Subject: Breastfeeding Advocate thrown off the BBC World Service
Dear friends,
We have just received news via LACTNET (Lactation Information and Discussion) that Morgan Gallagher, Chairperson of Nursing Matters, a non-profit making, voluntary organisation that advocates for breastfeeding babies was thrown off a BBC World Service programme for saying that unsafe formula feeding kills babies in Africa.
Portions of her posting on LACTNET - reproduced with permission from Morgan.
" Just a quick note to let you know, I've just been thrown off a BBC World Service programme, for saying that unsafe formula feeding kills babies in Africa.The programme went out live at 6pm, BST time, here, and I was booked, at the last minutes, to do an hour of the whole world programme, and then the 30 minutes afterwards, on Africa only.
When I asked the discussion about breastfeeding be 'creepy' be about women being put in impossible position, and maybe we should look at why an intelligent, articulate, well educated woman in the UK would be so creeped out by a baby touching her breast... the mic was closed. When I said we needed to address the pressure to formula feed, not the pressure to breastfeed... the mic was closed. When I stated that 4000 babies die everyday from unsafe formula feeding... the mic was closed.
When I was then taken off air, and roundly shouted at by the producer. I challenged her, and stated that we could not have global context discussion on breastfeeding, without discussing formula feeding, and how on earth could she ask a women in Nairobi if she'd support a woman to formula feed if she wanted to? That ignoring the situation in Africa with formula, and acting if we were all in the UK, was precisely the bias they were showing. She said the World Service was for everyone, and I asked how a women in the slums in Kenya, tonight, would feel, listening to us prattling on about formula feeding as a supported choice. Did she have any idea who many babies would die tonight, in Kenya, from formula feeding? She blew up, said I'd said formula feeding kills babies, and that was making her very angry, and I was out of the programme. A taxi would be called to take me away right away, and good bye."
To listen to the entire podcast (about 50 minutes long) please click on the link below.
WHYS 30 June 2010: Is breastfeeding 'creepy'? Wed, 30 Jun 10
Kathryn Blundell is the deputy editor of a leading parenting magazine here in the UK and she's got women all over the the world talking. She didn't breastfeed her children - she says that her breasts are for sex not for feeding.
If you've had children, did you feel a pressure to breast-feed?
We hope that you will share this news with your network especially for those who have experience in living or working in resource poor settings to write to the BBC that as a worldwide broadcast - they must carry a world view perspective and understand they have a responsibility to ensure that it is made clear that while the "choice" to formula feed in the UK or Western Europe might be one that can be made with limited negative impact on child and mother that this is simply not the case in much of the world- that that formula feeding commonly results in death in much of the world.
From: Karleen Gribble Sent: Friday, 2 July 2010 12:10 AM To: 'worldhaveyoursay@bbc.com' Subject: formula feeding in resource poor settings
Hello,
I listening to your program on whether breastfeeding is “creepy.” I thought that it was a very interesting program and that the exploration of the issues surrounding why women in a country like the UK might choose not to breastfeed was valuable. However, I thought that because the BBC World Service is broadcast worldwide that there was a responsibility to ensure that it is made clear that while the “choice” to formula feed in the UK or Western Europe might be one that can be made with limited negative impact on child and mother that this is simply not the case in much of the world- that (as Morgan Gallagher tried to communicate) that formula feeding commonly results in death in much of the world. This is a message that MUST be broadcast.
In two months I will be conducting training at a meeting convened by UNICEF in the Philippines on infant feeding in emergencies. One of the things I will be talking about is how whenever there is a natural emergency, media reporting drives the literal flooding of emergency areas with donations of infant formula- usually sent by well meaning individuals and organisations that are simply unaware of the risks associated with formula feeding in resource poor contexts. Programs like yours, that presented formula feeding as a simple, legitimate and costless choice add to this problem. They cause harm. Increased infant morbidity and mortality results directly from media reports that present infant formula as something that will help infants, ignoring the risks. Health ministers and aid orgs like UNICEF and Save the children working in countries affected by emergencies tear their hair out trying to stop the container and truck loads of formula arriving in emergency aid arriving and being distributed.
Please, could you consider actually having a world view in your programs and understand that what might be OK in the UK may not be OK in India or in Botswana or Peru. Could you please consider having interviewees who know what they are talking about- are experts on infant feeding, on the marketing of infant formula, on the support needed by women to breastfeed, on the relative importance of infant feeding decisions in developed vs underdeveloped contexts?? The cultural blinkers of living in a privileged environment with good sanitation and health care were evident in your interviewer.
If you did consider doing something on this I could certainly put you in touch with a variety of such experts and would be happy to be interviewed myself.
