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This week's letter is in regards to Julia Glass' article,
"The Truth About Breast-feeding: If Breast-feeding
is so Good for Babies, Why is it so Hard for Mothers?"
To the Editor:
I was disappointed in Julia Glass' article, "The Truth
About Breast-feeding: If Breast-feeding is so Good for Babies,
Why is it so Hard for Mothers?" While I applaud her
discussions of the obstacles faced by nursing mothers seeking
help from ill-informed medical professionals and of the lack
of support for breastfeeding within the workplace, I feel
that Ms. Glass herself was not especially supportive of those
mothers who continue to nurse despite numerous impediments.
I believe that Ms. Glass fell into the trap so common among
writers discussing breastfeeding: in an effort to present
a "balanced" view and not offend those who cannot
or choose not to nurse their children, she underrates the
importance of breastfeeding to our children's health, to
women's health, and to our nation's social and economic health.
As a nursing mother, I was extremely offended by Dr. Harris
Burstin's characterization of breastfeeding women as "cows."
Negative statements such as this, especially by a pediatrician,
discourage women from breastfeeding as well as encourage
mothers to wean prematurely. Perhaps Dr. Burstin is unaware
that the American Academy of Pediatrics (AAP) recommends
that pediatricians "promote and support breastfeeding
enthusiastically."
I was also very disappointed by the author's negative portrayal
of La Leche League (LLL). As noted in the article, breastfeeding
is most successful when the mother receives adequate information
and support, and LLL is the international authority on breastfeeding.
Discouraging women from seeking their assistance might make
the difference between a happy breastfeeding couple and a
baby being fed formula unnecessarily. It is very likely that
the woman mentioned in the article who called LLL for advice
on weaning was told to wean gradually. This is by far the
most sensible approach to weaning for both mother and child,
since it will minimize discomfort and the risk of breast
infections for the former and emotional distress for the
latter. But to say the LLL is "about never stopping"
breastfeeding is unfair and untrue.
Similarly, mothers may be deterred from utilizing lactation
consultants by Ms. Glass' characterization of them as unreasonably
overzealous. It is the lactation consultant's responsibility
to provide the support and assistance to facilitate the nursing
relationship, just as it is the mother's responsibility to
determine when enough is enough. Thus, I was pleased to see
a sidebar advocating the use of lactation consultants despite
Ms. Glass' negative statements in her article.
Perhaps most disturbing is that article leaves one with the
distinct impression that the author never bothered to read
the AAP's policy statement, "Breastfeeding and the Use
of Human Milk." Had Ms. Glass done so, she would have
seen the abundant research proving incontrovertibly that
breastfeeding is not just "preferable" to formula
feeding, but that formula feeding carries significant health
risks. The AAP, in its policy statement, provides copious
documentation that "human milk and [the] breastfeeding
of infants provide advantages with regard to general health,
growth, and development, while significantly decreasing risk
for a large number of acute and chronic diseases." Furthermore,
the AAP documents proven benefits to maternal health as well
as the social and economic benefits of breastfeeding. In
the latter case, a mother can save over $1200.00 in the cost
of formula if she exclusively breastfeeds for one year. Then
too, formula carries special risks for infants in low income
families: its high cost leads some mothers to over-dilute
formula.
Given these facts, I find the author's statement that breastfeeding
"offers statistical advantages, not guarantees"
disingenuous at best. The corollary to this statement is
"most children do just fine on formula." Most children
who aren't strapped into car safety seats will not die or
be injured in automobile accidents, but we legislate the
use of such seats because of the unacceptable statistical
risk. Most infants don't die when we put them to sleep on
their stomachs, yet pediatricians now recommend against this
practice because of the increased statistical risk of SIDS.
Nonetheless, as a society, we feel that the advantages of
breastfeeding and the risks associated with formula feeding
should not be disseminated because mothers who cannot or
chose not to breastfeed might feel guilty or like failures.
Isn't getting our children off to the optimum start worth
risking a little maternal guilt?
Only 3% to 5% of all women are physically incapable of breastfeeding.
Despite this, less than 60% of mothers are breastfeeding
at the time of hospital discharge, and only about 20% are
still breastfeeding their babies at 6 months. Clearly, we
must increase the numbers of mothers who breastfeed if we
have any concern for the health of our children. By discounting
the benefits of breastfeeding and diminishing those individuals
who support nursing enthusiastically, we do nothing to further
this goal.

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