Context is crucial in comparisons

http://www.news.com.au/top-stories/hardline-counsellor-slams-bottlefeeding/story-e6frfkp9-1226458040994

Currently, the above article is being linked to on many of the Facebook boards I frequent, with the headline Australian Breastfeeding Association class told baby formula 'was like AIDS'.  Shocking, right?  Propaganda, total exaggeration, just the sort of thing that makes people call lactivists 'Breastapo', 'Boob Nazis' and pushes away exactly the people that we are trying to reach?

Well, yes and no. This sort of HEADLINE is like the Times 'Are you mom enough?' headline – it is not giving the correct impression of what is actually going on. And the headlines are what make people feel that lactivists are all judgy-smuggers (if I may borrow a perfect turn of phrase from this lovely article http://www.acornpack.com/content/exploding-breastapo-myth-once-and-all).

The simile of formula feeding being like AIDS is apt – in context. Just as the metaphor of colostrum as 'liquid gold' is apt – in context. Just as the comparison between breastfeeding and urination is apt – in context.

Lactivists often get upset/angry/exasperated by the urination comparison – and I'm sure some of my readers will be shocked by my opinion on this – but it is actually a brilliant simile, in its place.

It's not ok to do things in public on the sole grounds that it is natural. It is not reasonable to suggest that something is beautiful because it is natural. Therefore, one can easily dismiss these as reasons why no one should mind NIP (nursing in public) by using the fact that breastfeeding is like urination in that it's natural. Obviously, breastfeeding is NOT like urination in many many other ways – and often when the urination simile is trotted out, it is used to suggest that natural acts are NOT appropriate in public, because urination (a natural thing) is not. The flaw in this reasoning can easily be shown by flipping the argument and saying that since breathing – a natural act - is acceptable, and even expected, in public, so too must be urination. But I digress.

Being appalled by these comparisons, when they are used correctly, is like thinking that when people refer to colostrum as 'liquid gold' they are advocating pouring a molten metal into the stomach of a newborn. That's going to kill the baby! Clearly they are saying that colostrum is fatal!

Colostrum is like liquid gold in that it is an extremely valuable, gold-coloured liquid.  Colostrum is NOT like liquid gold in that it is not metal, it is not at least 1064 °C (the melting point of gold, according to a quick google), it does not traditionally get made into wedding rings or jewellery....

Here is the context of the simile of formula feeding to AIDS: “Nobody actually dies from AIDS; what happens is AIDS destroys your immune system and then you just die of anything and that's what happens with formula. It provides no antibodies.”

So, formula feeding is like AIDS in that it doesn't actually kill you, but it does make you more vulnerable to other things that might kill you.

It's a brilliant comparison. It refutes the idea that because no death certificate claims formula feeding as the cause of death, formula feeding does not cause deaths. (No death certificate will put 'smoking' as the cause of death either, of course.) It increases the understanding of what is ACTUALLY the problem with formula feeding – which is not that it will doom your child to definitely getting x,y and z, but that the risks of these things are increased.

Or we could use a bike helmet simile. Breastfeeding is like wearing a bike helmet in that *if* you crash your bike, you have more (but not infallible) protection from head injuries. If you don't crash your bike it makes no difference whatsoever whether or not you were wearing a helmet. Someone wearing a bike helmet who crashes their bike will be more badly hurt than someone who isn't wearing a helmet who doesn't crash.  However, please don't forget that breastfeeding is not like wearing a bike helmet in that you are not supposed to do it while on a bike!

Once upon a time...

ONCE UPON A TIME...

There lived two sisters. They lived in two pretty little cottages, one of the north side of a wide river, and one on the south, and in the garden of each cottage, there was a magic berry bush. For no matter the season or the weather, whenever a berry was plucked from the bush, another berry would grow before the next morning.

One day it happened that both of these sisters were visited by a witch, who made them a curious offer. “Simply give to me, each day, 10 of the berries fresh picked from the magic bush. Do this for a year and a month and a day, and on that last day, I shall give you a bag of gold.” Well, as you can imagine, both girls jumped at the chance, and went diligently to pick 10 berries for the witch. On that first morning, the girls both got ten berries, and several scratches as well, but thinking of the gold, they both handed the berries to the witch happily, and she went on her way, promising to return next morning for the next 10 berries.

