Guest Post – Response to Chicago Tribune article: “Has breastfeeding been oversold?”

(The views expressed in guest blogs do not necessarily reflect the views of Unlatched.  I just like giving people a place to voice their views or opinions. – Rachelle Unlatched)

Here is the original article from the Chicago Tribune:

http://articles.chicagotribune.com/2012-12-19/news/sc-health-1219-breast-feeding-lies-20121219_1_breast-lactation-consultant-outcomes

Response from my guest, Debbi Smith-Moore, CLS:

Dear Ms. Schoenberg,

Your article of December 19, 2012, entitled “Has Breastfeeding Been Oversold?” was brought to my attention today. I feel you left out important information, generalized quite a bit, and overall did damage to the progress of a lot of really amazing women.

First, I would like to explain the distinction among the terminology used to define Lactation Consultants.  Anyone who has training in lactation can call themselves a consultant.  However, there are differing levels of training.  Those with the title of “CLC “ (Certified Lactation Consultant) or “CLS” (Certified Lactation Specialist) have had formal education consisting of around 45 hours in lactation and have taken and passed a certification exam by a governing body.  Those with the title of “IBCLC” (Internationally Board Certified Lactation Consultant) have had much more formal education in lactation, often have a degree in some form of healthcare, and have taken and passed a certification exam by a governing body (The International Board of Certified Lactation Examiners).  It is my understanding that ALL of these people must also accumulate an amount of continuing education to stay current in the field, and also must periodically pass a certification exam to keep their certification.

I would like to begin by saying that I am very sorry you had a poor experience with the lactation consultant with whom you worked.  Not all lactation consultants are in the right line of work for them, just as not everyone who knows how to construct a sentence should be published authors.  Additionally, not everyone one speaks to in the postpartum unit who gives advice on breastfeeding is a credentialed lactation consultant. I know this personally through my own bad experiences, and from the experiences of the women with whom I work.  Moreover, not every lactation consultant has to have delivered twins to understand the mechanics of breastfeeding twins.  Not every LC has to have delivered a premature baby to understand what will likely happen in that situation, either.  Anyone with credentials in lactation support and education is trained to handle most issues that could arise when breastfeeding is attempted.  If they are not credentialed in lactation, they should not be giving advice beyond the absolute basics.  It is my opinion that ALL labor and delivery and postpartum nurses should have training in lactation, as should ALL OBGYNs and ALL pediatricians.  ANYONE working with the mother-baby dyad should know much more than just “the basics” of breast anatomy.

To be fair, unless you asked, you have no idea what your lactation consultant has “endured.”  Maybe she has not carried and delivered twins. Maybe she had a baby born at 32 weeks.  Maybe she has no children at all, maybe because she has fertility issues.  Your characterizations are unfair, and only included for effect.  I call that dirty pool.  Additionally, you don’t know what kind of day she has had.  Yes, she should not be showing negative feelings to a new mom who is struggling.  But maybe she was “impatient” because she is over-worked and has many other moms she still has to see before SHE can go home, and it is close to the end of her shift.  Your fault?  Absolutely not.  But I will tell you a secret… She’s a human being.  Cut her some slack.  You made it clear you believe she has not walked in your shoes.  I would bet money that you have never walked in hers.

Also to be fair, you had just given birth to twins.  I have never done that, so I can only imagine how you felt at that time.  I DO know how I felt after giving birth four times, including two very long, induced labors, one that was progressing very slowly then suddenly very quickly, and one emergency c-section after an ambulance trip to the hospital while gushing blood.  I was exhausted.  I was hormonal.  I will even admit to likely being rather grouchy and possibly uncooperative.  But one thing I will now admit that I was not is objective.  I would guess you probably were not either.

To address your statement about leaving the hospital late:  Here’s another secret…  You can walk out at any time you want.  You are not a prisoner.  They will not hold your babies hostage.  They will not have security shoot you in the back as you make a run for the door.  You stayed because it was your choice to stay.  The end.

Here’s another secret for you… I know of very few moms who are struggling with breastfeeding that don’t feel that they are doing “just about everything wrong.”  Me included.  We are women.  We internalize guilt for EVERYTHING and make it our fault.  That’s what we do.  I can remember sitting in the NICU with my youngest daughter, who was about a week and a half old, crying and saying to my LC “Women have been doing this for thousands of years, why can’t I get this right???”  Her response?  “Because your baby wasn’t supposed to be born yet!  She is not physically capable of nursing at this time!”  So why were we even trying?  PRACTICE!  And let me tell you, I am so thankful I had her, and her co-worker, because once my daughter figured out what to do, she nursed like a champ!  For 19 months!  If you had told me the day she was born that I was going to breastfeed her for 19 months, I would have laughed in your face.  Why?  Because I had had a bad experience breastfeeding my older son, didn’t even try with my younger son, and had a HORRIBLE experience breastfeeding my older daughter.  The difference?  I had amazing lactation support with the last child.  A month-long NICU stay will do that for a girl…  I don’t recommend it though.  I knew I had people to turn to.  People who are passionate about helping moms like me be successful at breastfeeding.

