks at conferences
waiting to use the toilets because there would be ENOUGH of them for those
of us who can't just 'whip it out' and relieve ourselves.

It is common practice here in Norway to require a doctor's or a health
visitor's 'verification' if a mother wants to take breastfeeding breaks as
is her right under the law, if the child is over 9-12 months.  It has never
been clarified what this verification is about: is it a verification that
the mother has been instructed to BF for medical reasons, or a verification
that she is, in fact, lactating?  As far as I know, a note from a doctor or
health visitor simply stating that mother is BF, is sufficient for the
employer who chooses to make a mother jump through this particular hoop, but
it has (happily) never been put to a test.  Given the very different
climates here and in the US, I would not feel comfortable with IBCLCs (or
midwives, or nurses, or doctors) in the role of BF police on behalf of the
state.  If really necessary, let the state train a special group of law
enforcement officers or welfare inspectors to do this.  The relationship
between a woman and her health care providers should be based on mutual
trust and respect, free from the potential for this kind of abuse of power.
Having an IBCLC or any other HCP carry out such a task is reminiscent of
population control policies from countries the US does not like to be
likened to, where individual freedom is officially regarded in a very
different way from how it is officially regarded in the US.

Thanks for the explanation of Temporary Assistance to Needy Families (TANF).
It had me stymied, too.

Rachel Myr
Kristiansand, Norway

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