The next morning, when the girls went to their berry bushes, they found that only 8 berries were easy to reach – for the others were growing high up, and in the thick of brambles. Persevering, the girls reached the berries down, and when the witch arrived, handing the berries over. But the witch said to the each sister in turn “See, this berry you have plucked is not ripe. I have only 9 berries that I can eat here. Please pick another one for me.” The first sister nodded, return to the bush, and with some difficulty, plucked an eleventh berry for the witch, who thanked her kindly and left. The second sister, however, frowned at the witch and said 'Do not try to trick me, crone. Our agreement was 10 berries each day, not 11 – I owe you no more than 10.' The witch was most disappointed, but agreed that the payment had been made, and the deal was not broken.

The next day, the same thing happened, and the next. But on the fourth day that the witch came, the first sister had no difficulty in plucking ten ripe berries – for as she had plucked all the berries from high up on the bush, and deep in the brambles, now the berries grew on the outer parts of the bush, and were plentiful and easy to reach. The second sister however, had picked only the easiest berries to reach, and the ones that had been in the thickest part of the bush had rotted on the branch. So, when she picked her ten berries, they were harder to reach, and she was much pricked as she got the tenth. More than ever, this day, she would not listen to the witch's request for ripe berries – and this time, her complaint was that three of the berries were not good to eat.

Well, and so it continued, and as time went on, the first sister found more and more berries on her bush, plentiful and easy to reach, and she found pleasure in spending a few minutes of her day in the sunshine of her garden, with such an easy and pleasant chore, and then the visit from the witch, who was congenial company, and became her friend as they grew to know one another.

But each day, the second sister found it harder to reach the berries, and was more worried and unhappy each time, as the witch scowled at the hard, small, sour offerings the girl made to her. The husband of the second sister saw how scratched and worn she was, and how she hated this task the witch had set her, and he bethought himself how it could be made easier on her. “My love,” he said one day, as she picked the berries “You have but 5 berries for all your travail this morning, and need twice that number, and the bush cannot provide. Why don't you rest yourself, and I shall go and call upon your sister, and see if she can spare us a few of her berries?” Well, the sister agreed, of course, and off he went on their donkey, to the bridge across the river. And in a short time, he returned, with five berries, as promised, and gave them to the witch himself. And she parted, happier than she had been for a long while.

The following day, it was only three good berries that she found upon her bush, and the husband was off again to the sister, and returned with seven berries. And the next day, it was only one berry she found. It did not sit well with the husband to be begging each day from his sister-in-law, so he offered to pay a copper coin each day for 10 berries, and the bargain was struck.

So, for a time, both sisters were happy. The witch had ten berries from each girl, and the first enjoyed her berry picking, and the second enjoyed her leisure time as the husband fetched the berries. But after a while, the husband spoke to his wife, saying “These berries are not cheap, when we must buy them each day. Can you not pluck some more berries from the bush, and save us the coin?' But when they went to look at the berry bush, they saw that it was barren, and no berries at all grew on it – for all had rotted away, and not been picked, and so the bush was bare.

And there came a time when the husband had to sell their donkey, and take himself to find work in the town – and so it fell to the sister to make the long walk across the bridge each morning to buy the ten berries off her sister. And whenever she tired, she remembered how the brambles had scratched her arms, and counted herself lucky to have merely a long walk each day instead.

And after a year and a month and a day, the witch came to the first sister, smiling, with a bag of gold. And instead of bidding her farewell, the sister said that, if she wished, she could come to visit anytime, and welcome. “There will always be berries and a warm welcome for you.” said she.

And the witch came to the second sister's house and was given the last ten berries, and handed over the bag of gold. And the door was slammed in her face. And much of the gold was spent before they could enjoy it – a new donkey, and shoes for both man and wife – since their shoe leather was well worn with the walking each day.

Both sisters gave the witch her berries. Both sisters received a bag of gold for doing it. And both sisters felt they had the better part of the deal.

THE END

Starving strawmen

No one is advocating letting babies starve.

It seems rather strange that it needs saying, but apparently it does. I've read the sentiment SO many times: “I couldn't breastfeed, I suppose you'd rather I let my baby starve!'

Um...no. Obviously not.

