NEWS: Stop the Madness

Community Leader
Registered: 10-01-2010
NEWS: Stop the Madness
37
Tue, 07-24-2012 - 8:44am

Stop the Madness

For the second time in 8 days, the New York Times is running an opinion piece criticizing “polarizing messages” about breastfeeding and questioning the evidence linking breastfeeding with differences in health outcomes for mother and child.

Neither writer interviewed an epidemiologist or a scientist who has studied associations between breastfeeding and health outcomes, and neither writer acknowledged evidence-based reviews of the literature by the US Agency for Healthcare Research and Quality or the World Health Organization. Instead, they quote a retired physician who authors a controversial blog and journalist who wrote a piece on breastfeeding in 2009, and they conclude that breastfeeding isn’t that important after all.

Both Alissa Quart and Jane Brody go on to suggest that it’s unrealistic to recommend 6 months of exclusive breastfeeding, because too many women encounter insurmountable barriers that make these recommendations impossible to achieve.

And yet, for the second time in 8 days, a New York Times writer has chosen to ignore the major public health strategies currently in place to address these barriers:
The Affordable Care Act requires workplaces to provide unpaid break time in a private space that is not a rest room so that hourly employees can pump.
The Surgeon General’s Call to Action to Support Breastfeeding outlines 20 action steps ranging from support for individual mothers to paid maternity leave to stronger national leadership, all designed to help mothers achieve their own infant feeding goals.
The Institute of Medicine’s “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation” recommends peer support programs, workplace accommodations and improved maternity care policies.

These documents do not make mothers feel guilty or berate them to try harder – rather, they outline specific policy recommendations that would address the very obstacles that Quart and Brody suggest make breastfeeding too difficult. But these documents are conspicuously absent from their critiques of current breastfeeding policy.

I appreciate that 6 months of exclusive breastfeeding is a lofty goal. I see mothers in my practice who struggle with breastfeeding, and we talk a great deal about the gap between what is recommended under ideal circumstances, and what is possible for this particular mom and baby.  Sometimes, breastfeeding does not work.

But the answer is not to cast aspersions on the evidence and say breastfeeding doesn’t matter.  Lactation is a normal part of human reproductive physiology. When this physiology is disrupted, the best evidence that we have indicates that risks increase for mothers and for infants. The fact that so many mothers and babies run aground reflects our failures as a society – and it underscores the urgent need to address those failures.

We need to make sure that mothers get accurate and evidence-based information during pregnancy so they can make an informed decision about infant feeding. We need to educate health care providers so that they can support that decision, both before and after birth. We need maternity hospitals to discontinue practices that undermine mothers and babies in the first days of life.  We need paid maternity leave, on-site daycare, policies for babies-at-work, and barring those options, access to pumps so that mothers do not have to choose between earning a living and nurturing their children.

And we need journalists writing about breastfeeding to treat it as a real public health issue, not another round in the media-generated “mommy wars.”  An essay reviewing the evidence on heart disease would source the science with a clinician-scientist, not a controversial blogger or a journalist.  A commentary on management of hypertension would reference national recommendations for screening and treatment. But when it comes to breastfeeding, it appears that personal anecdote and armchair observations about “underlying issues” is sufficient to get published in the New York Times.

There are real, actionable policies that would enable more women to achieve their breastfeeding goals.  As Regina Benjamin wrote in the Surgeon General’s Call to Action to Support Breastfeeding:

 The time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding.

The time has come to stop the madness. We have work to do.

Source: http://bfmed.wordpress.com/2012/07/23/stop-the-madness/

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iVillage Member
Registered: 03-16-2010
Re: NEWS: Stop the Madness
Wed, 07-25-2012 - 8:16am
nisupulla wrote:

Statements like these are going to be a huge turn-off to most people and cause them to become defensive and tune out anything actually useful she might have to say.

Yes, I agree. The FFF and other formula defenders behave defensively. They find statements such as "breastfeeding is normal" and "formula is risky" to be threatening to their beliefs.

However, I disagree with the premise that to stop talking about the importance of breastfeeding is the solution to the threat. Also, even if formula defenders take issue with the biological purpose of breastfeeding as antithetical to their ideology, it does not change the biological purpose of breastfeeding.


