The Sword of Damocles, by ikaa
I've been asked to repost here, in an open forum, two comments I made about the informed milk sharing, in the past 24 hours. You can see by the context, I'm discussing attitudes to milk sharing, and the female body. You can also tell by the picture, and the title, my thoughts on the position we put mothers into, when discussing this. :-) The comments stand alone, but I'll ask permission for the post I'm responding to on number one, to be published here - when the poster wakes up on the other side of the planet!
EDIT: permission given. And can I just thank Karleen Gribble and award her the Nobel No Prize, for "peer to peer milk sharing" and the apt and accurate comparison between bed, and milk, sharing. Go Karleen!
EDIT: permission given. And can I just thank Karleen Gribble and award her the Nobel No Prize, for "peer to peer milk sharing" and the apt and accurate comparison between bed, and milk, sharing. Go Karleen!
-o0o-
So my prophecy came to pass
A milk banking person saying how dirty and dangerous informal milk sharing is.... sigh... Jack Newman is quoted with similar sentiments in the same article. Very unhelpful and fits right in with the pervasive viewpoint that breastfeeding and breastmilk is icky, dangerous stuff that should be kept hidden- part of the reason why breastfeeding in public is so unacceptable and why working mums get such grief about their expressed breastmilk from their colleagues and from the carers of their infants. Shame! Shame!
Karleen Gribble
Australia
http://www.thestar.com/living/article/898077--breast-milk-banks-latch-on-to-social-media
However, the society does not endorse informal milk sharing. "I think it's dangerous," says Dr. Sharon Unger, a neonatologist at Mount Sinai Hospital. "I completely understand why women do it, but you really don't know what you're getting . . . it's very unsafe."
Unger is spearheading an initiative to set up a Toronto milk bank, but says it's still a few years away - pending more research and funding - and will initially make sick babies its priority
Karleen Gribble
Australia
http://www.thestar.com/living/article/898077--breast-milk-banks-latch-on-to-social-media
However, the society does not endorse informal milk sharing. "I think it's dangerous," says Dr. Sharon Unger, a neonatologist at Mount Sinai Hospital. "I completely understand why women do it, but you really don't know what you're getting . . . it's very unsafe."
Unger is spearheading an initiative to set up a Toronto milk bank, but says it's still a few years away - pending more research and funding - and will initially make sick babies its priority
-o0o-
Just to add my tuppence worth here to Karleen's prescience, and with respect to Diane, ask people to Watch Their Language.
Those of us in the lactation community who disagree with mothers taking control of their own milk supply, are using very specific language..
The Risks of Informal Milk Sharing.. casual milk sharing... unprocessed milk sharing... all of which are misnomers.
What is being discussed by the mothers taking control, is the difference between Informed, and Uninformed, Milk Sharing.
"Informal" milk sharing is being used to suggest no discipline, methodology or information about milk sharing. It conjures up the Hoary Old Spectre of the slack alice mother, going on ebay to buy a shed load of human milk, from the woman keeping her breast pump in the dog basket. The crack whore is also selling her milk, when discussing "Informal Milk Sharing." said crack whore has just come from her HIV treatment centre (which is [not] a problem actually, as she'll be on ARVs, but let's not muddy the analogy with science!) That woman down the end of the street with a fur coat and no knickers is involved in informal milk sharing, and she's giving it to the daft woman at No 6, who buys stuff from Internet channels as well.
However, when discussing Informed Milk Sharing, mothers are engaged in a discourse with each other, and the science and research, on which is the greater risk to their baby - donated human milk, or formula. They are discussing screening options, and processing options. They are scrutinising blood readouts and health check information. They are deciding how to mitigate risks, so they are less than those of feeding formula.
The removal of this aspect of the discussion, on various forums and posts, is very troubling to me. The various milk sharing sites make information known to all women, of the spectra of risks that can exist in milk sharing. And most provide resources on how to mediate, or mitigate, them.
To deny that element to the discussions, is to do a great disservice to everyone.
So please, can we stop with the 'Informal Milk Sharing' and be specific. You may as well just go straight to Icky Milk Sharing.
You may disagree with mothers making informed decisions on milk. You may think it's a terrible idea. You may genuinely believe that no mother can mitigate the risks. But to present the concept as having no discussion at all of the risks, is disingenuous at best, and dishonest at worst.
Mothers can undertake discussions about risk: let's not rob them of that, no matter how we feel about Informed versus Uninformed, milk sharing.
Informed Milk Sharing is the activity under discussion.
The discussion about "peer-to-peer" milk sharing
Do you like that terminology better Morgan??