Try these on for size:

• 'I TRIED to quit smoking, but I couldn't. I suppose you'd rather I just injected myself with heroin!'
• 'I can't afford designer jeans, so I'm wearing these supermarket own brand ones. I suppose you'd rather I was naked!'
• 'The supermarket had run out of your favourite chocolate, so I bought MY favourite brand instead. I suppose you'd rather have nothing!'

• And a topical one (A-level results came out today in the UK) 'I got a B! I know you're disappointed I didn't get the A I was predicted, so I suppose you'd rather I'd failed!' (I managed to avoid saying that to my Dad back in the early 90s – who thought criticising my B was funny – and I was an exceptionally stroppy teenager!)

It's petty, it's absurd, and it's based on misconceptions. Not only does this make the assuption that there are only three possible options, but it also assumes that expressing a preference for option A over option B means that you think option C is also better than option B. It makes no sense!

There are grey areas.

The jeans wearer has an enormous range of clothes to choose from, and the chocolate buyer has a huge variety of chocolates available. The smoker has the option of continuing to smoke as they do, quitting altogether, cutting down on the amount they smoke, changing the brand of cigarettes for a less harmful one....or a whole HOST of other things less insane than attempting to replace nicotine with heroin. 

The other common phrase is 'Formula isn't POISON, you know'. We do know. It's not poison (although it does contain some poisonous chemicals - but then so does the human body), but then nor is glass - but that doesn't mean it's a good idea to eat it. It's false logic. It's a strawman - a false representation of one's opponent's position. 

For the record, here is the hierarchy of what is the best substance to be fed to an infant. The lower down the list you go, the higher the risks.

1. breastmilk directly from the mother

2. expressed breastmilk from the mother

3. wet nursing – breastmilk directly from another human

4. donated breastmilk

5. formula

6. raw animal milk (I don't know for sure, but it seems logical that the more similar to human the animal, the more appropriate the milk would be. So a primate's milk would be better than cow's milk, which in turn would be better than cat's milk.)

7. pasteurised animal milk

8. coconut milk/almond milk/fruit juices/cola and other liquids that contain some nutrition

9. solid foods

10. allowing the baby to starve. Or poison. You know, this-is-literally-going-to-kill-you-if-you-eat-it poison. (Which formula is not. Truefact, that.)

Hope that clears that one up!

Oh, and by the way, the risk increases hugely between numbers 5 and 6 on this list. WAY more than it does between 1 and 4. To go back to the A-level analogy and use grades – numbers 1-4 are very roughly the equivalent of A+ to A-, number 5 is C+, and 6 is an E-. Everything else is a failing grade!

In which I rabbit on about informed choice...

Informed choice requires two things – information and choice!

Seems a bit self-evident really. So why, when it comes to infant feeding, is giving people information – and pointing out inaccurate information (a quick thank you and link to the wonderful Dispelling Breastfeeding Myths here – whose mission is to do just that!) – so often seen as an attempt to curtail women's choices? And why do people seem to think that because some people don't have a choice, the information should be suppressed or downplayed? Or perhaps that it must be incorrect or exaggerated?

If a woman chooses to formula feed, that is her right. She should not be bullied into breastfeeding.

If a woman chooses to breastfeed, that is her right too. She should not be bullied into formula feeding (regardless of whether or not she is experiencing difficulties establishing breastfeeding).

Nevertheless, it is only fair that both of these women are made aware of the genuine risks vs benefits of her choice – and how it may affect her health or that of her baby. They should also be made aware of the other alternatives to breastfeeding or formula – donated milk or her own pumped milk. There are also options that are so far from ideal that they aren't even considered options, such as skimmed milk, coconut milk, fruit juices... Technically, these are all choices that could be made – it's OBVIOUS that any health care professional would criticise a mother's choice to feed any of these to her newborn infant. But, hey, would they rather the baby starved? 

 

It is impossible to make an informed choice if you do not know all the options, or you do not have sufficient information about the options, or you cannot realistically make a different choice.