Sorry, but what are you responding to, with your talk about statements such as "breastfeeding is normal" and "formula is risky"?  I said that saying things "there isn’t any way to safely feed formula" and live birth (vs. egg-laying) and lactation ARE how motherhood is defined for mammals" were a huge turn-off to most people and cause them to become defensive and tune out anything actually useful she might have to say.  That is, that if you have something useful to say to women, it is tactically unwise to include in your message unnecessary statements that they will find offensive, because once they stop listening, you're accomplishing nothing.

iVillage Member
Registered: 03-16-2010
Re: NEWS: Stop the Madness
Wed, 07-25-2012 - 8:24am
nisupulla wrote:

Sadly, just as KD is unaware of the FFF previous writings, it seems you are unaware of KD previous writings.

No, I'm aware of them, I just disagree. Again, it's wrong to assume that disagreement must stem from unfamiliarity.

Sure, literally, KD wrote what women should feel "anger" and shouldn't feel "guilt", but in the Lactivists circles that is short hand for all the writing that has been done by Lactivists in response to the constant use of the word "guilt" by formula defenders.

If her audience is lactivists, then using shorthand like that is fine I guess.  Preaching to the choir is different than trying to reach a wider audience.   In this context, though, she was responding to a formula feeder, however. 


 

iVillage Member
Registered: 03-16-2010
Re: NEWS: Stop the Madness
Wed, 07-25-2012 - 8:31am
nisupulla wrote:

One could argue that KD comments are "off-base to most people" in the sense that most people are not interested in the BF/FF debate. However, the FFF is not most people and the NYT introduced the debate. Both parties want a debate.



I didn't say KD's comments were "off-base."  I said your suggestion that the FFF does not want to support women's efforts to breastfeed was "off-base." 

As a breastfeeder, I don't feel that talking about how risky formula is is a significant part of supporting my efforts to breastfeed.  I DO feel my efforts to breastfeed are supported by LCs who diagnose tongue-tie and thrush, pediatricians who clip tongues, OBs who treat thrush appropriately, workplaces that give me a place to pump, and laws that allow me to nurse in public.  FFF may not be in favor of the first type of "support," but she is in favor of the second, which is far more important.

iVillage Member
Registered: 03-16-2010
Re: NEWS: Stop the Madness
Wed, 07-25-2012 - 9:12am
nisupulla wrote:

that pain matters and should be taken seriously;

She does NOT use the term pain, she uses the term "guilt". I can certainly see how not being able to breastfeed if one wanted to would cause "pain". As another commenter wrote that pain could be anger. It could also be a sense of betrayal, a sadness and a whole host of other emotions. The formula propaganda is that the pain is simply guilt brought on by Lactivists. From all that I have read and experienced, only an extreme outlying Lactivist would disagree that not breastfeeding is a very emotional experience. Most however would argue that summing up the complex emotions as "guilt" attributed to Lactivism is faulty.

The FFF claims that because Lactivists argue against "guilt" they are denying "pain". She is mistaken.

Well, she doesn't say that (at least in this post), but regardless, many lactivists DO deny that FFers feel "guilt" attributable to lactivism.  Which is where I disagree. 

The pain FFers who wanted to BF feel includes things other than guilt--like anger or regret--but those are often in addition to the guilt.  And the guilt may be caused by things other than lactivists, but that is often in addition to the guilt caused by lactivists.


Arguing that I don't know what my feelings are or that they're actually the product of formula company propaganda is deeply offensive. 


 

iVillage Member
Registered: 03-16-2010
Re: NEWS: Stop the Madness
Wed, 07-25-2012 - 9:16am
nisupulla wrote:

Statements like these are going to be a huge turn-off to most people and cause them to become defensive and tune out anything actually useful she might have to say.

Yes, I agree. The FFF and other formula defenders behave defensively. They find statements such as "breastfeeding is normal" and "formula is risky" to be threatening to their beliefs.

However, I disagree with the premise that to stop talking about the importance of breastfeeding is the solution to the threat. Also, even if formula defenders take issue with the biological purpose of breastfeeding as antithetical to their ideology, it does not change the biological purpose of breastfeeding.

One could argue that KD comments are "off-base to most people" in the sense that most people are not interested in the BF/FF debate. However, the FFF is not most people and the NYT introduced the debate. Both parties want a debate.

