Informed choice is only possible when the information available is factual
and free of conflict of interest.  The way information is presented is not
unimportant either. I didn't find the AAP statement to be as irksome as many
others did, because my fundamental assumption is that when women do gave
what they need to make an informed choice, namely, factual information free
of conflict of interest, there is really only one choice, and that is
breastfeeding. I saw the AAP statement as saying in the politest possible
way, so that Rosin may not even realize she is being called unscientific,
that feeding decisions ought to be based on evidence, not on skewed
interpretations of the evidence.

I am not going to defend the AAP's continued acceptance of money from the
breastmilk substitute industry, nor defend the letter to the Atlantic, and I
don't know which approach, 'theirs' or 'ours' is most effective. 
I'm just saying it didn't set me off the same way.  To advocate women making
an informed choice about breastfeeding is in no way saying that we should
give equal time to breastfeeding and artificial feeding when conversing with
women about this or that we should present them as two equivalent choices. 
It is, on the contrary, insisting that we be honest about the health
effects, the function, and the purpose of breastfeeding as distinguished
from artificial feeding.  

And does anyone really think that when something is defined by a society as
illegal, with sanctions to be imposed on anyone found guilty of breaking the
pertinent law, that people have the same freedom to choose to do it as when
it is *not* defined as illegal?  Even here where women have paid leave for
months and months on end I would not favor a law requiring every woman to
breastfeed.  I can't imagine it ever being necessary here, either.  You
don't change a bottle feeding culture to a breastfeeding one by locking up
or fining anyone who doesn't conform.  You just end up with more people
getting sent up for their transgressions.  And who is left holding the baby
then?

How about a law on breastmilk substitutes as for tobacco, greatly limiting
the opportunity to advertise the product, accompanied by laws limiting the
opportunity to use the product?  If we can get the gigantic companies who
couldn't care less about public health, out of the bed with mother and baby,
we would not need lactation police at that bedside to make sure everyone is
practicing on-cue breastfeeding well enough for us purists as regards
frequency and duration.  The biggest barrier to informed choice about infant
nurturing in the US is the presence of advertising of foods that compete
with breastmilk in the first 6 mos after birth.  The biggest barrier to
women being able to breastfeed, is the lack of universal paid leave for the
time when a woman is putting in at least a full day of work caring for her
young baby.

Rachel Myr, who trusts women's drive to care for their children, in
Kristiansand, Norway

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