Dear Friends:
     Oooh, I see feathers being ruffled. Let's step back for a minute on this
guilt/ignorance issue.
     Being a physician now is not the money-making deal that it was, say 30
years ago. I know more unhappy physicians now than ever before, what with
having maybe 5 minutes to see each client and dealing with huge malpractice
premiums and lowered reimbursements. If you want to be rich in the healthcare
system in the USA today, be the CEO of a HMO or an insurance company, not a
physician.
     There are so many factors leading into the lack of trust and support for
breastfeeding in the USA today. Can't just point to one thing. Let me remind
you of some of these factors, which all come from historical research.
     We have the strong beliefs from 3 generations ago that isolation and
lack of contact were ways to increase health of babies and children. This was
bolstered by the new psychology, that didn't believe babies loved their
mothers. This new science (and in the early 1900s, it was very new) said that
babies were conditioned to respond to their mothers because mothers had the
milk. It wasn't until 1950, with the work of Harry Harlow, that it was proved
that babies would prefer touch and comfort, even when the wire mother had the
milk. This was a revolutionary idea that shook up many disciplines. ( I
highly recommend D. Blum's book 'Love at Goon Park' which is a fabulous
biography of Dr. Harlow and his times.) These notions of isolation and lack
of touch are very deep and I can see them in my grandparent's parenting of my
parents. Child rearing texts of the era are chilling. You can see where
breastfeeding with all its touch and close contact would not be popular.
People really believed that a mother's kiss was germ laden, and as germs
carried disease, babies shouldn't be touched. As 25% of babies under five
died between 1850-1900, and mortality rates in many orphanages was 100% for
babies under age 1, people would do anything to keep their babies alive,
including ignoring their mothering instincts. Don't you remember reading
about mothers crying in their rooms while babies cried in their cribs,
because the doctor said that babies shouldn't be comforted, as it would spoil
them? That notion lingers today......
     We also developed an incredible awe about science in the USA. Can you
imagine the impact of growing up on a farm and walking barefoot to school and
then seeing a man on the Moon, all in one lifespan, as my grandfather did?
Science was revered and worshipped; how many of us can remember our
grandparents saying "The doctor said..." in tones of total reverence,
respect, and obedience? The doctor represented science, which was going to
give us a wonderful new world.
     Another thread in this cloth is the power of the healthcare system.
Around the turn of the century, the new AMA made friends with rich and
powerful industrialists, like Carnegie and Rockefeller. This new trade union
systematically went after every other healthcare profession. Midwifery is
still battling those old beliefs; you can see it in What to Expect When You
are Expecting. There is a comment in the household hazards section that says
"all of today's environmental perils combined (alcohol, tobacco, and other
drugs excepted) are far less of a threat to you and your baby than one
untrained midwife with unwashed hands was to your ancestresses." (p. 67) Such
a comment is a direct descendent of the smear campaign conducted against
midwifery in the early 1900s.
     (It was the doctors that brought puerperal fever to their clients in
Austria, NOT the midwives. People really believed that a gentleman couldn't
carry germs. Semmelweis had his hands full to be believed.)
     The AMA went after everybody: chiropractors, homeopaths, you name it.
And our feeling that everything that isn't an MD is "alternative" or
"complementary" medicine is another descendent of that powerful work done by
the AMA. Even though acupuncture and auryveda are 5,000 years old, and
homeopathy is older than allopathy, they aren't considered "real" medicine.
Medical doctors claimed to have science on their side. And sold this idea to
the public.
     The notion of "formula" came from mothers going to pediatricians to have
the breastmilk substitute changed every so often, because mothers were making
it at home and needed a recipe. The doctors changed the recipe along with the
growth of the baby, using a formula.  "Formula" fit right in with this
incredible trust in science, the power of the physicians, the notions of
cleanliness and lack of contact.
     We have the long association between profit and health services as a
result of this country's capitalistic system. Elements of this system have
become exaggerated over the generations, until now they are toxic. By toxic
capitalism,  I mean that health is not compatible with profit, unless there
is such an incredible grassroots movement and enough people are maimed and
damaged that change begins.
     That is a reason that the Reagan administration refused to sign on to
the WHO Code in 1981. Such a Code would be in restraint of trade of the poor
formula companies, so the USA would not support it. Especially when the
formula companies told the Adminstration that they were doing many of the
things that the Code recommended anyway.
     Here in the USA, people feel the way about bottles and formula that they
should feel about their mothers. This is why folks froth at the mouth at the
notion formula isn't good for babies; that "Look at me, I'm fine.........and
don't you DARE say I am not"  attitude is an outgrowth of a baby attaching
some feelings to a substitute feeding method.
     These factors influence what is taught in schools, how laws are made,
and how norms and values are shaped. And I know that there are more factors
that I haven't touched on. And this can't be a book, but only a post!
     People get used to situations heretofore intolerable because they become
common.  I mean illness in children. In the USA, people accept that babies
cry a lot and get ear infections. In the USA people accept that new mothers
get the blues. People confuse "common" with "normal." Yet the evidence is
strong that babies don't have to get ear infections nor cry a lot if baby is
held and breastfed; other cultures, where having a baby is honored, don't see
postpartum depression.
     We are dealing with a HUGE cultural juggernaut now, that will take lots
of plain speaking of truth, and and enormous number of sick, injured, and
dead babies before enough ordinary citizens start to wonder and care. And it
also needs all our dedication and crusading to sow the seeds for that day.
     Think about the generations of women being drugged into oblivion in
birth. Did you know that the suffragettes wanted drugs in labor and crusaded
for relief of pain in childbirth as an emancipation? And that led to nearly
50 years of unconcious  birthing mothers until Majorie Carmel wrote her book
"Thank you Dr. Lamaze", and also published in a mainstream women's magazine
(Ladies' Home Journal?) about the joy of being present for one's labor and
birth.  Which led to a whole movement, and the birth of childbirth education.
    I should stop now, it's too early for such polemics. My point is that
there are SO many factors that have  created our situation here in the USA
today, that we can't point a finger at any one thing. As with breastfeeding,
there is more than one issue to deal with here.
     We have to mobilize with each other, every discipline from medicine to
nursing to dentistry and nutrition and childbirth education and doula work
and massage therapy and all.
     Warmly, and taking a breath now.
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CCE, craniosacral therapy
Adjunct faculty, Union Institute and University, Maternal and Child Health:
Lactation Consulting
Supporting the WHO Code and the Mother Friendly Childbirth Initiative

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