When Nils Bergman was in our community speaking, I went up to him
during break and asked how long he thought it would take for what is
evidenced based to become standard of care.  He looked at me and said
something like:  It would require a paradigm shift within the medical
community and that is not likely to happen in the near future.  When
asked about bathing babies so soon after birth by one of the nurses he
laughed and said that was our tradition, not a medical necessity. I
have to say, one thing about this work I do I find the most
frustrating is the tolerance of mother baby care not being evidence
based and the acceptance of poor staffing and a lack of space as a
good reason to deny due care. If this same argument was used in
cardiology, cancer, neurology, or any other field of medical care it
would be unacceptable!  I mean really, what is it about the care of
women and babies that makes it acceptable to give a standard of care
that is below evidence based just because that is how it has been done
for years!? If we used that standard of care in other fields of
medicine patients would be outraged.  Yet, women dare not be outraged
and babies have no voice.

There is this way of working with women and babies that seems to
ignore what we know now just because of what we knew then. I have to
say I agree with Nils.  I don't see the paradigm shift coming anytime
soon.  In far too many instances, women's maternity care from birthing
to breastfeeding is provided based on past practice and tradition, not
evidence.

Pam MazzellaDiBosco, IBCLC, RLC
Florida, USA

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