Dear Lactnet Friends:
Pat Young asks why medical practice takes so long to change? This leads me
to an onslaught of random morning thoughts.
All the rules I grew up with are gone. I used to count on evidence and
research papers as a foundation for my practice; now that whole arena is
corrupted by economic and political pressures.
https://link.springer.com/article/10.1007/s00192-017-3389-1
This is probably one reason that good research findings aren't implemented.
Another reason is that breastfeeding has no economic value. Breastmilk
does, and now breastmilk is to be grown in a laboratory, so investors are
frothing at the mouth to get in on that pile of money. But the actual
relationship of parent and baby that is breastfeeding. . . .nah!.
Nobody makes money when babies go skin to skin. What women know about
mothering is clearly suspect; never mind that mothers have been keeping
babies alive for hundreds of thousands of years. Any research supporting
our own instincts is lost in the tide of new drugs and procedures that are
deemed more important.
So Vioxx took maybe 10 or 20 years to go from an idea to being withdrawn on
the market, whereas s2s, first published in 1966, didn't reach mainstream
acceptance into practice until 40 or 50 years later.
Another reason is that a Cartesian view of medicine discounts anything that
can't be measured. An example: in cardiology, everything about the heart
will be measured except its beliefs and love. Yet what our hearts feel
feeds our brain and informs our emotions and our body's chemical
reactions. So much of breastfeeding and mothering involves a domain where
things can't be measured, except retrospectively and that type of study is
deemed less valuable than the RCT.
The Cartesian, mechanistic view of the body has led to the proliferation of
specialists in body parts and systems; unlike the body, none of those
specialists communicate with each other. So my 95 year old stepmother went
into hospice last year; part of hospice care was taking her off all the
prescriptions. She was taking at least a dozen: some from the GI doctor,
some from the cardiologist, some from the pulmonologist, and some from her
internist. She promptly got better, so much so that she was discharged from
hospice care!
We see this fragmentation in our work, where the mental health expert will
prescribe medication so the mother can sleep all night, without considering
that a lactating person can't go for 8 hours without milk removal, and the
OB/GYN (for the most part) is clueless about breastfeeding, and the
pediatrician (again for the most part) prescribes formula. But this mother
wanted to breastfeed; and her baby wants to breastfeed..
Never mind that the RCT has its limits, and that research studies are
designed based on the intention (whether conscious or not) of the
researcher.
Patriarchy is probably another factor; how many of us have grown up hearing
how men are logical and women aren't, and what men do is important, but
what women do isn't. How many lab results use the male body as a baseline?
So like everything in today's world, the answer is multifactorial and
complex.. . and non-sustainable.
warmly,
--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC, RYT
Reviews Editor,* Clinical Lactation*
www.nikkileehealth.com
Pronouns: she/her/hers
*Communications are confidential and meant only for whom they are
addressed.*
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