Tuesday, February 19, 2013

In which I eat humble pie (and also agree to disagree)

Back in November 2012,  a couple of articles in the press by two well-known babycare writers (Miriam Stoppard and Robin Barker) inspired me to write a post called When mainstream babycare gurus go bad. Shortly afterwards, Ms. Barker herself actually emailed me. Here's our (very slightly edited) exchange.
Hi there, 
 For starters I am not well into my seventies, sixty-eight to be exact. Unlike many others who produce parenting tomes, I have thirty years of hands-on professional experience helping parents in the first three years. I also have had two children and two grandchildren who I spend a lot of time with.   Secondly, I am well aware that the piece on The Drum was extreme. Did I have a moment of aberration? Or is it indeed senile dementia? No, not really. 
I was asked to do the piece after one of the editorial staff on The Drum was horrified by the breastfeeding stats they saw published by whoever published them. I decided to put out some extreme ideas to see what the response might be. In actual fact, extreme though my ideas may have been, there was a poor response, judging by the number of comments published on The Drum – good responses on that site generate 400+ comments, my breastfeeding views, a miserly 100+. Most people couldn’t give a toss one way or the other. 
The thing I was interested in is this: the importance of breastfeeding is religiously trotted out by communities and governments alike yet the number of women breastfeeding much beyond an initial burst has not increased in over fifteen years and doesn’t look like it ever will. Does this matter enough to put in place some of the ‘extreme’ ideas (which I don’t necessarily support) I listed? I was keen to make the point that communities and governments would need take a radically different path – a path I am aware is almost certainly unacceptable – than what is currently being pursued if we are truly serious about the ‘importance’ of breastfeeding. 
The other thing I am always intrigued by is this: the less breastfeeding there is, the more infant food manufacturers stand to gain financially so why is it they emerge as the understanding compassionate goodies while anyone who goes out on a limb about supporting breastfeeding (zero financial gain)  becomes the enemy whose sole aim in life is to ‘make mothers feel guilty’. 
The general ignorance about infant formula is mind boggling: the experimental nature of the product - bearing in mind that for  babies not breastfed (currently the majority) it is, in their first four months or longer, their only food (so let’s hope the manufacturers get it right); the assumption by parents that ingredients generated from fish oil, egg yolk lipid, fungus, marine algae and inert plant yeast are equivalent to their counterparts in breastmilk; the now embedded notion that infant formula is an essential part of infant feeding; the push to make formula a necessity right through the toddler years; the subtle advertising of formula that undermines breastfeeding every step of the way are all aspects of artificial infant feeding the majority of parents appear to be unaware of. Depending which way you look at it, infant formula marketing has been a huge success, breastfeeding marketing mostly an abject failure. 
I think you say you have never read my book Baby Love. It is popular in Australia because my work entailed, unlike Penelope Leach and others you mention, seeing many parents (mostly mothers) and babies every day for many years. It was my job to help them in the particular circumstances they found themselves in. I helped many women to breastfeed through a myriad of difficulties, I helped many women through the distress of weaning, I guided many women in the best use of infant formula. My book reflects the numerous dilemmas and options available in caring for babies in the first year. I am above all uncritical, practical and pragmatic but that doesn’t mean I enjoy sitting back and seeing infant food manufacturers getting away with what they get away with, largely on account of the general apathy and ignorance concerning infant feeding, and the false notion that supporting breastfeeding is a whip to beat recalcitrant mothers about the head with. 
Please publish this on your blog. 
All the best,
Robin Barker plus all her marbles

My response:

Why yes, I did just randomly add a nice photo of some jellyfish. Jellyfish are pretty and make everything more awesome.
Dear Ms. Barker, 
First of all, my sincere apologies for the extreme delay in reply! I will be honest--I added an "email for inquiries" to my front page (thinking, "This will brighten up the blog a bit!") and then promptly forgot all about it since I had too many other things to think about... such is the life of the working mother, I fear. 

Anyway, thanks for getting in touch and for taking the opportunity to give me your own side of the story. First off... my comments about age were clearly (a) inaccurate (b) pretty discourteous, now I reflect on them (especially since I did after all start my blog with the hope of creating some science-based dialog, not flippant remarks or ad hominem attacks etc.). So, as they say, "Point well taken"; that was not a courteous way to speak at all, and I apologize. 
Regarding your other points: I see that you yourself are not in favor of formula-on-precription-only (which I am relieved about, as I maintain that such strategies would be both dangerous and unnecessarily shaming to formula-feeding mums). I guess my own slightly waspish reaction also needs to be considered in the context of the debate surrounding infant feeding in recent years. Perhaps it has a lot to do with the rise of the internet as mums' main source of information, but the rhetoric of a lot of breastfeeding advocates seems to have become more and more extreme... and it's not unusual to hear people seriously advocating for such extreme measures as formula-on-prescription-only, forcing bottle-feeding mothers in hospitals to listen to lectures or to bottle-feed only in places where other mothers can't see them. So upon seeing your article and the mention of prescription-only formula, my overwhelming feeling was one of "Oh God, not Robin Barker too?? I'd always been told that she was one of the sensible breastfeeding advocates....!"
The exclusive-breastfeeding-to-six-months is, I'm afraid, also one of those things that tends to touch a nerve with me for personal reasons; I started solids a bit earlier than that as a carefully-researched decision, not because of commercial pressures, and tend to get a bit defensive when I hear governments using the six-month thing as a barometer to judge breastfeeding rates, because it makes me feel as though I'm being told that all the milk I was pouring into her somehow doesn't count. So I maintain that there are saner ways to measure breastfeeding rates in developed countries; perhaps measuring to four months, or having a definition of "exclusive" that included up to one bottle of formula per week or something. Who knows....
I do hear you on the fact that there are tremendous commercial pressures that exist behind formula and baby foods (though I don't know if it's true to say that there is no money to be made from breastfeeding either... lactation consultancy and so on have become pretty big businesses). I guess the trick is to try and find a balance between protecting breastfeeding AND making sure that women who want to or need to use formula are able to do so without feeling harassed. It's a difficult issue, that's for sure.
You are correct that I haven't read your book; I included it on my list of go-to resources on the advice of a couple of online friends who liked it a lot. I hope to get round to reading it soon (still working my way through quite a list of books right now, mind you) and if I find it a useful resource I'll do the right thing and put it back on the list. Let's face it, if I were to remove every book/resource whose author had at any time said anything I (slightly) disagreed with, I'd have a very short list indeed.
Anyway, I'd be happy to include your side of the story on the blog. Hope this is a constructive response--I like to think blogging is about having a conversation, rather than running a "bully pulpit"! Please enjoy the rest of the summer in Australia.
Best wishes
Breastfeeding Without BS

I'm publishing this particular exchange at full length not only because Ms. Barker asked me to in order to present her side of the story, but also as a little reminder to myself of the importance of maintaining courtesy when blogging--not just because behind the author, journalist or activist we are sniping at is always a real person with feelings, but also because I want this to be an evidence-based blog... and that means sticking to the evidence, not resorting to attacking other commenters on the grounds of sex, age, religion or anything else. Even when disagreeing with someone (and Ms. Barker and I definitely do disagree on several points here, including the validity of some of the ingredients in infant formula and the notion that breastfeeding is in retreat, at least in developed countries) we need to do so with courtesy and empathy for the other person.


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