<if you figure out how to inspire docs to learn about lactation, please let
me know.> Kathy Leeper, MD, IBCLC>
And please let me know too. I think it's a combination of a number of
factors, mostly operating unconsciously. Firstly, most doctors genuinely
are unaware that breastfeeding is important or if so, that there is anything
to know about it.
Most doctors in this country certainly are aware that it's important for the
poor at least, but they don't know that there's anything in particular that
they can do about it other than advise a mother to do it. It's a mother's
personal choice, and rather than address a topic that is an area of total
ignorance to many of them, they leave it alone. Before I read the Womanly
Art of Breastfeeding, when I was pregnant with my second child, I really
thought it was a matter of luck whether a mother breastfed or not - that is,
if she wanted to. I mostly blamed the mother who didn't breastfeed for not
wanting to. Until I wanted to, and didn't. I hadn't breastfed my first
because of the usual hospital mismanagement, but I didn't know that then. A
good lesson, however sad. There is some truth to this too, there isn't much
you can do when you don't know anything about breastfeeding, which is
because medical training hardly mentions it.
Then, there's the control issue, which I think is major. The whole male
domination culture - breasts are theirs, and they can't control
breastfeeding, they don't know how much the baby gets, or how to manage it.
Artificially fed infants provide huge scope for management and control.
And I have even wondered about an unconscious need not to sabotage their
means of earning a living, since artificially fed infants need doctors much
more....
I once gave a talk to a group of GPs and caught their attention by
explaining my feelings about breastfeeding - that it gave me confidence as a
mother, grew my self-esteem as a woman, made me feel normal. That after
failing to nurse my first child, something inside me died, but I would never
have admitted that, if I hadn't succeeded with my second. And that I had no
idea ahead of time that it would affect me that way; I planned to breastfeed
because I considered it normal, and of course for the health benefits.
Jelliffe quotes Weichert in his"Human Milk in the Modern World":
"....a functional castration of women has occurred. They have aquiesced to a
combination of forces, medical and cultural, which have eventuated in the
use of the breast as the primary sex symbol and yardstick of feminine
desirability, divorced from its nurturing role. Women in a critical period
of their life cycle have become divorced from themselves and from the
ability to confirm their identity fundamentally. In this instance, the
degree of concern of the medical profession might be described as inversely
proportional to the dimension of the problem. To draw an analogy, would the
professional distance of physicians be maintained were it routinely
recommended that all insemination be accomplished artificially? Would
anyone suggest seriously that males abstain from intercourse, bind
themselves, take drugs to relieve congestion, or be mechanically relieved
routinely, and that it would be as good?
The apparent absurdity of the analogy goes to the heart of the problem. If
one sees lactation as part of a psychosexual continuum in women, the analogy
can be taken seriously."
Weichert C, (1975) Paediatrics 56:987 Braestfeeding, First Thoughts.
Nan Jolly MB BCh IBCLC LLLL
Port Elizabeth, South Africa, where MB BCh means what MD does in the USA
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