Nancy,

All parents need to be informed that anything other than milk made by one's
mother is a risk.  The risks of artificial feeding would be a better way to
describe the true risk to parents rather than the risk of infant formula.

You asked, "Do you work directly with mothers and babies?"  No, not at the
moment.  I volunteered as a La Leche League leader for 10 years.  I was employed
by the WIC program in Volusia County of Florida for 4 years.  I had a private
practice as an LC up until 2001.  I have been lucky to share in the successes
of the mothers and babies I worked with; but I have also shared in the
disappointments, when breastfeeding for one reason or another did not work out.

Since 2001, I have been doing research on the patenting of human milk
components.  I am currently employed with a local Bed & Breakfast, part of the
Florida tourist industry--an optimistic group of business people.  My employment has
little stress and gives me enormous flexibility with my children (being a
single parent) and time to research and write.  But certainly not a job in my
chosen field of work.

Maybe my life has colored my view of the world.  I assume that is what you
are implying by your comments--"I find that my optimism grows with successful
resolution of breastfeeding issues.  Do you have the chance to be a part of
those kinds of experiences?"

One of my experiences in the WIC Program with a mother and her baby had an
enormous impact on me.  It was a defining moment and one that would send me in
search of answers.  A young mother and her baby came to me because she wanted
to breastfeed.  She was formula feeding her infant and the baby was not
tolerating the formula.  I had been told by the head nutritionist that she was hiv
positive and it was quite clear to me that it was going to be my job to tell her
she couldn't breastfeed (this was 1998).  I told her that the CDC did not
recommend that she breastfeed.  I told her exactly what I knew at the time--next
to nothing other than the CDC recommendation.  I will never forget the look on
that mom's face.  She asked no questions, just left my office.  The hiv
recommendation in regard to breastfeeding has never made any sense to me--even
then.

This case made me realize my lack of knowledge about hiv/aids.  I didn't
understand the recommendation, it made no sense to me.  It was the moment I
realized that I could not say what I really thought to this mother.  Ultimately, I
understood in my heart that I was afraid to say what I really thought to this
mother for fear of losing my job.  It did lead me on an interesting journey of
self-education about the policies of hiv/aids and breastfeeding.  That journey
ultimately took me to asking a microbiologist about a patent he mentioned at
his website.  Which lead me to doing research on the patenting of human milk
components (also finding patents on infant formula).  I suppose that I wanted
to prove to myself that I had given the mother the best recommendation.  But
there is no peace for me in regard to believing that I had given the mother the
best recommendation.

The CDC recommendation on discouraging breastfeeding because of hiv/aids was
based on 2 letters to the Lancet involving a total of 4 cases.  I find this
unsettling.  I find it upsetting when I read patents from the government in
which human lactoferrin will be used to inactive or treat  hiv/aids.

Despite it all, I am optimistic.  If not for this mother and baby, I would
not have undertaken my quest to understand our policies on hiv/aids and
breastfeeding.  I suppose the irony of it all is that I feared I would lose my job and
I ended up quitting not long afterwards anyway.  I quit because I wanted to
be a career service employee which would entitle me to benefits--like health
insurance.   I was OPS--considered contract work with no benefits, etc.  There
was no career service job called "lactation consultant" in the WIC Program in
Florida in 1998--I believe that is still the case.

I do believe that I have a level of freedom to say what I think because I am
not employed by an agency or an institution that would be "unsettled" by my
comments. I had seriously entertained the idea of not recertifying as an IBCLC
in 2001 because I no longer have employment in my chosen field.  But, I have
come to believe that my research is of value to the breastfeeding community
whether or not they want it.  Gratitude and optimism are important components of
life, without them we no longer have hope and courage.  May all of us continue
in hope and courage despite the many setbacks we encounter in life.
Valerie W. McClain, IBCLC


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