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All
health professionals say
they are supportive of breastfeeding.
But many are supportive only when breastfeeding is going
well, and some, not even then.
As soon as breastfeeding, or anything in the life of the
new mother is not perfect, too many advise weaning or
supplementation. The
following is a partial
list of clues that help you judge whether the health
professional is supportive of breastfeeding, at least supportive
enough so that if there is trouble, s/he will make efforts to
help you continue breastfeeding.
How
to know a health professional is not
supportive:
1.
S/he gives you formula
samples or formula company literature when you are pregnant, or
after you have had the baby.
These samples and literature are inducements to use
the product, and their distribution is called marketing.
There is no evidence that any particular formula is
better or worse than any other for the normal baby.
The literature, CD’s or videos accompanying samples are
a means of subtly (and not so subtly) undermining breastfeeding
and glorifying formula. If
you do not believe this, ask yourself why the formula companies
are using cutthroat tactics to make sure that your doctor or
hospital gives out their literature
and samples and not other companies’?
Should you not also wonder why the health professional is
not marketing breastfeeding?
2.
S/he tells you that
breastfeeding and bottle feeding are essentially the same.
Most bottle-fed babies grow up healthy and secure and
not all breastfed babies grow up healthy and secure.
But this does not mean that breastfeeding and bottle
feeding are essentially the same.
Infant formula is a rough copy of what we knew several
years ago about breastmilk which is in itself only a rough
approximation of something we are only beginning to get an
inkling of and are constantly being surprised by.
For example, we have known for many years that DHA and
ARA were important to the baby’s brain development, but it
took years to get it into formulas.
But it doesn’t follow that the addition of these to
formulas is doing what they are supposed to, as their absorption
from formula is different from breastmilk.
The many differences have important health consequences.
Many elements in breastmilk are not found in artificial
baby milk (formula) even though we have known of their
importance to the baby for several years—for example,
antibodies and cells for protection of the baby against
infection, growth factors that help the immune system, the brain
and other organs to mature.
And breastfeeding is not the same as bottle feeding, it
is a whole different relationship.
If you have been unable to breastfeed, that is
unfortunate (though most times the problems could
have been avoided), but to imply it is of no importance is
patronizing and just plain wrong.
A baby does not have to be breastfed to grow up happy,
healthy and secure, but it does
help.
3.
S/he tells you that
formula x is best. This
usually means that s/he is listening too much to a particular
formula representative. It may mean that her/his children tolerated this particular
formula better than other formulas.
It means that s/he has unsubstantiated prejudices.
4.
S/he tells you that it is
not necessary to feed the baby immediately after the birth since
you are (will be) tired and the baby is often not interested
anyhow. It
isn’t necessary, but
it is often very helpful (See handouts #1 Breastfeeding—Starting
Out Right and #1b The Importance of Skin to Skin Contact).
Babies
can nurse while the mother is lying down or sleeping, though
most mothers do not want to sleep at a moment such as this.
Babies do not always show an interest in feeding
immediately, but this is not a reason to prevent them from
having the opportunity. Many
babies latch on in the hour or two after delivery, and this is
the time that is most conducive to getting started well, but
they can’t do it if they are separated from their mothers.
If you are getting the impression that the baby’s
getting weighed, eye drops and vitamin K injection have priority
over establishing breastfeeding, you might wonder about
someone’s commitment to breastfeeding.
5.
S/he tells you that there
is no such thing as nipple confusion and you should start giving
bottles early to your baby to make sure that the baby accepts a
bottle nipple. Why do you have to start giving bottles early if there is
no such thing as nipple confusion?
Arguing that there is no evidence for the existence of
nipple confusion is putting the cart before the horse.
It is the artificial nipple, which no mammal until man
had ever used, and even man, not commonly before the end of the
nineteenth century, which needs to be shown to be harmless.
