Of course Anne, and this is called "choice". It is very important to
protect her right to make a choice right? The threats used to get
mothers to comply are unbelievable. Either you give formula or your
baby gets a needle in his head? Call the social worker, report her to
Children Protective Services, give her alternatives that scare her and
make her worry for her child, yes. I hear these stories all the time.
Why? Because choice is so important? Only the choice they want you
to make.
I am sorry folks, I am very angry about the issue of protecting
choice this week. A friend of mine got called on the carpet at the
hospital where she works because her breastfeeding class does not
encourage choice!!! Or, should I say it encouraged the choice to
breastfeed and one would expect that in the breastfeeding class you
would think. Her boss seemed to think she needs to encourage family
centered choice that is defined as the nurses choose and the mother
chooses to listen to the nurses. She needs to limit her information to
that which will ensure mothers make the choice they are encouraged to
make by the nursing staff. Of course, that is not what they said.
They said she is just too passionate and strong in her beliefs and
that the mothers need to not feel 'forced' to breastfeed. Right. She
is one IBCLC in a rather large delivering hospital who only works full
time, and she barely has enough time to see the patients who want to
breastfeed and ask to see her! Surely if they are asking for help
they are not feeling forced to choose breastfeeding. My friend is a
nurse, this is not nurse bashing. I am very lucky in my area to have
some of the best and brightest IBCLCs working in our delivering
hospitals. And there are some great nurses making a difference
too.They, however, are not in charge. They are working in unfriendly
environments, walking on eggshells at all times being careful not to
say the wrong thing or come across as overly encuoraging of
breastfeeding in case they offend someone who thinks formula is just
as good. I would not be able to do this work. I would be sick every
day! Anne, no wonder you want to cry! I would want to cry too! It
cannot be healthy to work day in an day out in the stressful situation
of a hospital based IBCLC where breastfeeding is tolerated, but not
supported and where your job is not considered an intregal part of
maternal services. I cannot blame LC's who do not rise to the
challenge every single day....it must get exhausting and the fight is
just so huge that they are overwhelmed! It is much easier to just
encourage the formula, rent the pump, etc. They have to do the best
they can in the work environment to keep their job or they cannot do
any good at all.
Something about mother baby care encourages health care providers to
make decisions and encourage choices based on their own choices. We
do not see this in management of any other health care field. Could
you just imagine a cardiac surgeon telling a patient that while it
would be better to quit smoking, here is a cigarette just in case you
cannot manage to quit? And that by pass surgery you just had would of
course be encouragement to quit, but I smoked for years and I have a
very healthy heart. Smoking probably doesn't play that huge a role in
your cardiac health anyway. I know, the ressearch, but they are just
anti smoking and don't want to protect your right to smoke." Or a
endocrinologist trying to get someone's diabetes under control saying
'look, all this sugar you eat is not that good for you, but I cannot
imagine giving up my donuts, so here is a coupon to the local bakery."
No way. Why, because that is not good medicine.
Choice? Do we talk about choice in any other medical field that
requires a behavior change to remain healthy? No we do not. No, this
is not about choice. This is about what it has always been about.
The way women and children receive care. Mothers because the subtle
discrimination against women's health is very real and the lack of
respect for women interferes with giving them any true information to
even make an informed choice. When the care provided says epidurals
are 100% safe, and why would you choose not to have one...no one gets
a filling without novacaine! and my goodness, you don't want to have
fecal incontinance when you are 50 from that pushing or ruin that
tight vagina, a cesarean is so much better for you. And if they want
a medical reason...well, you know 38 weeks is really full term, I am
going to be gone the week of your due date....let me induce you so you
don't have to see another doctor....oooops....well, you have been on
pitocin and your epidural for close to 20 hours now and the baby is
not coming so we need to do a ceserean. I hear mothers want epidurals,
mothers want cesarean births. Sure they do! Who wouldn't after
hearing how great they are! Choice? Where is the mothers full
informed consent and why is the attitude "mothers ask for this"
considered valid when doctors refuse to tell them the truth and act
like there is no danger at all of any kind with an epidural or an
induction or a surgical birth and recovery. Where is the ethics that
say we cannot do this because there are risks that outweigh the
benefits so mothers and babies are not encouraged to make choices that
are risky thinking they are safer. Babies have no choice because they
have no voice. They cannot even choose the day they are born in my
area! If I talk to a mom who carried to 40 weeks or beyond it is now
a rare occurance. The baby cannot say "please, I prefer not to have
that bottle nipple shoved down my throat and choke on that stuff you
are feeding me and could you please slow down I cannot breathe!!"
Choice has no place in the baby's world. He depends on the choices of
others.
Look at Lactnet. We know there are awesome doctors, midwives and
nurses all over the world! There are great health care providers who
do indeed work to make a difference. It is not easy for them either.
How hard is it to be a pediatrician in a large practice who wants to
eliminate formula handouts, but cannot get it done. Or even be a
member of the AAP and not be able to stop formula funding? How hard
to be an OB/GYN who wants to let his patients walk and eat during
labor, but hospital policy won't allow it. Unfortunately, those
doctors and nurses are up against the same system that the IBCLC is
dealing with. And why? In the USA I would say most likely money.
Money from the formula companies that encourages loyalty to their
cause...loyalty to the choice to formula feed. I have no idea why
other countries have maternal/child care practices that are not baby
friendly One thing I am sure of, it is not about the mother's right
to make a choice.
Maybe we need to start countering that argument every time it comes
up. I'll protect the right of a mom to choose formula when there
really is a choice! When hospitals do not peddle products for profit
and when breastfeeding is actively protected and supported. When
every mother who needs assistance with breastfeeding gets it before
she gets handed the bottle of formula. When breastfeeding is shown as
normal just as often as bottle feeding. Then, when there is equality
of feeding choices I will believe it is about choice. But, until
then, I see it is really about money. Protect the money.
Ah, and this is the end of breastfeeding week....
Take care,
Pam MazzellaDiBosco, IBCLC, RLC
On 8/5/07, Anne Hinze <[log in to unmask]> wrote:
> well the nurses won. i just talked to my client and she said they told her that because the
> baby hadn't peed since yesterday morning (last night) that they were going to have to put
> an IV in her head and keep her for a week if she didn't give her the formula. >
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