I'm noticing that there are several real worlds represented on Lactnet.  The
ideal world doesn't exist in tangible form for any of us, but our various
realities resemble the ideal in different ways.  I'm reminded of the five
blind men trying to describe an elephant, each of them feeling one part of
it with his hands, and describing five very different things.

Some of us live and work in countries with poor infrastructures and poor
economies, where breastfeeding hasn't completely stopped being taken for
granted, at least in large segments of the population.  Some live and work
in wealthy countries where most of the wealth is in control of private
interests, and health care is not seen as a public responsibility.  Others
live and work in places where health care is publicly funded and controlled,
but breastfeeding is not appreciated as an element of public health.

I live in a country where breastfeeding is given a fair amount of lip
service, and there is a high degree of compliance with the WHO code though
it has never been enacted into law.  Health services are publicly funded and
universally available.  Even so, Laurie Wheeler's examples of ignorant
professionals using their position to impede good physical and emotional
health in parents and children are very familiar to me.  Yesterday I was
back at my old job, just as a 'guest appearance'.  I got my IBCLC credential
just as I was leaving that job to assume the editorship of my professional
journal (midwifery).  My job before was to run the out-patient clinic for
mothers and babies who either opted for early discharge (early means before
72 hours post partum), or who were experiencing significant BF problems.

I am the only person *ever* to work in our maternity ward who has been (I
still am!) a mother-to-mother BF counsellor, and the only IBCLC in Norway
outside of Oslo, which is 5 hours away by car or train.  In my absence, a
series of different, dedicated midwives have staffed the clinic, and done
the best job they can.  During that entire time I have had about one family
a week visit me at home, sometimes even on their way home from a clinic
appointment, to get help coaxing a hesitant baby to the breast.  These are
just the families who happen to find me through the BF mothers'
organization, or through friends.  We (mothers and I) have not failed yet to
get a baby breastfeeding.  There is no mechanism in our current system for
me to get paid by the health service for this kind of consultation, and at
times even I wish there were third-party payors here.  When I work a float
shift at the hospital I am not compensated for my skills in BF support
because 'those aren't relevant except in the out-patient clinic'.

Meanwhile, I have been invited to speak at a European Congress in Perinatal
Medicine to be held in Oslo this June, on 'how health professionals convince
mothers to BF' in Norway.  Before I had received a written invitation, or
agreed to speak, my name was printed in the information sent to potential
attendees as one of the speakers at a symposium on normal birth and infant
nutrition.  Forewarned by others who have attended this conference when it
was hosted in other countries, I asked what role, if any, Nestlé would have
at the conference.  I was told they were not a sponsor.
Learned recently that they are indeed a partial sponsor, though not of our
symposium.  But they are providing the coffee and probably some food at
breaks in the conference.  Since the topic of my talk is the modern
BF-friendly society, I have decided that this situation will give me an
opportunity to point out the hypocrisy inherent in drinking free Nescafé
while listening to a talk about how society can protect BF.  I will have a
thermos along and I will not accept any free food or drink whatsoever and I
will specifically focus on why not.  I considered just withdrawing but the
thought that Nestlé might take the opportunity to provide a replacement
speaker was too chilling.

What is most amazing to me is that the organizers of the congress don't seem
to get it.  They thought it would be wrong for Nestlé to have a stall in the
hall with all the other industrial exhibitors (baby scales, scopes, fetal
monitors, ultrasound, isolettes, etc., all the accoutrements of modern
perinatal care), but they don't see how letting Nestlé take care of our
refreshments is a much bigger problem.  Sheesh, sheesh and sheesh again.
And this is NORWAY, for pity's sake!

Again, I think this discussion can be very fruitful.  Seeing where others
draw the line, in the context of their lives, and weighing potential good
against potential harm, is a help to me.  Wherever we draw the line, we owe
it to mothers to be open about it: where we've drawn it, and why.  My bottom
line is that there can be no role at all for a breastfeeding supporter that
involves being in the employ of a company whose marketing of breastmilk
substitutes is in violation of the WHO code.  I appreciate the stance of
Magda's group, and I appreciate the stance of Barbara Wilson-Clay, and of
others who have posted.  As a resident of The World Outside the USA it is
easier to see how pervasive the societal 'givens' are, and how they impact
on breastfeeding.  I'm with Magda, in my conviction that it doesn't have to
be that way, and there are countries that are living proof thereof.  Still,
you have to choose where to put your energy and we can't all live here,
either!

To me, advocacy is an integral part of supporting and protecting BF.  How
much the advocacy part dominates our activity is individual, but
acknowledging it is essential.  Not everything in the world should be bought
and sold, IMO, and in my 'best of all possible worlds', babies would be
nourished by the community, which would see to it that babies unable to get
their own mothers' milk, got the next best thing.  (I have great hesitancies
about surrogate motherhood, too, especially for pay.)  I think it
dehumanizes us all to view body substances and functions as commodities, in
any context.  The very notion of putting a cash register between my babies'
mouths and their food, offends my human sensibilities.  That is also part of
why I breastfed them.

So, that is my description of some part of an elephant, and I'll climb down
from the soapbox now...
Rachel Myr (midwife and IBCLC and general rabble rouser)
Kristiansand, Norway

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