>The marketing of pumps around the world is not just a problem in Saudi
Arabia as Maureen Minchin mentioned, but in many other countries (third
world especially) where those who work there report that pumps are not only
irrelevant but potentially dangerous.<

I think Jan Cornfoot of CAPERS is misunderstanding or misquoting me here. I
thought I said that technophilia was reported to be very strong in affluent
Saudi women and asked for confirmation from those who might know more as a
result of direct experience in Saudi. Of course, having reviewed it
world-wide, I think pump marketing is a problem everywhere, not least the
persistent marketing of the bicycle horn pump that works by exerting
suction on the nipple face and splitting it apart if enough pressure is
generated. These too can be useful but are the most hazardous of all pumps:
yet so often the complaints are about intrinsically safer and easier to
clean (if more expensive) models, and the people who complain about pump
marketing seem to have done nothing to get these impossible-to-clean
objects banned them. It's as though nasty cheap pumps are no problem
because while they harm women and make money, they don't do it obviously by
linking up with public professional groups. Is this sensible? And I for one
have no problem whatever with NMAA being involved with breast pump
companies, and disliked an earlier Lactnet post sent to me privately which
seemed to criticise NMAA. I think it's far more hazardous to let pump
manufacturers go their own way, as has happened for a century with the
rubber bulb pumps, which I have found everywhere in the world that I have
ever looked, from Africa to Asia to Eastern Europe. NMAA has an excellent
training programme for counsellors, and to my knowledge teaches more women
about breastfeeding and hand expressing than it ever teaches about
pumps.But it is also a pragmatic organisation run BY and FOR breastfeeding
women, and naturally will sell equipment of many kinds which its review
process finds helpful to those women. Long may it do so. Its sponsorship
policies are fine in my book.

One of the key points I made in the Wellstart review was that there is no
such thing as countries where technology is a problem and countries where
it not. We live in one world. In every country there are affluent and
disadvantaged communities, rich and poor people. People's bodies are the
same, infant or mother alike. The physical problems are therefore the same
but the outcomes vary if poverty compounds them (or conversely, enforces a
particular outcome, somtimes a better one than where women have
"choices".). I hate terms like developing country, though I am sometimes
forced to use them as a sort of shorthand, or at the insistence of journal
editors.

Making money from promoting pumps and objects detrimental to breastfeeding
can take many forms. Yes, when APMAIF allows a particular advertisement
(notice of availability or change of formulation or somesuch) for a
particular reason, some Australian parent magazines publish that
advertisement. It should be said int heir defence that the magazine Jan
criticised in an earlier post has had policies for many years that say that
no infant formula advertising will be accepted that is not approved by
APMAIF: pretty good it seems to me, when it involves them in losing money.
Before APMAIF they accepted none for many years.

Pump persons and magazines are not the only interest groups to profit from
artificial feeding. It distresses me greatly that a book co-written by a
very well-known infant formula company dietitian is being sold by
booksellers including CAPERS. This includes gems such as "Bottle feeding:
top class nutrition off the shelf" "Bottle feeding should not be regarded
as a poor or second-rate alternative" "and (this one is for you, Kathy!)
"contrary to what you might hear, the closeness and bonding experienced
with breastfeeding can also be experienced with bottle feeding"; reason to
wean: "dislike of having baby always clinging to you - some of us need more
personal space". There is a great deal more that I won't waste Lactnet
space on, from dreadful positioning to complete equation of breastmilk and
formula and weaning recommendations to diets that give a baby 5 feeds of
200 ml at 4 months (4 feeds, breast or bottle at six months. 3 feeds in the
6-9 month period). And there are other breastfeeding and baby-rearing books
in the CAPERS catalogue that I consider very detrimental to breastfeeding,
and would never sell, except to LC friends who need to cut them up for
pictures of bad positioning etc.. Booksellers could do a lot to advance
optimal infant feeding by learning enough about it to ensure that they
don't disseminate misinformation, whether written by company dietitians or
simply ignorant well-meaning mothers. It's harmful whoever writes it.

So those of us who rent and sell pumps need to be careful. Those of us who
write or sell books need to be just as careful about what we do in our
professional capacity, as we demand that others are in theirs. Glass houses
are fragile things, and none of us is perfect or always right in the
judgments we come to, however hard we try to get it right. But the good
thing about being human is that repentance and reparation is always
possible.. (See what that SIN thread has done to me!) I must go to bed....M


Maureen Minchin, IBCLC
5 St, George's Rd., Armadale Vic 3143 Australia
tel/fax after March 1: 61.3.95094929 or 95000648