I think that the discussion about peer to peer milk sharing has much in common with discussion of bedsharing with infants- in that it's something that one cannot outright recommend because it depends on the situation. I've given many interviews over the years to journalists about bedsharing and many have wanted me to say that it's safe and parents should do it. I won't.
Why?? Because we know that there are situations in which bed sharing is not safe. What I do do is state that there are good reasons why mothers share sleep surfaces with their infants, that they should be given information about how to manage the risks of bed sharing and then that it is up to parents to look at their individual circumstances and make their decision about where their baby sleeps and what that environment looks like. It's much the same with milk sharing. Mothers have good reasons why they might want to use donor human milk from a peer. They should be given information about how to manage the risks of sharing milk and then it's up to them to decide what to do. No professional needs to endorse milk sharing, nor do they need to condemn it. It is entirely possible for professionals asked to provide comment to recognised why women might want to obtain human milk via peers (banked donor milk unavailable, infant formula deficient), how they might manage the risks associated with peer to peer milk sharing (recognising that the risks are manageable) and that it's up to parents to decide what to do.
Karleen Gribble
Australia
Those of us in the lactation community who disagree with mothers taking control of their own milk supply, are using very specific language..
The Risks of Informal Milk Sharing.. casual milk sharing... unprocessed milk sharing... all of which are misnomers.
What is being discussed by the mothers taking control, is the difference between Informed, and Uninformed, Milk Sharing.
"Informal" milk sharing is being used to suggest no discipline, methodology or information about milk sharing. It conjures up the Hoary Old Spectre of the slack alice mother, going on ebay to buy a shed load of human milk, from the woman keeping her breast pump in the dog basket. The crack whore is also selling her milk, when discussing "Informal Milk Sharing." said crack whore has just come from her HIV treatment centre (which is [not] a problem actually, as she'll be on ARVs, but let's not muddy the analogy with science!) That woman down the end of the street with a fur coat and no knickers is involved in informal milk sharing, and she's giving it to the daft woman at No 6, who buys stuff from Internet channels as well.
However, when discussing Informed Milk Sharing, mothers are engaged in a discourse with each other, and the science and research, on which is the greater risk to their baby - donated human milk, or formula. They are discussing screening options, and processing options. They are scrutinising blood readouts and health check information. They are deciding how to mitigate risks, so they are less than those of feeding formula.
The removal of this aspect of the discussion, on various forums and posts, is very troubling to me. The various milk sharing sites make information known to all women, of the spectra of risks that can exist in milk sharing. And most provide resources on how to mediate, or mitigate, them.
To deny that element to the discussions, is to do a great disservice to everyone.
So please, can we stop with the 'Informal Milk Sharing' and be specific. You may as well just go straight to Icky Milk Sharing.
You may disagree with mothers making informed decisions on milk. You may think it's a terrible idea. You may genuinely believe that no mother can mitigate the risks. But to present the concept as having no discussion at all of the risks, is disingenuous at best, and dishonest at worst.
Mothers can undertake discussions about risk: let's not rob them of that, no matter how we feel about Informed versus Uninformed, milk sharing.
Informed Milk Sharing is the activity under discussion.
-o0o-
The discussion about "peer-to-peer" milk sharing
Do you like that terminology better Morgan??
I think that the discussion about peer to peer milk sharing has much in common with discussion of bedsharing with infants- in that it's something that one cannot outright recommend because it depends on the situation. I've given many interviews over the years to journalists about bedsharing and many have wanted me to say that it's safe and parents should do it. I won't.
Why?? Because we know that there are situations in which bed sharing is not safe. What I do do is state that there are good reasons why mothers share sleep surfaces with their infants, that they should be given information about how to manage the risks of bed sharing and then that it is up to parents to look at their individual circumstances and make their decision about where their baby sleeps and what that environment looks like. It's much the same with milk sharing. Mothers have good reasons why they might want to use donor human milk from a peer. They should be given information about how to manage the risks of sharing milk and then it's up to them to decide what to do. No professional needs to endorse milk sharing, nor do they need to condemn it. It is entirely possible for professionals asked to provide comment to recognised why women might want to obtain human milk via peers (banked donor milk unavailable, infant formula deficient), how they might manage the risks associated with peer to peer milk sharing (recognising that the risks are manageable) and that it's up to parents to decide what to do.
Karleen Gribble
Australia
No one is minimising risks, or invalidating actual risks.
But the construction that women are inherently diseased, and must be tested and tested and tested, to maintain their purity, is one we cannot allow to stand.
