Wednesday, April 30, 2014

Breastfeeding & 'Experts'

When choosing 'Experts' to dispense advice, it is important to ensure that they are appropriately qualified for the advice that they will be meting out... Seems pretty simple, doesn't it?  They should have the education and experience on the subject matter, to support their stance and suggestions, right?

In the past, I have written about critical thinking and how it is important for mother's to look at where the advice (that they are inevitably inundated with) comes from.  Be it your OBGYN, your family practitioner, your paediatrician, your nurse, your mother/mother-in-law, your best friend, the lady in the grocery store, the man down the street, so on and so forth.  Everyone has an opinion when it comes to mothering, and it is important to keep in mind that some people are more qualified than other's to share their opinions (and having 'Dr' preface your name does not necessarily give you carte blanche in the advice department). 

Last week I wrote an open letter to CityLine, (a Toronto-based morning television show) regarding a breastfeeding segment that they will be airing in May.

I think it is wonderful that CityLine is airing a breastfeeding segment, but I question the breastfeeding advice that mother's will receive when the segment is being sponsored by Medela (a breast pump, bottle and breastfeeding alternative product company).

Medela's profits rely on interrupting the biologically evolved mammalian infant feeding norm - feeding babe at the breast. If mother's are able (and choose to do so) to feed their children exclusively at the breast, they will not need to buy Medela's products.  So, is it not questionable that this is the company CityLine has sponsoring their Breastfeeding segment?  Can we not assume that there will be a conflict of interest?  Would it not be safe to assume that Medela wants to make money, and to make money mother's have to feel as if they need their product, as if they could not feed and/or care for their child without Medela's product?  Does this not seem as if we are setting mother's up to fail? 

I question what advice will be given by their  breastfeeding 'expert', Marjorie E. Dixon, MD, FRCS(C), FACOG (whose professional affiliations include the American Society of Reproductive Medicine, the Canadian Fertility and Andrology Society, the American College of Obstetrics and Gynecology, and the Society of Obstetricians and Gynecologists of Canada), straight from her website 'First Steps Fertility':
Her research thesis and interest lies in the field of recurrent pregnancy loss, looking at mediators of inflammation and their impact on the genetic expression of factors involved in the failure of embryo implantation. She also specializes in difficult reproductive endocrine cases including polycystic ovarian syndrome (PCOS), reproductive aging, hypothalamic problems, thyroid disease and endometriosis as well as general gynecology and surgeries.

No mention of lactation.  No mention of mammalian infant nutrition.  No mention of breastfeeding.  

If you were sourcing out your own breastfeeding expert, would you not expect that breastfeeding, lactation and/or mammalian infant nutrition be an interest of theirs?  Would you not expect that they had spent time independently educating themselves on the biologically evolved norms of feeding ones baby at the breast?   

What really burns my butt (aside from the fact that CityLine essentially brushed off my concerns with this response:  'Thanks for your email.. we always appreciate viewer feedback.. I have passed your email along to our Sales department for their review.. someone will be in touch..'  I'm not sure why I require a response from their Sales department, since I am not trying to sell them anything), but what really burns my butt is that mother's will see that a doctor is the expert for the segment (factor in that she's female, and an OBGYN), and very few will question her advice.  

When we are inundated by suggestions from strangers; the lady at the grocery store or the man down the street, we automatically question their advice.  We wonder about what qualifies them to dispense such sage words of wisdom, and we actively take that information and put it through our own personal filter.  When it is a doctor putting forth a recommendation, it is harder for most people to question them.  We immediately think of the amount of time that they have put into their education, that must mean they are qualified.  Right?  

But that is not necessarily true!  A doctor will only have as much lactation and breastfeeding education as they wish to independently pursue.  Paediatricians and gynecologists cannot agree on who should be well-versed in lactation and breastfeeding information (it is my honest opinion that it should be both... paediatricians should be well-versed in the biologically evolved norm for human infant nutrition, since their specialty is human infants/children and gynecologists should be well-versed because they are delivering these babies and helping their mother's immediately after birth) and so the ball is dropped, and neither are experts on the matter.

It is my opinion that CityLine has missed out on an amazing opportunity; Toronto has a wealth of lactation and breastfeeding resources (ones that many expectant, and new mother's are unaware of).  

If you are a CityLine viewer, expecting a baby, a mother or someone that is interested in supporting breastfeeding mother's; please consider contacting CityLine ( or their email) and expressing your frustration.  Tell them, in no uncertain terms, that mother's deserve to have unbiased, scientifically supported (not anecdotal) breastfeeding advice.  


Breastfeeding Resources:
Dr. Jack Newman
La Leche League Canada
WHO (World Health Organization) 
Lactation Advocacy Group:  I hate it when people act like breastfeeding is obscene, GET OVER IT!
KellyMom
Ontario Lactation Consultants Association
Best for Babes Foundation
Infact Canada


Thursday, April 24, 2014

An Open Letter to {CityLine} -- Supporting Breastfeeding Mothers

  • http://site.en.todaysparent.com/medela2014/

    Dear CityLine,

    I find it puzzling that you are doing a segment on breastfeeding and rather than conferring with a lactation consultant, a La Leche League Leader OR (Toronto's own) Dr. Jack Newman in conjunction with Medela; instead you are solely relying on Medela (a bottle and pump company) to provide balanced breastfeeding advice.