If you have a choice between spending £1 or £2 on the same item, spending £1 is a good idea, the WISE choice. If someone then tells you that you could've spent 50p instead if you'd been in a different shop, that doesn't negate the fact that you WEREN'T in a different shop (and had no way of knowing about the price in that shop, and possibly couldn't have made it to that shop even if you HAD known). Nevertheless, responding to this information with 'I couldn't buy it for 50p, so I suppose you'd rather I'd spent £2?' or 'I know 50p is cheaper, but £1 isn't any more expensive', or telling others considering making a similar purchase 'I spent £1 and I didn't go bankrupt, so it doesn't matter if you pay £1 instead of 50p' is just nonsensical.

Or a more detailed metaphor:  

The local café has 3 sandwiches on the menu: ham, cheese and rabbit.

Andy and Belinda have never eaten rabbit in their lives. Andy elects to try it, while Belinda plays it safe with cheese. These are choices, but not truly informed choices.

Chris is not told that there is rabbit on the menu. He chooses cheese over ham – it's a choice, but it was made without all the information. Not informed.

Dave is a vegetarian. While he is technically choosing the cheese sandwich (after all, it is his choice to be a vegetarian, and if he doesn't want cheese he could go elsewhere for his lunch), it is hardly a fair choice. It's informed, but his choices were hugely limited.

Ellie is told they have run out of rabbit. She wanted to try the rabbit, but settles for cheese. It's her choice, but between cheese and ham – her choice was informed, but still limited.

Now – suppose that the café is visited by a food critic, who says that, while the cheese and ham sandwiches are passable, the rabbit sandwich is the greatest thing ever. Does this criticise the CHOICES that Chris, Dave and Ellie have made? Surely it can't, since none of them really had the option of a rabbit sandwich! The only people who had that option – Andy and Belinda – had no idea at the time that it was recommended, so it doesn't even criticise Belinda's choice (or for that matter congratulate Andy's), all it criticises is...the food! So, how can the solution possibly be to not give this information to others?

It is indeed rude, insensitive and pointless for Andy to tell all his friends how great the rabbit sandwich was if they won't be visiting the café again. It would be fairly unpleasant of Andy to specifically tell Dave about how great the rabbit is. (Rather like deliberately savouring a cake in front of someone on a diet!*) But Dave being a vegetarian is not a good enough reason for Andy to avoid mentioning that the rabbit is excellent to people who ARE planning to visit the café, even if it happens to be in Dave's hearing.

The fact that a vegetarian can only have the cheese is irrelevant to how good the rabbit is. It doesn't help vegetarians if omnivores decide to eat cheese instead of rabbit. In fact, if you want to help vegetarians get the best possible sandwich, surely advocating for higher quality cheese, or even better - rabbit-flavoured tofu – would be a far more useful solution than bitching about the rabbit-eaters trying to persuade other omnivores to eat the rabbit! In short - giving people reasons to try the rabbit does not remove cheese from the menu.

(* Have I just put a simile inside the metaphor? Blimey...I should wrap this one up)

A is for apple, B is for bottle, Pink is for girls...

Every so often another baby t-shirt appears in the shops with a slogan that annoys the breastfeeding community. Something along the lines of 'Party in my crib. 2am. Bring a bottle' or the Old Navy 'formula powered' onesie that caused a fuss a couple of years ago, or the latest one I've seen (which inspired this post), linked on Facebook, on the wonderful Analytical Armadillo's page, which was just odd: an equation showing a picture of a cow + picture of a milk bottle = feed me.

Lots of people say 'Chillax, it's only a t-shirt – Jeez, way to overreact!” when this sort of thing gets flagged as less than ideal. What they are failing to realise that this t-shirt is not the problem; it's a symptom. It's as if you've described a blemish on your body to your doctor, and they tell you, 'Hey, it's one tiny zit, don't freak out' – not understanding that the significance is not that one spot, but that there are hundreds of them forming a rash all over your body!

This culture has a pervasive attitude of bottle = baby. These t-shirts feed into that assumption, making it harder to challenge, and making it harder for people to choose to breastfeed. Everyone THINKS they know breast is best, but the message they actually get is breast is the ideal, a special extra, for those privileged few who can manage it, while formula is normal, and just as good. (Which is not logically possible, people. But that's a topic for another day.)

This prevailing attitude and assumption is very comparable to the reasoning behind 'Pink stinks' http://www.pinkstinks.org.uk/ Everywhere we look, the idea that 'pink is for girls' is reinforced. It's as well known as 'a is for apple'! There is nothing wrong with pink as an option. There is EVERYTHING wrong with giving boys a choice between blue and green and red and yellow (but not pink), while girls have the choice between coral and fuchsia and rose and cerise! Surely such cultural bias is even more problematic when the preferred, expected option (bottles) is intrinsically inferior to the far less visible option – breastfeeding.