I would like to know how much you actually know about the benefits of breastfeeding and providing breastmilk to babies.  Did you know that the act of a baby nursing (as opposed to drinking from a bottle, regardless of the contents) will likely save a parent money down the road in lower orthodontia bills because the baby’s mouth and jaw are in the proper position for feeding and therefore develop better?  How about that the position a mom uses to breastfeed can affect her success?  Humans are mammals.  We want to be on our tummies as babies to eat, which triggers those primitive neonatal reflexes in both baby AND mom, and baby is better at latching and sucking.  Did you know that a child who is breastfed is less likely to reject a donor organ after transplant?  How about that breastmilk is being studied as a food source for chemo patients and patients going through radiation therapy because it is so easy for the body to digest and greatly reduces nausea?

You cite that breastfeeding does not significantly increase the I.Q. of a child.  So what?  Every little bit helps, right?  I.Q. also is influenced by external stimuli.  It doesn’t matter how high a child’s I.Q. is, if there is no external stimulation for the child to use to learn, they won’t.

You also cite that the weight loss isn’t that great.  This is also influenced by other factors.  I didn’t lose much weight that I was able to keep off after my children were born, any of them.  But I am also a Coke addict (as in –a cola, not –caine), so I am consuming many, many empty calories every day that my body doesn’t need, so to use me as an example (which I know you did not), is not objective.

You cite that breastfeeding isn’t free and discuss earnings.  Let’s look at the cost of formula.  An average household that is exclusively formula-feeding their baby will spend around $1,500 to $2,000 per year on formula powder.  The liquids are even more expensive.  That doesn’t include the costs of bottles, nipples, bottle brushes, dish soap, water to prepare the formula, water to wash the bottles and nipples, electricity or gas to heat that water, etc.  It also doesn’t take into account the lost time parents DON’T have because they do not have to take time off work when the child is sicker.  Are formula-fed babies generally sicker?  That is a resounding YES!  (My youngest daughter got the least amount of formula of all my children and she is by far the healthiest, even though she was born six weeks early.  We have been passing a nasty virus around our house for three months, and she is the only one of all of us that hasn’t gotten really sick from it.)

Let me extrapolate that out a little farther.  If a child is less sick, generally that child’s family will be less sick, which means the other children aren’t taking germs to school and mom and dad aren’t taking germs to work.  Which means the children and staff at that child’s school aren’t getting as sick, and the co-workers of mom and dad aren’t getting as sick.  Which means their families aren’t getting as sick.  And so on, and so on, and so on.

Are the benefits you cite negligible?  Maybe, maybe not.  I would say not, but I’m no expert.  But I would like to offer an example.  This brings to mind those bank accounts where the bank takes the change from the transactions and drops it into a savings account.  A few cents here, a few cents there, doesn’t really seem like a lot.  But over time, it adds up, and suddenly one has enough money to go on vacation.  That is kind of like the benefits of breastfeeding.  One may not notice them right away, maybe not even ever, but over time, they sure do add up.  They did for me, and my youngest is only two.  We haven’t even talked about the bonding between the baby and the mom.  My youngest daughter will still come to me when she is sick or hurt or upset, crawl up into my lap and stick her hand down the front of my shirt.  She doesn’t play around, she just puts her hand between my breasts, where she would often put it while nursing, and sits.  And I’m happy I can still comfort her in a way nobody else can.

Now, in the interest of full disclosure:  I work in the field of breastfeeding and am one of those passionate advocates.  I work for my county’s WIC clinic as a Breastfeeding Peer.  I started this job as just another WIC mom who breastfed, but have since gone on to receive additional training and am a Certified Lactation Specialist, and am hoping to become an IBCLC in the near future.  However, I am not a lactation nazi, as some people call us.  I hope all the moms I work with will choose breastfeeding, but I know they all won’t.  I educate, encourage, support, and hope for the best, but realize that in the end, it is the mom’s choice, and I can only do my best.  Knowing what I know about formula and how truly lacking it is, I don’t personally understand the choice to not breastfeed, but again, it isn’t my choice.

I welcome your response.

Very truly yours,

Debbi Smith-Moore, CLS