That we live in a society where women are healthier, better fed, more intelligent and have more power to make informed decisions, than has ever occurred on the planet before... that is what needs to be the opening statement. In that context, other women are a resource to help keep our babies alive.. a resource that has to be looked at where the majority of women are perfectly acceptable donors, with some work done to ensure risk has been minimised... is the one we should be aiming for.
That wonderful Chinese police officer, who breastfed, and kept alive safely, 5 babies, in an emergency, would, in terms of this discussion, being told to let them die, rather than infect them with whatever she couldn't prove she didn't have? She was breastfeeding her own baby, so what? She's AUTOMATICALLY too dangerous to feed another without a battery of testing?
The irony here, is that we're asking for a level of purity that is nigh on impossible, from the cleanest, safest, healthiest nations on earth.
And this notion that we must assume disease, rather than work with each individual circumstance, is going to do so much harm, and harm so many babies, if we let this myth be constructed around us.
The vast majority of mothers in the countries considering milk sharing (which requires a huge amount of hygiene and money rich resources) have all been tested during their own pregnancy, just prior to their lactation. Certainly, in the USA, where litigation is a more everyday fact of life, then more caution would have to be used. but that's about context.
The spectrum of mothers available for donation, starts with the VAST majority being perfectly safe to donate, and all of whom, just about, have the blood work to prove it. Only when you get into tiny percentages of overall population, do you run into the TINY percentage of the population, that should not donate.
Whilst we continue to discuss the entire spectrum as only the TINY minority, babies will be harmed.
Already, in the USA, double the newborns on formula, die as on breastmilk. Seeing every mother who may give life giving milk to a baby without enough, as Typhoid Mary, is simply obscene. And ignores the science, and the general population's actual behaviour and health.
Again, that heart warming story of the baby being breastfed by 5 young mothers, on a rota, as the baby's mother died in childbirth... gone. That baby is now on formula.
The double standard here is that you are asking more of a woman, than you are of a cow. Even when we know the cow's milk has potentially lethal contamination in up to 14% of the product. Yes, there is merit in the cross-species argument, versus same species, but that's part of the balance of risks for that individual baby - not a huge banner statement that infection and disease is running rife through our mothers and babies.
And we know that far LESS than 14% of the lactating population, is a risk. And that's before we get to the fact that most women are looking at both screening, and home flash heating with donated milk.
I can see a doctor's office, in the not to distant future, where a Dr is telling a mother not to breastfeed her own baby, until she can prove her milk is safe.
And the seeds of that horrible vision, are being sown in here, right now.
I grew up in a world where doctors and scientists had told mothers not to breastfeed, as their milk was not good enough. I cannot comprehend that returning via well meaning intentions on fear based philosophies. And you will see it rise, I can assure you, in the wake of these discussions on the automatic dangers of diseased women, and their polluting bodily fluids, that must be sanctified as 'safe'... by science and technology.
The risks are relatively small, the base population immensely healthy. The way to mitigate the risks, quite easy and manageable. The decision, the mother's. She should be supported in her decision, in either direction. That's the baseline.
I've stood by women who are HIV positive, who were being told needlessly, that their babies would be removed at birth, and they would never see them again, if they breastfed. I've listened to their anger, and their fury, and their fear. I've heard them cry. I've had to inform them of the dangers of the drugs they were being forced to take, to dry their milk. When there is no reason for this AT ALL.
Stand by the women I've stood by, and listen to their pain. You may find yourself reflecting on how healthy our society is, rather than how diseased it is. And how 'choice' is a dangerous, and load bearing, responsibility, that neither assumes, nor negates, hope.
But the construction that women are inherently diseased, and must be tested and tested and tested, to maintain their purity, is one we cannot allow to stand.
That we live in a society where women are healthier, better fed, more intelligent and have more power to make informed decisions, than has ever occurred on the planet before... that is what needs to be the opening statement. In that context, other women are a resource to help keep our babies alive.. a resource that has to be looked at where the majority of women are perfectly acceptable donors, with some work done to ensure risk has been minimised... is the one we should be aiming for.
That wonderful Chinese police officer, who breastfed, and kept alive safely, 5 babies, in an emergency, would, in terms of this discussion, being told to let them die, rather than infect them with whatever she couldn't prove she didn't have? She was breastfeeding her own baby, so what? She's AUTOMATICALLY too dangerous to feed another without a battery of testing?
The irony here, is that we're asking for a level of purity that is nigh on impossible, from the cleanest, safest, healthiest nations on earth.
And this notion that we must assume disease, rather than work with each individual circumstance, is going to do so much harm, and harm so many babies, if we let this myth be constructed around us.