Personal anecdote time - my son is growing his hair out. It's not quite long enough to tie back in a pony tail yet, but he needs to be able to wear a head band of some sort to keep the hair off his face. So I started looking for hair bands for him. It took weeks before I found what I was looking for – something cheap and practical that was neither pink nor covered with flowers. In the interests of full disclosure, I did find purple – but it was a lilac shade, and very 'girly' looking. And how depressing is that? Even I, who am proud of my boy's occasional tom-girl tendencies, who am fully aware that 'pink is for girls' is a limiting nonsense – feel obliged to buy into the societal norm of NOT putting pink accessories on my son. (He is at an age where his peers are likely to tease him for it, and adults have occasionally mistaken him for a girl, purely because of his longish hair. I don't want him to be teased, and I certainly don't want to risk him ending up utterly rejecting all things feminine in reaction to it!)

This culture 'knows' that long hair = girl = pink. Just like this culture 'knows' that baby = bottle. Which isn't a noticeable problem if you fit that norm. But it makes it harder, much harder, if you don't. And adds extra pressure to conform. Especially if you are at a vulnerable time in your life – say you're a child, or a tired, nervous, struggling new parent.

Of course no one chooses to formula feed on the basis of one t-shirt. Of course they don't. And no one decides their favourite colour on the basis of one t-shirt either. But when almost every t-shirt, toy and accessory you've ever owned is pink, or has some pink on it, you start to associate pink with nice things, and you learn to love pink. What do you think is the most commonly stated favourite colour among girls? Is there any doubt in your mind? Now, it is true that some people claim that the cause and effect goes in the opposite direction: i.e. there's a biological difference between men and women – and girls get pink stuff marketed to them because they are naturally drawn to it, rather than being drawn to pink because it is advertised to them. But I can't think of a single logical reason for such a preference to have evolved (at least not only in females), and it seems even less plausible in light of the fact that in the past pink was considered a masculine shade (being similar to red - a strong colour, while pastel shades – such as pale blue – were considered more suitable for girls!) It seems much more reasonable to accept that the pervasive message of girl = pink is affecting the choices and preferences of the last few generations of women. And even if one were to accept the premise of a biological preference - there can be no real doubt that marketing pressure exaggerates that preference to a ridiculous degree. Similarly, the existence of the 2-5% of mothers who have a physical need to supplement their own milk does not account for the fact that well over 90% of mothers in the UK do so before their baby reaches 6 months!

Marketing works. It's not insulting, or suggesting people are too stupid to make up their own minds to say so. If you think you are not affected by adverts, I suspect you are either lying to yourself or have a brain that does not make synaptic connections in the usual manner. Could you sing a jingle from an advert you haven't seen recently? Do you occasionally realise you're hungry when you see an advert for food? Do you know what I mean by 'the Dulux dog' or 'the Andrex puppy'? Then you have been affected by ads. I have never – as far as I recollect – brought Andrex or Dulux in my life. But I would be more likely to refer to those dogs by the brand name than the breed name! I know the names of the products, and if I needed paint or loo roll, and had a choice between the famous brand and an unknown one (assuming they were at the same price etc.), I'd probably go for the famous brand. I've been conditioned to believe it's a good choice – through advertising.

Advertising works. And it works on everyone. And its effect is cumulative. And any t-shirt/greeting card/wrapping paper design/icon that plays into the baby = bottle assumption is adding another layer to the advertising of formula, and therefore undermining breastfeeding. Every time we see the image of a bottle associated with a baby, that association is reinforced in our subconscious, and the idea that actually babies (and their parents!) can manage perfectly well without bottles seems less likely, even to the point of being ludicrous.

When these sorts of t-shirts appear, and get challenged, we aren't really saying that this particular t-shirt is a terrible threat. It is a symptom of the problem, not the problem itself. And people ARE working to fix the problem, but the symptoms need to be acknowledged and treated too. All we want is to challenge the insidious idea that formula is the normal way to feed babies. It's not ok that this culture treats the breastmilk as special and formula as normal. FORMULA is special – it's a lifesaving medication for those in need. Breastmilk is normal. And it's a shame that the assumption is that baby = bottle.

