The word choice seems to be seen as "choose between two equals" and I
do not view choice that way at all.  Choice can simply mean to choose.
 Like I choose to buckle my child in the car seat.  I choose to not
smoke.  I choose to birth without medical intervention in my own home.
 I choose to feed my family whole foods and very few processed foods.
I choose which doctor I see, and which type of health care I prefer. I
choose.

 Choice is not a dirty word when the choice being made is one we agree
with. I read the responses from AAP and ABM, and it read to me like
they were saying "choose breastfeeding".  All the research says it is
what babies need, and mothers should not be making choices based on
some woman's personal issues. The article was about pressure the woman
felt to breastfeed, how tied she felt because of it, and she was
venting her discontent with the pressure society placed on her to
breastfeed, when she was not so sure it was all that important...and
at the end, what mattered to her was the touching, more than the milk.
 She did a lousy job and the article read like a typical long day as a
mom vent we usually have on girls night out, and then go home and love
our kids.  We hardly get national attention for it.

 Breastfeeding was already the choice she made, she was ranting about
how she felt about being made to feel pressured to make that choice
and not really being sure it was worth it. The responses were to to
choose breastfeeding and that it does make a difference, that all
research supports breastfeeding for babies.  It seems we are in
agreement, however relunctantly, that we cannot make women breastfeed.
So, the goal is to make them want to.  To make it seem like the normal
thing to do. And hope they choose it  It is unfair to blame the AAP or
the ABM for the social reality that women do not want to be the main
care provider of their children.  Yes, they helped it along, but so
did the politics of the women's movement when they chose to make
separattion equal liberation.  There is so much more going on than
breastfeeding is what babies deserve.

I have read all the responses on this topic.  What I am reading is
that we want the wording of all statements to be more firm. To not say
"choice" or "choose" becaue we see the alternative as formula, which
is not an equal choice.  We want the wording to reflect the
importance.  Words such as recommend, urge, and other strong words
that suggest that the alternative does not even exist as an option.  I
am fine with that.  I thought I said so already...that the statements
can be as clear, concise, strong, and there can be wording where there
is not misunderstanding at all.  Breastfeeding is the way babies are
to be fed and every woman who can should, and every baby who can
should be allowed to.  I see no reason why the wording can't change to
be more recommending than pick one.  But, it won't change a thing in
the USA.  It will be like any other 'health issue' and we will never
be able to make people make the right choice..even when they KNOW
better!  And, I do believe that as of today, women KNOW that
breastfeeding their baby is what is right and good for their babies,
and as hard as it is for us to admit it about other women, they just
really don't want to.  Oh, they start, but they quit early.  They are
tired, they need to sleep, blah blah blah.  And, sadly, I don't think
removing fromula from the picture would change them much.

No one doing what we do is pleased when breastfeeding and alternatives
are presented as equal options to choose from. This is unacceptable.
Of course there is a difference. But, formula does exist.  Bottles do
exist. No matter how you want to twist this, get angry about, or
frustrated about it:  Women choose to allow their babies to
breastfeed, or they choose not to.  In the USA, they are likely to
choose to breastfeed, or feed expressed milk, or use formula. They do
not have the easy opton of donor milk.  And, they are not choosing to
hire other women to breastfeed their children.

A very recent thread discussed how women have found ways to not
breastfeed since recorded history.  Wet nurses, containers, liquid
substances, etc.  I know I was fed a non commercial substitute for
breastfeeding.  As was my mother and her mother before her.
Breastfeeding was what poor women did who could not afford someone
else to do it or pay for real milk to feed their babies.  Even before
women had the right to vote, they could choose not to breastfeed their
own baby.  Women not wanting to breastfeed...choosing not to
breastfeed...is not something new.  What is new is the immense profit
being made from that choice.  Money being made on the health of our
babies is unacceptable. The medical community is responsible for this
happening, and responsible for turning it around now that they know
better.

We can agree that the decision to not breastfeed is a serious one.
That it should not be made based on some woman's rant about her
discontent with life as a mother who breastfeeds.  Her ambivilant
attitude is real, but it should not be what women use to make a
deicsion that is about the health of their child!  They should use
credible sources, and make their 'choice' based on real information.
Doctors/society/culture encourages, makes possible, influences, etc.
But they do not put the baby to breast.

Tell the truth, be clear about it, and then let me decide.  I feel
this way about every single health statement.  They provide the
statements, the information, the suggestions, the recommendations, and
"I" choose what I want for myself/my children. The words choice and
rights are very strong words in the USA.  I am all for limiting some
as they relate to the rights of others.  But, I know it would require
a massive paradigm shift that would rock our entire cultural
expectations of women to make the USA be about the rights of the baby.
 Especially when we start deciding which rights we protect, who
decides those rights, and what rights we enforce.  It just is not
happening.

We can't even have the right to give birth where we want in all states
because it is not good for the baby.  Home birth is actually illegal
in some states and VBAC is not a choice all women are allowed to make.
The rights of the baby can easily be used to limit the rights of the
mother.I have big issues when we use the word choice and rights
because we can't be sure who will decide how to use them against women
for some other issue that is decided to be what's best for the baby or
best for the mother.  I do not want anyone mandating what is best for
me or my child.  Those choices belong to me.

I want the information about the choices that need to be made to be
extremely objective and based on solid research.  I want the science
that backs up the fact that baby needs to be breastfed to be common
knowledge and accepted by all health care providers.  When someone
uses the word 'choice' I want it to be clear that they are making a
health decision that has serious consequences when the choice is to
not breastfeed.  I want formula to be something we have to
relunctantly use...like oxygen when babies can't breathe on their
own...and not something we think every baby needs just in case or at
every little challenge. We don't give oxygen to a baby with a stuffy
nose!

We say "make healthy choices" all the time.  Make wise choices. Make
good decisions. We say things like "it's not a lifestyle choice, it's
a health choice".  It is a choice because there are alternatives. Tell
women the truth. Don't let the industry control the truth with their
half truths and outright lies.  Don't let a health care statement be
connected to the funding received.  Make a clear and unified
statements that babies need to be breastfed by their mothers. Give
mothers the medical and social paradigm shift they will need to make
breastfeeding a possibility and a reality in their lives. And then
trust women to make the right choice for their babies.

Pam MazzellaDiBosco, IBCLC, RLC
Florida USA

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