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Subject:
From:
Sarah Vaughan <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 21 May 2012 11:37:33 +0100
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On 18/05/2012 05:32, Maria Paciullo wrote:
> I am a little in disbelief at the reasoning in this discussion.  Re:  going to any lengths--
> I will say that I missed many of the posts on this topic

I think this is a large part of the problem with this debate - that, in 
the tangents of this complex topic, the context in which I raised my 
original objections has been lost, and that people are thus 
misunderstanding what I have actually been saying.

My original post was a reply to a poster who felt it would be a good 
thing  for formula to disappear from the world due to being entirely 
replaced by donor milk as the *only* available option for parents unable 
to provide breastmilk as their babies' sole nourishment. This is rather 
different from simply expressing the wish that donor milk become widely 
available for those parents who make an informed choice to use it. It is 
a viewpoint that completely disregards the many practical and cultural 
reasons why parents may choose formula milk over donor milk even when 
given a choice. A world in which donor milk was the only available 
alternative for women not breastfeeding or not fully breastfeeding would 
allow for no more choice than a world in which donor milk is 
unavailable. I was objecting to this idea; to the idea that we should 
work towards this world as the ideal.

I am not 'promoting formula'. I am not claiming that formula is 'better' 
than donor milk as far as health outcomes are concerned. I am pointing 
out that we do not currently know very much at all about the extent to 
which donor milk is better than formula or the circumstances in which it 
is or is not better, and that this is something we really ought to know, 
and consider carefully, before assuming that it is appropriate to work 
towards a world in which it is the option promoted for everyone unable 
to fully breastfeed, far less a world in which it is the *only* option 
available for such women.

> , but seeing this one. . .
> Is the question what price is it worth it to pay to get your baby milk that will help it survive?
Hardly. At least, not in the sense that I think most of us would 
interpret that question. The phrase 'will help it survive' suggests 
we're talking about a situation where a sick baby is in dire need of 
something that will make a major difference to its chances of dying. In 
that situation, I doubt anyone would question the need to do whatever 
they could to get hold of what was needed. That's not at all the same as 
a situation where there is a *remote* chance that taking one course of 
action rather than another may result in a baby's death, and where this 
is weighed up against the various practical reasons for choosing one 
course of action rather than another. The latter choice is the same 
choice we make as a matter of course whenever we take our children for a 
car journey.

Hope that clarifies.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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