And that is why people get irritated. Not because they are judging formula feeders, or even the companies that make these t-shirts – they are just doing their job, and probably have no idea of the ramifications of their product. Not because they think this one t-shirt alone will inspire someone to formula feed instead of breastfeeding. Leaving the tap dripping into a bucket for one minute won't flood your house. Leaving it on for one week would. And one of those minutes is going to be the one when the bucket starts to overflow...

Comments confession

I admit it, I have a problem. I keep on reading the comments. I know I shouldn't, but I do it anyway. Every single time. It's just so hard to resist, even though it almost invariably makes me sad. In general, I believe in people – I think, on the whole, people are smart, and capable of great kindness and tolerance. The comments section of almost any article seems to indicate I'm wrong on that one.

But then again, on the whole, smart, kind and tolerant people don't often comment on articles. So the people who do comment are those who feel particularly strongly about the subject matter (which doesn't always lead to the most tactful phrasing), or those who are too self-obsessed to realise that other people have valid feelings and opinions too. And trolls, of course. And naive people like me, who want to make the world a better place, and think they can help others to see the point that has been so spectacularly missed. But the comments section of almost any article seems to indicate I'm wrong on that one, too.

It seems like every time an article appears mentioning how breastfeeding is actually better than the alternatives, at least one person has to comment that that's all very well if you can do it, but some people can't, and some people choose not to, and how dare anyone suggest they should be shamed for this? Plus formula has never done THEM any harm, and they know a breastfed infant who's always sick....and so on and so forth.

Doesn't all this seem a bit, well, irrelevant, to anyone? I mean, imagine this...

Dear Water Fascist

I was appalled to read your judgemental article in 'Sporting Today' entitled “Swimming – it could be the sport for you!” There are so many things wrong with it, I hardly know where to start!

Most of us – shock horror – live on dry land. And if we want to cross a stretch of water, well, that's what aeroplanes and bridges are for! So your point about how 'it could save your life' is totally irrelevant in this country, and is really meant for people who send all their time on boats.

You completely ignore the fact that a lot of people find swimming really hard, and just can't do it. My lifeguard friend informs me that many people are not naturally buoyant, and are simply physically incapable of remaining afloat. Did you stop and think for even one minute how they might feel to read 'it's one of the best forms of cardiovascular exercise out there, and it's fun too”? How insensitive! Way to make them feel guilty!

And then there are those who, like me, simply decided that swimming wasn't for them. That is MY CHOICE, and you have no right to force me into the water! I prefer not to show my body off in public pools, with their communal changing rooms and showers. Maybe I just have more modesty than these swimming crazies who love to flaunt their bodies and rub the noses of decent people in the stench of chlorine. How dare you shame me for making a different choice to you? I'll have you know that I am super fit, unlike my obese, diabetic cousin, who goes to the pool every weekend, and even went surfing in the sea last summer, where she nearly DIED, and had to be rescued by the lifeguard. And yet SOMEHOW I survived paddling in rock pools, despite my inability to do the breaststroke. It must be a miracle!

If someone actually wants to swim, more power to them. As long as they cover up properly – after all, if you wouldn't be comfortable wearing a bikini to go shopping, why would you think it's OK to dress like that just because you are going swimming? But, provided no one is forcing me to watch their prune-like, wrinkled behinds as they skinny dip, I'm happy to live and let live. Why oh why can't you people do the same?

Lucy - Landlocked, and Loving it!

Did I miss anything? (I couldn't manage to fit comparisons to sex/urinating in there, and besides, that little chestnut has it's own post brewing....)

Latch on NYC (Needs Your Comprehension)

Over the last few days, I've read several articles about 'Latch on NYC' – which is about regulating the use of formula in New York hospitals. A lot of people are up in arms about this, claiming it's about bullying mothers, undermining their choices, will lead to hungry, screaming babies, etc, etc.

As a starting point, here are two of the numerous articles I've seen on the subject: the most negative and the most positive ones I have come across. 

nypost

phdoula

In addition, there was a comment on another article (this one, IIRC: http://www.askmoxie.org/2012/07/the-illusion-of-choice-the-free-market-and-your-boobs/comments/page/2/#comments) suggesting that the restriction of formula in this way was equivalent to refusing women epidurals until they were at a certain threshold of pain.

