Emily wrote about her midwife's skepticism to the possibility of
breastfeeding through pregnancy.  The first part of Emily's post revealed a
serious deficit in the competency of her midwife, in that formula samples
were foisted upon her by office staff.  Before attempting to educate this
practitioner about the finer points of mammalian physiology, I'd advise
getting her a copy of the WHO Code on ethical marketing of breastmilk
substitutes, underlining the sections about the ban on provision of free
samples by health personnel, and check into whether the midwife's
professional association has endorsed the Code.  I think there are
associations in the US who have done so even though the US as a nation has
declined to get on board.  If she belongs to such an association she should
be alerted to the discrepancy between her practice and her professional
commitment to protect, promote and support breastfeeding, and if she doesn't
understand the problem she should be reported to the association's ethics
committee.

I would be extremely hesitant to follow breastfeeding advice given by any
person with ties to the breastmilk substitute business.  Furthermore it
would make me wonder what forces shaped the care she was providing for me in
my pregnancy, and since this is something about which I feel very strongly
it might well prompt me to seek care elsewhere, and tell her why.  

As a midwife I feel embarrassed on behalf of all my colleagues every time I
hear something this inane.  I know it's not my responsibility to guarantee
that all midwives are competent or ethical, but I still take it way too
personally.  Shudder.

Rachel Myr
Kristiansand, Norway

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