But the artificial nipple has not been proved harmless to
breastfeeding. The
health professional who assumes the artificial nipple is
harmless is looking at the world as if bottle feeding, not
breastfeeding, were the normal physiologic method of infant
feeding. By the
way, just because not all, or perhaps even not most, babies who
get artificial nipples have trouble with breastfeeding, it does
not follow that the early use of these things cannot cause
problems for some babies. It
is often a combination of factors, one of which could be the
using of an artificial nipple, which add up to trouble.
6.
S/he tells you that you
must stop breastfeeding because you or your baby is sick, or
because you will be taking medicine or you will have a medical
test done. There
are occasional, rare, situations when breastfeeding cannot
continue, but often health professionals only assume that the
mother cannot continue and very often they are wrong.
The health professional who is
supportive of breastfeeding will make efforts to find out
how to avoid interruption of breastfeeding (the information in
white pages of the blue Compendium of Pharmaceutical Specialties
and the PDR are not a
good references—every drug is contraindicated according to
them as the drug companies are more interested in their
liability than in the interests of mothers and babies).
When a mother must
take medicine, the health professional will try to use
medication that does not require the mother to stop
breastfeeding. (In
fact, very few
medications require the mother to stop breastfeeding).
It is extremely uncommon for there to be only one
medication that can be used for a particular problem.
If the first choice of the health professional is a
medication that requires you to stop breastfeeding, you have a
right to be concerned that s/he has not really thought about the
importance of breastfeeding.
7.
S/he is surprised to
learn that your six month old is still
breastfeeding. Many
health professionals believe that babies should be continued on
artificial baby milk for at least nine months and even 12 months
(and now that the formula companies sell formulas for up to 18
months and even three years, soon some health professionals will
be urging mothers to use formula for three years), but at the
same time seem to believe that breastmilk and breastfeeding are
unnecessary and even harmful if continued longer than six
months. Why is the
imitation better than the original?
Shouldn’t you wonder what this line of reasoning
implies? In most of
the world, breastfeeding to two or three years of age is common
and normal, though, thanks to good marketing of formula, less
and less common.
8.
S/he tells you that
breastmilk has no nutritional value after the baby is 6 months
or older. Even
if it were true, there is still value in breastfeeding.
Breastfeeding is a unique interaction between two people
in love even without the milk. But it is not true.
Breastmilk is still milk, with fat, protein, calories,
vitamins and the rest, and the antibodies and other elements
that protect the baby against infections are still there, some
in greater quantities than when the baby was younger. Anyone who
tells you this doesn’t know the first thing about
breastfeeding.
9.
S/he tells you that you
must never allow your
baby to fall asleep at the breast.
Why not? It
is fine if a baby can also fall asleep without nursing, but one
of the advantages of breastfeeding is that you have a handy way
of putting your tired baby to sleep.
Mothers around the world since the beginning of mammalian
time have done just that. One
of the great pleasures of parenthood is having a child fall
asleep in your arms, feeling the warmth he gives off as sleep
overcomes him. It
is one of the pleasures of breastfeeding, both for the mother
and probably also for the baby, when the baby falls asleep at
the breast.
10.
S/he tells you that you
should not stay in hospital to nurse your sick child because it
is important you rest at home.
It is important you rest, and the hospital that is
supportive of breastfeeding will arrange it so that you can rest
while you stay in the hospital to nurse your baby.
Sick babies do not need breastfeeding less
than a healthy baby, they need it more.
11.
S/he does not try to get you help if you are having trouble
with breastfeeding. Most
problems can be prevented or cured, and most of the time the
answer to breastfeeding problems is not giving formula.
Unfortunately, many health professionals, particularly
physicians, and even more particularly pediatricians,
do not know how to help. But
there is help out there. Insist
on getting it. “You
don’t have to breastfeed to be a good mother”, is true, but
not an answer to a breastfeeding problem.
Questions?
(416)
813-5757 (option 3) or
drjacknewman@sympatico.ca or
my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate
Breastfeeding Book of Answers in
the USA)
Handout
#18. How to Know a Health Professional is not Supportive of
Breastfeeding.
Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further
permission,
on the condition that it
is not used in any context in which the WHO code on the
marketing of breastmilk substitutes is violated.
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