To the non-interested people, the bottom line needs to be simple. The FFF and others in the NYT article are stirring up debate and unnecessarily making a straight forward message convoluted.

Breastfeeding is important. Every baby has a right to be breastfed and therefore no one has the right to interfere with a mother's right to breastfeed her baby. Each mother has the right not to breastfeed her children. If breastmilk is not available, formula is literally a life saver.

The FFF interfere's with mother's right to breastfeed by villifying Lactivists and making false statements about them. She takes the straightforward message about breastfeeding and attempts to distort it with misinformation such as the importance of breastfeeding is exaggerated,  it is meant to cause guilt, that it is based as much on ideology as much as it is on fact, that Lactivists are opposed to formula except in extreme cases. Her claim that she is "balanced" and Lactivists are not is ridiculous, IMO.

I would have more respect for her if she helped women with the "pain" of not breastfeeding instead of attacking Lactivists. That, however, does not seem to be her goal.


I've read almost every word on her blog, and it's helped me with the "pain" of not breastfeeding my first more than everything else I've read on the subject put together.  And I read her blog all through the months of my breastfeeding difficulties with my second, without for a moment thinking that they "interfered with my right to breastfeed." 

I think people who have not tried and failed to breastfeed in the current climate (say, the past five years) may not be completely aware of what it's like.

Community Leader
Registered: 10-01-2010
Wed, 07-25-2012 - 9:36am
jessica765 wrote:

I think people who have not tried and failed to breastfeed in the current climate (say, the past five years) may not be completely aware of what it's like.

 I agree. I remember back when I had my first, feeling like such a failure for not being able to breastfeed my son. To the point where I literally thought the LLL group would toss me out the door when they found out.

But that was all in my head, and no one thought that - almost everyone formula-fed their babies back then, and that was the feeding method that was strongly supported outside (what you could find at a LLL group).

I never felt fear of judgement when I fed my baby a bottle, I never had anyone approach me and say anything about giving him formula. As far as everyone around me was concerned, I was feeding him the"right way". No one cared how I fed my baby, as long as he was fed.

But now, with al lthe strong messages about how important breastfeeding is, with so many moms making breastfeeding their first choice, and so much talk about it in the media, online and in your doctor's office and maternity floor - I do believe there is so much more pressure.

I would not want to "fail" breastfeeding in the current times, I am sure for some women it would be devastating if it does not work out for them.

 

 

 

iVillage Member
Registered: 07-11-2006
Wed, 07-25-2012 - 9:41am

In this context, though, she was responding to a formula feeder, however.

No, she was not responding to "a" formula feeder, she was responding to "the Fearless Formula Feeder" who was claiming knowledge of Lactivists. 

iVillage Member
Registered: 07-11-2006
Wed, 07-25-2012 - 9:47am

OK, to me "not breastfeeding is risky" is equivalent to "there is no way to formula feed safely". They are different IYO?

Again, IMO "live birth and lactation are how motherhood is defined in mammals" is akin to "breastfeeding is normal". Not so, for you?

OTOH, it is tactically wise to allow mothers to maintain their belief that formula is just fine and breastfeeding is overrated IF your goal is to stop the increase in breastfeeding rates.

iVillage Member
Registered: 07-11-2006
Wed, 07-25-2012 - 9:53am

I just disagree

What do you "disagree" with specifically? Based on your comments here on this board I think it is likely that you disagree with what you think KD has said rather than what she has said.

iVillage Member
Registered: 07-11-2006
Wed, 07-25-2012 - 10:01am

The Fearless Formula Feeder claims to be a crusader for all the unheard pain of women who are unsuccessful at breastfeeding. She creates animosity toward Lactivism.

For me, saying that Lactivism is responsible for a partially trained nurse who hands out bad breastfeeding advice is a bit like blaming the American Dental Association for a hygenist that isn't good at cleaning teeth. Just because there is a hygenist that isn't good at her job doesn't mean that there is something wrong with the idea that cleaning teeth is a good thing. It doesn't mean that the ADA is faulty.

Personally, I think the best place to get support for the pain of not breastfeeding is from someone who understands that breastfeeding is important. A formula feeder by choice and people who think formula is "almost like breastfeeding" are more likely to poo-poo the inability to breastfeed.

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