Amy Kwilinski asks about why so few U.S.A. hospitals have applied for BFHI
certification.

I am not an expert on BFHI.  But this questions echoes, to me, discussions we
have had about the international quality of certification for LCs and the
different standards needed in different countries; and also about why
Americans care so little about the WHO Code as a standard.

My take is that Americans just generally are not impressed by
internationalism.    I think most Americans would be more impressed by a
university degree in "lactation science" than they would by IBCLC
certification -- without necessarily having any idea how those might compare.
  The AAP pronouncement on bf has had small impact here but at least it made
the front pages of the newspapers and is given some lip service; a similar
UNICEF or WHO pronouncement is completely invisible to nearly all Americans,
buried in the back pages if indeed any newspapers report it at all -- and in
"most Americans" I definitely do include most American hcps.   And -- in
specific response to Amy's question --  I betcha that US hospitals would be
much more likely to sign up with a US Govt-sponsored baby friendly type
program, if such a thing were to exist, than with the international one.

Americans just generally tend to see themselves as the glass of fashion and
the mould of form for the whole world.   Some part of this is justified, much
is ugly prejudice.   But as a practical matter, for lactation advocates in
the US to push these international standards as "the reason" that others
should pay attention to a given credential, or to infant feeding, or to bf in
hospitals, etc etc, is to beat our heads against a brick wall.  Just as we
need to meet mothers where they are, we need to meet the culture where it is,
and American culture devalues internationalism.

Sad but I think true -- my eyedropper full :>.

Elisheva Urbas
NYC

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