The vast majority of mothers in the countries considering milk sharing (which requires a huge amount of hygiene and money rich resources) have all been tested during their own pregnancy, just prior to their lactation. Certainly, in the USA, where litigation is a more everyday fact of life, then more caution would have to be used. but that's about context.
The spectrum of mothers available for donation, starts with the VAST majority being perfectly safe to donate, and all of whom, just about, have the blood work to prove it. Only when you get into tiny percentages of overall population, do you run into the TINY percentage of the population, that should not donate.
Whilst we continue to discuss the entire spectrum as only the TINY minority, babies will be harmed.
Already, in the USA, double the newborns on formula, die as on breastmilk. Seeing every mother who may give life giving milk to a baby without enough, as Typhoid Mary, is simply obscene. And ignores the science, and the general population's actual behaviour and health.
Again, that heart warming story of the baby being breastfed by 5 young mothers, on a rota, as the baby's mother died in childbirth... gone. That baby is now on formula.
The double standard here is that you are asking more of a woman, than you are of a cow. Even when we know the cow's milk has potentially lethal contamination in up to 14% of the product. Yes, there is merit in the cross-species argument, versus same species, but that's part of the balance of risks for that individual baby - not a huge banner statement that infection and disease is running rife through our mothers and babies.
And we know that far LESS than 14% of the lactating population, is a risk. And that's before we get to the fact that most women are looking at both screening, and home flash heating with donated milk.
I can see a doctor's office, in the not to distant future, where a Dr is telling a mother not to breastfeed her own baby, until she can prove her milk is safe.
And the seeds of that horrible vision, are being sown in here, right now.
I grew up in a world where doctors and scientists had told mothers not to breastfeed, as their milk was not good enough. I cannot comprehend that returning via well meaning intentions on fear based philosophies. And you will see it rise, I can assure you, in the wake of these discussions on the automatic dangers of diseased women, and their polluting bodily fluids, that must be sanctified as 'safe'... by science and technology.
The risks are relatively small, the base population immensely healthy. The way to mitigate the risks, quite easy and manageable. The decision, the mother's. She should be supported in her decision, in either direction. That's the baseline.
I've stood by women who are HIV positive, who were being told needlessly, that their babies would be removed at birth, and they would never see them again, if they breastfed. I've listened to their anger, and their fury, and their fear. I've heard them cry. I've had to inform them of the dangers of the drugs they were being forced to take, to dry their milk. When there is no reason for this AT ALL.
Stand by the women I've stood by, and listen to their pain. You may find yourself reflecting on how healthy our society is, rather than how diseased it is. And how 'choice' is a dangerous, and load bearing, responsibility, that neither assumes, nor negates, hope.
The Sword of Damocles, by Paul Hudson
6 comments:
"I can see a doctor's office, in the not to distant future, where a Dr is telling a mother not to breastfeed her own baby, until she can prove her milk is safe. "
Umm.... This already happens, all the time. "While you're on the medication/have a fever/detoxing, just to be safe don't breastfeed for 24/48/72 hours."
We need to always understand RELATIVE risk. How contaminated does breast milk have to be before formula becomes the safer choice?
Morgan, I think I love you. I saw your post on LactNet but I am so happy that you've posted it here as I can now share your words with those who really need to hear them. Off to read the rest of your fantastic blog!
I've always used the term "direct donation" to describe the couple-thousand ounces I have donated through MilkShare or to friends. I also dislike the term "informal donation," because I went through a great deal of blood testing, which I assure you, isn't at all informal.
I agree that some of us are very informed. I donated over 500 ounces to a milk bank (and so went through questionnaires and blood testing) and then had smaller quantities of stored milk that I gave to some friends. They know my lifestyle and habits and that I had been tested to donate to the milk bank and so I consider that a wonderful choice and milk-sharing relationship.
Many of the comments on another BF list were talking about the safety of meeting strangers through social media networking or the milk being bought by perverts or wierdos. This made me stop and think for a while, and I can certainly see why people would and possibly should, be concerned about such things, but on reflection I have come to see this as a feminist issue. Women should have autonomy over their own bodies and therefore their own bodily fluids.
Fascinating post - well written
I breastfed and pumped for my babies and donated to my local milk bank too - subject to the usual raft of tests. Only trouble is that I am now left (because collection is an issue locally) with a freezer with a large stash of perfectly good expressed milk I am not using and the milk bank can't take) - I'm very tempted to offer it but who would take it given that expressed, donated milk is seen as less 'good' than formula?
I wish the medical professions would take a step back, think and realise that women are able to make decisions for themselves and that their bodies are, in general, to be trusted to the jobs they need to
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