Dear all:

Does the formula industry take the stance that they are not going to influence women?  Do health 
care practitioners take the stance that they are not going to do anything about cigarette smoking?  
Diabetes? Overweight? What about crib manufacturers?  Have they decided that they are not going 
to do anything about trying to influence women to put babies into cribs as the safer alternative for 
reducing SIDS?

Any time we communicate with mothers we are affecting behavioral change.  We can influence it 
positively or we can influence it negatively.  If we do not provide truthful information to women 
about their infant feeding choice, we are patronizing her by not providing her with the evidence.  
We are assuming that she cannot handle the information.  We can decide to put the information in 
terms she can understand and tell her at the moment that she is most receptive.

How many times have I seen moms who told me that they were not going to breastfeed, only to 
have someone plunk the baby on the breast, or the baby cries and they will give it a try.

I have a colleague who desparately wanted pain medications for her first birth. She asked 
everything about pain medications during her birthing classes.  She didn't even think about how 
she would feed the baby.  Her obstetrician said to try breastfeeding for a week. Had her OB never 
told her that, she would not have breastfed - let alone become a lactation consultant.  Had she not 
been given different information that ran counter to what is currently being given to women about 
hospital births she may never have gone on to have two beautiful children at home.

If you truly are not influencing change in the health care profession, then that means that your 
services are not needed at all.  Why would I pay a health care practitioner if I did not want that 
person to steer me in the direction of optimal health?  I would not want my health care practitioner 
to tell me something that a pharmaceutical company pushed on them that would increase my 
health risks! 

While we can all site appropriate and inappropriate uses of home and hospital births, I do not 
think that there is any justification behind saying that a greater than 30% C-section rate is 
medically necessary.  Something is wrong when one third of women are being subjected to major 
abdominal surgery.  Recently, I heard from a mother who lives in Australia that women routinely 
plan their "Cesars".  She mentioned a 70% C-section rate because this procedure is now elective.  
I'm sure my Australian colleagues can comment on whether or not this was an exaggeration or 
not.  Can this truly be considered normal and for the benefit of mother and baby?

I do think it is perfectly appropriate to constantly challenge what we have determined to be normal 
based on cultural practices.  Having lived in many different countries, I do find that what is 
accepted as normal in United States hospitals in regards to birthing practices is highly intrusive 
and unecessarily so in the vast majority of cases.  Yes, I am glad that there are interventions that 
save women's and infant's lives. No, I am not happy that many unecessary interventions are added 
into that hospital stay and remain so unquestioned that to bring up the topic causes such 
consternation.

We should all, always be open to taking a good hard look at the practices we deem routine and 
aks ourselves from time to time if our assumptions are correct about these practices being 
beneficial or sometimes harmful.  Whether we are in private practice or we are in the hospital or 
we are working in WIC clinics, when someone challenges us to really look closely, we should look 
closely --- maybe we might learn something even if we are very experienced, even if we have a 
bunch of letters after our names, even if (and probably particularly if) we have always done things 
a certain way.

I cannot tell you how many times I have learned wonderful things from a mom with no education 
who could not read or write and didn't speak French or English, taught me something very 
important.  Those illiterate mothers in Zaire when I joined Peace Corps taught me how to speak 
Lingala, to bargain hard for market goods, that children were not the collossal pain in the butt I 
had thought they were from my US experience, that even polygamy has its place when you work 
well with your cowives (and gang up on your husband), that illiterate third world women can 
actually be quite terrific business women (and somtimes earn more money than their dilapidated 
European or American husbands), and that you can argue hard with your friends in a loud voice 
and vociferously and still love them warmly.

Best to all, Susan Burger

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