This analogy is completely flawed. The equivalent would actually be hospitals not offering epidurals to women who don't ask for them. And explaining, to women who do, that it is medically healthier not to have one. And then, if they say they want one anyway, giving it to them! What currently happens (not every time, nor in every hospital, but it's not rare by any means) is the equivalent of women being offered epidurals as soon as they arrive at the hospital, no matter how well they are tolerating labour and what their birth plan says, and if the woman declines, saying “Well, I'll get everything ready for it anyway, for when you change your mind.” Sadly, this often does happen with epidurals (and c-sections) too, actually. 

And with that....the first metaphorical story of this blog was born:

Imagine you have to go into hospital for minor surgery. There are 2 types of medication you could use – Formex and Boobimel. You are aware you'll need to take the medication once a day for a week. Boobimel is universally acknowledged to be medically the safer, better option: the list of potential side effects from Formex is long and varied (ranging from mild constipation to complications that can prove fatal), but there are no known side effects from Boobimel. Still, no one you know ever had a problem, and most of your friends took Formex because Boobimel was simply not offered at the time they needed it. They are all fine. (Well, some of them have medical issues that are listed as potential side effects of Formex, but LOTS of people have similar medical issues who never took Formex - and no one can know for sure that Formex caused/exacerbated these issues in your friends.) Sure, there's a risk, but it seems to be relatively small.

Boobimel is injected (you hear it's a REALLY BIG needle and hurts like hell), Formex is taken orally and apparently it tastes yummy. You also see adverts for Formex on TV and billboards. Not that they influence you, of course, but you are vaguely aware that if it was that much worse than Boobimel they would be in trouble with trading standards, surely...

You haven't made up your mind as you enter the hospital, but you think you'll probably give the needle a shot (no pun intended). If you don't like it, you can always take Formex for the next 6 days, after all.

Scenario A:

The doctor tells you that you will need to find your own way to the other side of the hospital to be injected with Boobimel, and there is no guarantee that it will actually be ready for you when you get there. There is a Formex packet on the table next to you, and you can take one RIGHT NOW. The doctor looks at their expensive watch, which bears a Formex logo, impatiently, and hands you a glass of water...

Scenario B:

The doctor tells you that Boobimel is the recommended medication for this procedure, and shows you where to go to find it in the hospital. They explain that there might be a bit of a wait, but there is tea and coffee in the waiting room. They answer any questions you have and reassure you that the needle is not as big as you've heard. You ask about Formex, and are told that it is certainly an option, and, so long as you are fully aware of the potential risks involved, they will go and fetch you a Formex, though they are ethically obliged to suggest you at least attempt Boobimel for the first day.

Scenario C:

There is no Boobimel in the hospital, and your surgery has to happen today – you are in a lot of pain! In addition, you are utterly needle-phobic. You have to endure an hour long lecture on why Boobimel is better and are told that the Formex will probably kill you, before the third doctor you speak to reluctantly allows you to have a packet of Formex pills, and walks out in disgust, without telling you how many to take.

No one, absolutely NO ONE, is advocating option C. The current initiative is about replacing option A with option B. (In the circumstances described in Scenario C, the doctors should be apologetic, and sympathetic, and recommend, in your case, going with the Formex, although if you really want to wait til the next day in the hope some Boobimel will arrive in hospital, that's your choice, they will keep monitoring your condition and inform you if anything changes.)

Sure, post-natally, you are often scared, in pain, suffering, and don't WANT to be reminded that it isn't a good idea to supplement when that seems so attractive when your newborn is struggling to latch. But when I was in labour, scared, in pain, and told my baby was not coping very well, I signed the c-section consent form. I would have let them cut me open if they believed it was MEDICALLY a good idea. Heck, I'd have let them cut off my arms and legs at that point if they had told me it would help! I didn't have a c-section, because I didn't need one in the end. I don't think it would have been appropriate for them to accept my hasty signature (while in pain and panicking) as my 'choice', despite the lack of medical necessity, since my birth plan, into which I'd put a lot of thought, clearly stated that I wanted to avoid interventions if possible.

