The Circle of Breastfeeding Attitudes
The conversation got around to attitudes and perspectives and how best to effect change, like it always does when 2 or more IBCLCs gather in a room. (For some reason, we can never seem to stop talking about breastfeeding!) Before long I had a dry-erase marker in hand and 2 of the smartest women I know waiting for me to scribble a gem on the white board. Here's the prose that came out:
Since the beginning of people, babies nursed and survived. Suddenly, we were told that formula is better than breastfeeding. Then, we were told that formula is the same as breastfeeding, so just choose one. Next, we began to hear that formula is not as good as breastfeeding. Now, we know that formula has risks.
Yes, everyone, that's the kind of fancy vocabulary you get with a college education. What I meant to say was that this is the progression of the public health message about breastfeeding over the past 60? 70? years. It's a rough timeline which follows pretty much along the same curve as where lactation advocacy and clinical practice came about in response to the previously unchecked marketing efforts of formula manufacturers.
Today, lactation advocates and educators are still struggling uphill every single day because too many individuals and groups of people are stuck back on "Formula is the same" and "Formula is not as good." Ask anyone who works with mothers and babies on a daily basis in the U.S. if they know a healthcare practitioner who still tells moms that breastfeeding doesn't matter. Why are there so many holdouts? I guess if I could answer that million-dollar question I would be famous. So what to do? On an individual level, we have all seen how receiving breastfeeding education affects some people to an extreme, igniting a passion for supporting moms and babies and jump-starting lifelong lactation advocates. And we have also seen how sometimes that same exact breastfeeding training doesn't "take." The learner goes through the motions for a while but never really changes their attitude and eventually stops being an effective breastfeeding supporter in their daily work. These two situations can arise out of a common class or course. There's a giant disconnect in some people regarding the validity of supporting breastfeeding.
The validity in supporting breastfeeding and the value of lactation advocacy are not entirely measurable quantities - with apologies, Dr. Jane Heinig, who reminded us at ILCA2011 that "If you can't measure it, it doesn't "matter." The value to the person receiving the help or the recipient of the results of advocacy are measurable; we have plenty of studies showing that moms who get quality lactation care and moms in communities with strong support networks breastfeed longer (and lots of other, similar quantifiable results.) The factor we may never be able to measure is how much these actions and efforts benefit the advocate or breastfeeding supporter themselves. The successes we each tally at the end of the day are often not the moms and babies - they already valued breastfeeding! We are looking for those more elusive victories - clarified with a doctor whether a baby truly needed that in-hospital formula supplement; talked to nurse who is considering pursuing her IBCLC credential; convinced employer to convert that old storage room into a pretty room for employees who pump; showed a high school nurse who knew nothing about breastfeeding how a breastpump works so she could support a teen mom; heard from neighbor who always thought breastfeeding was gross that she has given your number to her pregnant daughter-in-law. Those stories of changing attitudes a little bit at a time are the ones that keep us going. It takes a lot of hope to keep this momentum up!
We must continue to clarify a little more, with at least one person, at least once a day, why we are trying to move the message all the way around the circle to where it started. Breastfeeding is normal. Our work is not only to teach about the action or the importance of breastfeeding, but to move individuals forward on the circle so that attitudes match words.