    Medela's business model relies on women being unable to exclusively breastfeed; do you truly feel that they will provide complete, accurate and biologically sound breastfeeding advice?

    Successful breastfeeding does not rely on fancy gizmos and gadgets; at the root it is a very simple process (albeit, one not without challenges), one based off of supply & demand. The nursling (baby or child) indicates their need for nourishment and the mother responds, as the nursling breastfeeds they give the mothers breasts the signal to create more milk. Breastfeeding is learned by being around other mother's who breastfeed and by breastfeeding. A pump cannot teach a mother how to breastfeed.

    I understand that even though the current medical stance is exclusive breastfeeding to 6mos (continued in accompaniment with solid foods to two years and beyond; as long is mutually desired by mother and child); I understand that not all mother's will choose to do so, and I also understand that not all mother's have the luxury afforded to them to be able to stay home for 12mos and securely establish their nursing relationship with their child. In those instances, where the mother cannot stay home or does not wish to exclusively breastfeed, in those instances a pump and bottle are a possible alternative; and I do see the value in discussing these alternatives.

    No matter what a mother's decision, she needs to be supported with integrity, and I do not believe that exclusively relying on a company which makes money off of mother's not being able to exclusively breastfeed their children, is an appropriate way to support nursing mothers.

    I strongly urge Cityline to step up and contact the plethora of services, tap into an absolute wealth of knowledge that is at your fingertips; encourage and accurately inform women of the benefits, challenges and joys of the mother/child nursing dyad.

    http://www.lllc.ca/find-group-ontario
    https://www.nbci.ca/
    http://www.olcacanada.ca/

    And may I further the discussion with the following: A pump is not an essential breastfeeding tool, milk ducts are an essential breastfeeding tool. The majority of women, when PROPERLY supported (i.e. by LC's, by mother-to-mother support groups such as LLL, by physicians with breastfeeding knowledge and the willingness to refer women to experts when the questions and concerns are beyond the scope of their personal knowledge)... if they choose to do so, when properly supported the majority of women can breastfeed.

    It is a choice that every woman should be given whole and unbiased information to come to the right decision for their family. They should fully receive support, no matter what their decision and if they choose to breastfeed, they should be given help to work through the challenges so that they may reach their goals.

    A company which profits by interrupting the biologically evolved mother/child nursing dyad is most likely not going to provide unbiased, balanced breastfeeding advice. The company needs to turn a profit (as all companies do... I am not judging Medela for wanting to make money; money makes the world go round), and helping a mother *exclusively breastfeed* (which results in no profit for the company) is not beneficial to the business.

    And lastly: I applaud CityLine for hosting a segment on infant nutrition, but please call it what it is "infant nutrition"; for this to be a balanced segment including biologically sound and unbiased breastfeeding advice you should have lactation specialists included in your panel.

    I am absolutely positive that Medela is capable of fielding many an infant nutrition question, I do not have faith (when taking into consideration the nature of their business) that their breastfeeding advice will be neutral and completely unbiased.

    I do not understand why, when you are surrounded by a wealth of breastfeeding knowledge, you would not tap into the sources that are literally at your fingertips.
    Sincerely,
    A Muddled Mama 


    Edited to add: 
    The following sentiment could be taken as me implying that breastfeeding is easy-peasy lemon squeezy "Successful breastfeeding does not rely on fancy gizmos and gadgets; at the root it is a very simple process (albeit, one not without challenges), one based off of supply & demand."  
    I failed to include a disclaimer, that I was breaking breastfeeding down to its nuts & bolts (supply and demand); I didn't include that there are instances where mother's are concerned with their milk production, I didn't include that many mother's need outside sources to help establish and maintain their nursing relationship, and I didn't include the pitfalls & challenges of nursing.  I didn't include that there are some mother's who choose to pump, that there are some mother's who need the help of pumps to help boost their supply, or that there are some mother's who need the help of galactagogues to boost their supply.
    I did not include those things because I was not discussing the challenges of breastfeeding (they are real and they do exist, it is why mother-to-mother support groups such as La Leche League are so important, as well as grassroots mother led organizations such as I hate it when people act like breastfeeding is obscene,  GET OVER IT!, they are why Dr. Jack Newman's Breastfeeding Clinic exists and they are why LC's are so very important), I was discussing why I felt CityLine was doing expectant and breastfeeding mother's a disservice by exclusively relying on breastfeeding advice from a company that manufacturers pumps, bottles & other various breastfeeding alternative products.
    Pumps, bottles and breastfeeding alternatives all have their place; for some mother's, they can make or break a breastfeeding relationship (or they offer mother's the opportunity to choose how they wish to nourish their child), but not every mother needs (or wants) to use them.  Some mother's just need guidance, advice and support from a friend, their mother, or another mother who has nursed a baby; someone to bounce ideas off of (i.e. is this normal?, what is this?, what do I do now?).  

    May 5th -- Additional Edit:
    I wrote this letter after watching an episode on Cityline, when I originally went to the Today's Parent link, the expert had not yet been released as Dr. Dixon.  I went with the assumption that a segment sponsored by Medela would be biased towards pumping, I stand by that assumption.  No Medela is not providing the 'expert', but they are sponsoring the segment and I don't think it's unreasonable to believe that Medela is hoping to gain customers from some of the mother's calling in.  If you check out my follow up post here, you will see that even though the 'expert' isn't a Medela employee I am still questioning what makes this individual a breastfeeding expert.