Thanks, Regina, for a thoughtful and upsetting post about the ILCA
conference.
Appliances for the breastfeeding mother can indeed have a role, but I agree
with Kathy Dettwyler - the Avent ad showing 'all you need to breastfeed your
baby' with a photo of a pump, is a travesty.

The Avent representative in Norway is a very nice person who seems to want
to do a good job, but doesn't know much at all about breastfeeding.  She has
held the job for at least 3 years.  At the European Perinatal Medicine
Congress this summer she had a booth with a huge picture of a mother with
baby at her breast, in a TERRIBLE latch, baby sucking at the very end of the
nipple, with the entire nipple shaft visible outside the baby's mouth.
Mother smiling beatifically and lots of skin showing.  The rep said she'd
had lots of requests from foreign attendees, who wondered if they could get
copies to take home, because they thought it was such a great picture for
promoting breastfeeding.  She told me that when I asked why Avent didn't
supply her with a picture showing a baby with a good latch, actually
breastfeeding.  Turns out she took the picture herself, of her good friend
and colleague at Avent, with colleague's daughter.  I said that position was
bound to result in pain and soreness for the mother.  You could almost see
the light bulb go on over her head as she exclaimed 'You know, my friend WAS
very sore!!' as though I were some kind of genius or super-detective to have
figured that one out.

There seem to be no requirements by any governments that the devices peddled
at breastfeeding mothers be safe, effective, or supplied by skilled,
knowledgeable people.  As long as this is the case, LCs are taking no small
risk when allying themselves with such companies.  The terms need to be
clearly spelled out, and WE need to start making other demands when
accepting jobs or contracts from these businesses.
Like: that the companies lobby for universal, paid maternity leave that is
long enough to establish breastfeeding, and offer to help employers set up
pumping stations for mothers to use AFTER they are done with their leaves.
Or that they include multilingual instructions for use with their devices
(nipple shields might be a good place to start) with clear warnings for the
situations in which the device is likely to be counterproductive or even
injurious (engorgement, for instance, in the case of the shield).  Or that
they establish sliding-scale systems for supplying good pumps on a needs
basis to mothers of babies who can't be fed directly, and who don't have the
means to obtain them otherwise.
And of course, that every person dealing with sales of these items have at
least a basic knowledge of the anatomy and physiology of lactation, and not
just how to separate new mothers from their money.

Sure, ILCA, and many of us individually, need the money.  But the companies
need the credibility we provide.  They are dependent on us, or they wouldn't
be so concerned with buttering us up.

For the record, the word 'midwife' could be substituted for 'LC', and
International Confederation of Midwives substituted for ILCA, in this post.

Rachel Myr
midwife, IBCLC
Kristiansand, Norway

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