I personally feel the attitude that we hold back the truth to be a huge part
of the problem in all things called 'women's health'. Do we do the same for
the health of men? Do we worry about guilty feelings when we tell a man his
choices can hurt him or someone he loves? No. We save that patronizing
protection and 'need to know' for women. I am a woman and I find it insulting.
I think it is entirely possible to share the information in a way that
protects the mother from being unable to hear. (And, if she feels attacked in her
choice, she will shut out the information.) After all, what we are saying is
not what the rest of society is telling her. We are saying breastmilk is
unequaled and there are risks to the alternative, and she is seeing all around
her breast is best, but formula is just as good. While we may want her to
see the truth, she may be unable to since no where else is giving her the same
message. I still think she needs the message, and I think it is our duty to
tell it, but I think we have to be sure we do it in a way that respects we
are the only ones saying it. Her doctor tells her it doesn't matter, the
hospital nurses tell her it doesn't matter...the hospital sends her home with
proof it doesn't matter. If she is in the USA, is unlikely she has seen more
than a handful of women breastfeeding....if that. And, all her friends and
family think she is nuts, or at the very least will encourage her to quit at the
very first hint of trouble. Everyone basically nods their heads at her
choice to use formula and along we come telling her it makes a difference.
Is it militant? No. It is honesty. It is an unwavering belief that
breastmilk is not just best, it is base of normal development in all areas of human
health. It is the building blocks of not only today's healthy baby, but
tomorrows healthy adult. It is impossible to act as though it really doesn't
matter when you know it does and once you have the information, to be unwilling
to share it--or in many cases as a hospital based employee unable to share
it is unethical. I am so frustrated when I hear the word militant given to
those who choose to abide by their personal and professional ethics. The
assumption seems to be that we are unable to share honest information and the
truth without kindness and awareness of the discomfort that knowledge may bring.
I do completely and personally understand that formula is sometimes the only
choice mothers have in the USA to feed their babies. I do understand the
reality is some mothers cannot breastfeed, some babies cannot breastfeed, and
some must do some of both. However, I do not see that reality as incompatible
with knowledge. I am often in the sad place of explaining to a mother that
supplementation is necessary and why. I never make light of the seriousness
of not being able to breastfeed exclusively. I never make light of not being
able to breastfeed. She will hear that everywhere else. From me she will
hear the truth. It is unfair, her baby deserves to be breastfeeding, she
deserves to breastfeed her baby, and whatever is interfering with this reality is
unfair. With me she will know that it makes a difference and it is worth
more than a passing thought....not lifestyle choice, but a health choice that
affects her life and her baby's life Something so uniquely female and powerful
and purely mother that her body aches with the reality that she cannot do
what she desires most of all. Will she feel guilty? I don't know, I hope
not. But, if she does feel guilt, she can talk about that with me too and we
can dialogue to see if it is guilt, or more like anger, regret, grief.
I am trying to understand why it is not possible to both tell the truth and
at the same time not beat the mom over the head with it. I get that what is
done is done, and we don't want to lose all of breastfeeding over one bottle
or two or three... I understand we want her to continue to breastfeed no
matter how little. If she wants to use formula, likely she will do so no matter
what we say. But, maybe, just maybe, we will be the one to tell her the
truth--those bottles of formula do matter-- and she will realize that she can
breastfeed exclusively and be grateful for the knowledge. And if not, she won't
be able to claim ignorance. And, if that makes her feel guilty, well, sorry,
but if you are purposely make a decision with full knowledge of the
consequences and you are able to make another choice (and the key here is "able to
make the better choice") guilt is what you are supposed to feel. I can't be
everything to everyone, but I can be true to myself, my ethical obligations,
and my own personal professional standards. That requires me to tell the
truth, tell it gently, but tell it. I will no lie to a mother -- she is a woman
just like me and I respect her as such and will not hide from her what she
needs to know. I assume her intelligence and ability to make informed choices.
I do not feel the need to shield her from herself or her choices. I do see
it as my responsibility to be kind, respectful, and to share the information
in a way she can hear it and use it as she chooses.
Why is it that those of us speaking "for" something are called militant?
Why is it that when all evidence points to the validity of our concerns and we
speak up we are militant but when 'they' try to speak out 'for' their product
or procedure it is either good medicine or freedom of choice. I get so
frustrated by inequities of terminology used for various behaviors that seem so
similar but earn such different labels.
I keep thinking if we stay true, if we are honest, if we tell enough women
then eventually the ripples will flow and enough women will know, and believe,
and when that happens the voice of the angry women lied to and denied their
rights to feed their babies will be so loud it will shout down all the money
being made from the alternative. If we all keep it quiet, if we protect them
all from the knowledge, if we choose what they have a right to know with the
assumption we are protecting them, if we who know cannot speak, or will not
speak, how can expect mothers to find their voice?
Take care,
Pam MazzellaDiBosco, IBCLC, RLC
FL, USA
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