As lactation consultants we wear so many hats, but perhaps the two most 
important are activists trying to bring about social change and advocates 
for particular women with very individual needs. How we present 
information, is partly determined by which hat we are wearing.
 
As a change agent, I want to be especially careful that every claim I make 
can be backed up by science, because I don't want to leave myself open to 
attack. "Breast is best" can clearly be defended, based on mountains of 
research. To me that phrase incorporates the assumption that breast is 
also best for the mother, we have evidence to defend that position as well.

To claim that breastfeeding creates "better mothers" is very different, 
and while it may be true, I would not want to use this to sell 
breastfeeding. It's an open invitation for attack. 

When I'm working with an individual mother, I feel that it is sometimes 
appropriate to include my own hypotheses, as long as I make it very clear 
that they are my own. For instance, I will say "I suspect, based on my 
understanding of natural selection, that one reason inverted nipples have 
survived and not been selected against, is that humans are such social 
creatures, that if breastfeeding is impossible, a baby would be handed off 
to someone else to feed" This is not science, it's my opinion and I am 
careful to state that. 

At times, with some women, it might be helpful to point out that we 
believe  the hormones of breastfeeding are designed to enhance maternal 
behaviors, but at other times this could be destructive. This should be 
done on a case by case basis. And we still need to be careful not to use 
loaded words, like "better".

I don't think we are that far apart, I think it comes down to how what we 
know and what we suspect are presented.

Kathy Lilleskov RN IBCLC

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