Dear all,

It's Sunday today and a couple of weeks ago I decided I shouldn't be working on Sunday in the same way as I do on workdays.
Despite that I just couldn't help myself from checking my e-mail and was pleasantly surprised to see the Lactnet-folder.
I just love the fact that the discussion is held here, not only with a few words, but also with delightful long postings. Here, as well as in other contexts, opinions differ.
These days, Rachel and I are reading the same book that she mentioned earlier this week: "What Mothers Do, especially when it looks like nothing."
I'm at a quarter already, Rachel, and you are right: it is a beautiful book.
It deals with the immeasurable value of a mother's attentiveness, of her response-ability (my spelling) towards her infant/child.
I am not really interested in whether bottles cause suck confusion; in some they do, in others they don't.
Last year, I've written a lot about the guideline with regard to excessively crying babies and how some are in favour of promoting letting babies cry it out.
I have worked my but off to try and hand in my share of thoughts to convince the government that this should not be turned into official policy.
To be able to underpin my statements, I read a big number of books and they contributed to my conviction that a lot of the value of breastfeeding is in the process.
Of course: there is no doubt that the product is incomparable to most alternatives when it comes to its unique charecteristics.
It is, however, the process that keeps stress levels low, which greatly improves the functioning of the immune system, thereby keeping a baby healthy.
Much of today's problems have their roots in inferior stress regulation at many levels and in many circumstances. It's cause for great concern, as far as I'm concerned...
The more I read, the more I am inclined to see a pretty close connection to the process of breastfeeding (and lack thereof).
The WHO has a hierarchy when it comes to what kind of nutrition is preferred for a baby: mother's milk from the breast is number one.
Keeping that in mind, I think that if the Code were to be rewritten, this should be more explicitly stated, not less stringent, but *more stringent*!
Like others said: it is *not* about whether other options should remain available. Of course they can be available, but that doesn't mean that we, as lactation professionals, should no longer emphasize what is very well evidence based: feeding a baby a breast offers that baby the best possibilities of growing and developing according to its biological expectations, to its physiological blue print, because spending time with another human being and building a close relationship that facilitates secure attachment, is so crucial for good health. The sport brand ASICS means: anima sana in corpore sano, a sound mind in a sound body. There are intricately intertwined and that first, early relationship must have a lot to do with it. I just cannot be convinced otherwise (speaking of strict principles, Lydia... ;o)).
No doubt: EBM per bottle is much, much better that ABM per bottle. But... knowing all we do... we have a message that is not very well received by much of western society today: a well developed breastfeeding relationship between mother and child is much, much better than EBM per bottle.
Marsha mentions the fact that bottles should not be idealized. My return question is: *why* are they not to be idealized? There must be a ground for that! I think the ground is: the value of the process.
Like Rachel says: we *know* that breastfeeding is about much, much more than just handing over calories, both for mother and child.
From the bottom of my heart... I wish this were SO evident from the WHO-code, that we coulde easily refer to it, like Liz suggests: "See! It's right there!"
Taking breastfeeding as the norm, we can find ways (also with help from the Code) to adequately help those moms who cannot breastfeed.
Even if it isn't something we would say to an individual mother... I think there is a lot behind the scenes when moms don't *want* to breastfeed.
How great it would be, if those feelings could be addressed with patience and empathy, so that mom and babe can grow and develop together, mutually mirroring and inspiring one another...
(Yeah, yeah... I'm an idealist... SO WHAT?! That's a very powerful motivation, isn't it?! hahaha)

Warmly,

Marianne Vanderveen IBCLC, Netherlands



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