These sort of initiatives are about encouraging informed choice, not reducing people's choices, but expanding it.  If an infant is supplemented with formula, especially in the early days, that mother's milk supply is damaged, sometimes irreparably. This reduces her ability to choose.  If a mother is given accurate information - even if that information is unwelcome at the time - it has no impact on her ability to make a choice.

But I'm about to go off at a tangent, so I'll leave the matter of choice until next time...

 

Ok, here we go...

So, in honour of World Breastfeeding Week this year, I'm actually going to start my own blog.

I've been thinking about doing it for years, since the days when I actually HAD a breastfed child and first got involved with the whole online lactivist thing.  Every now and then, a response I'm writing to a comment or post gets out of hand and dissolves into a metaphorical story analogous to the situation. I've got several of these saved on my computer, that have never made it online (as I tend to go off at tangents.)

So, I'll pop  'em up here, as and when I get round to tidying them all up, alongside my thoughts on current relevant news and articles.


A couple of   A few  SEVERAL quick things about me:

1.  I am lazy and a talented procrastinator - so I will probably not update this as much as I should - or will update MORE than I should when I ought really to be getting on with real life stuff. I might get bored and not check comments for weeks or months. This is a hobby for me. Don't expect a professional standard of response. 
2. I'm English. I'll refer to nappies, dummies and trousers, rather than diapers, pacifiers and pants. If I use the word pants, I'll probably mean underpants. I will also spell colour and favourite with a u. (And, not that it's going to be relevant unless I write a poem, I pronounce 'grass' and 'castle' gr-ah-ss and car-sul. Which is EXTRA fun when I have a 5 year old son who is learning to spell, and most of the people around here say 'grass' and 'cassel'. And 'scone' has a magic e, dammit. Ahem.)
3. I use sarcasm a lot, and have little patience for hypocrisy. If you comment on here, and you can make a respectful, logical argument stating your case, I'll listen, whether you agree with my point of view or not. If you make illogical or hypocritical arguments, or are disrespectful, I will call you out on it, whether you agree with my point of view or not.  I'll probably be polite about it, at least as long as you are.
4. I don't care if you are male, have no kids, or have never breastfed, you still have every right to your opinion. The validity of an opinion is based on its own merits, not the experiences of the person who holds that opinion. (Although such experiences can lead to a more informed opinion, the lack of them does not mean it is ill-informed.)
5. Everything we do is based on a risk/benefit analysis - and only we can make our own judgements as to how these balance out.  ALL parents choose how to feed their children based on which method they believe to tip the scales more towards the benefits than risks.  ALL parents are doing the best they can in the circumstances they are in. It is rude, arrogant and, frankly, stupid to claim that because a parent made a different decision to the one you did/would make that they have deliberately chosen a more risky, less beneficial path. That's like assuming that because you found sports easier than music lessons at school, people who joined the choir instead of the football club were deliberately making things harder for themselves.
6. And finally - I am a true agnostic. I am talking here about my thoughts, feelings and beliefs. I have not done serious medical research, and am taking it on trust that the scientific research I have read (in summary - I'm pretty smart, but I'm no expert and find the actual research papers hard to digest) is genuine. However, to put this into perspective, I am also taking it on trust that Australia exists. I've never been there myself, after all.   I am such an agnostic that I am not absolutely convinced in the non-existence of the Flying Spaghetti Monster. It seems astronomically unlikely that such an entity exists, but it is not, I repeat, it is NOT impossible. Similarly, if you believe that formula is better than breastmilk, I will admit that there is a possibility you are right. You are extremely unlikely to be right, according to all the evidence I have ever seen - but the possibility exists. If you can make logical arguments to support your belief, I will listen to them. (See also point 3).
7. General disclaimer: I am not a medical professional. If I ever give any advice to anyone (I almost certainly won't, I'm not qualified, but if you ask, I might tell you what I think) - it's just that some random person, who did do a breastfeeding peer support course 5 years ago, and has kept up to date online on related stuff, but that's all, thinks. Nothing I say is to be taken as proof of anything. (See point 6.)

So - welcome to my blog. There will be stories, suggestions and similies; there will be discussions, debates and diatribes;  there will be rants, reasonings and randomness; there will be mammaries and metaphors, mostly on matters of motherhood. There may be an aspect of alliteration....