Sorry for not getting this post done until now. I started it in my head last night, after some criticisms emerged on some pro-breast sites. But a broken fridge door, has actually taken most of my time today! (It's now fixed.)
Comments have been made that I wasn't speaking appropriately, for a discussion programme, and others have asked what I was told before I went on. I thought I'd just make a few points.
I was asked to take part in a programme discussing an anti-breastfeeding article. An article that denigrated breastfeeding, and upheld formula feeding, explicitly. As part of that, in my interview by the journalist who booked me to appear, I was asked how I would respond to several questions, if they came up. I was probed on how I would respond to the points raised in the the article, about both breastfeeding, and formula feeding.
Again, this is memory. I didn't record the conversation! (Although guess what I will be doing from now on...?)
What was my reaction to Ms Blundell saying it was 'creepy' to breastfeed?
I answered that I wouldn't comment on Ms Blundell, as I didn't know her, but that in general, my reaction would be that someone expressing those thoughts, had a problem with their own body image and self-esteem, perhaps their sexuality. Which was hardly surprising, given how confused and contradictory our society is about women and their bodies. That some women did feel this, and it wasn't surprising, but really, working on it, for themselves, is the best thing.
What about a woman who had five children and needed to work, and she HAD to formula feed, what would I say to her, would I not have sympathy with that?
I replied that I'd tell the woman with the five children how lucky she was to be able to afford to formula feed her five kids. That millions of women live with five kids, on under a dollar a day. And if they don't breastfeed their kids, the kids might die. How lucky of the Mum to live in a world where she can afford to buy formula, and have clean water to make it up. And, if she really did want to breastfeed, she could. She could get help and support. That was the point, if she really wanted to, she could get support to make it happen. Working was not a barrier, and she should get the help she needed, and others would help her do so. But again, how lucky she was to live in a nice clean world where she COULD choose to formula feed, was what I'd say to her.
I expanded this point to say that's there is nothing wrong with formula feeding, as long as it was informed choice. If a baby was hungry, it needed fed, and the WHO recognised that if nothing else was there, then formula was the fourth choice to feed a baby. But it was fourth in line. The issue was informed choice, and not enough women knew that formula feeding carries risks.
I then expanded that point, by stating that when my husband has his heart attack, and I sent my up till then exclusively breast fed three month old baby, out to my family to be formula fed, I had had no idea I was putting my baby at risk. That when I needed help and information most, I was unaware that I was putting my beloved baby at risk, by sending him to a loving, caring family, who all had formula fed, but that they didn't know about formula safety. That my own family made up batches of formula in the morning, put them in the fridge, and put them in the microwave to heat them up all through the day. And I'd sent my baby out to that, not knowing that it was dangerous.
That that was the issue. Women knowing all the information, and making informed choices.
Edit: knew I forgot a bit.
There was a moment in the discussion, when we talked about risk, when I stated that the risk was not limited to poorer countries. That modern countries also had a problem. In the USA, for instance, twice as many formula fed babies dies as breastfed ones, in the first six weeks. It's a tiny tiny number, 2 per thousand, rather than 1 per thousand, but if you are the mother of that one baby in a thousand, it's a terrible thing. So I said that CLEARLY to the very nice and very coherent person interviewing me. Who was, in fact, as I've said, was lovely: very professional and extremely coherent and intelligent. Just to clarify on those figures 'tho, I did say it wrong, on the phone. It's 2 more babies per thousand, that die for formula feeding, in the first few weeks of life, than ones breastfed. It's 2 per thousand for breastfed, and 4 per thousand for formula fed. Referenceend edit
She also asked if I could not understand the problem of women being confused about breasts for sex, or for babies.
I replied yes, I could, that was very valid, and support needed to be done there. When women are told their breasts are sexual playthings, it can be difficult. It is difficult being female in our society, and women needed support.
She then asked my husband if my breastfeeding had caused problems in our sex life. He burst out laughing. :-)
I was then told how well I'd answered, and how good it was that I could speak well, and pepper facts in, without it all becoming to 'fact' heavy. That I had a good way of talking about things, and putting facts in as I went. Would I please come and do an hour and a half? We did, as I have recorded prior, discuss thoroughly that it was a free discussion programme between the women, and the male presenter would introduce, then back away and let us communicate with each other, like we would at a dinner party, chatting.
I was then asked how I would like to be introduced. After a few minutes discussion, - mother, breastfeeding supporter, lactavist etc I said I'd like to be introduced as a 'feminist' as this made the most sense to me.
I was, of course, introduced as Chair of Nursing Matters. (Which I had given permission for, so that was okay, but my point is I was introduced for that formal role.)
So, this is the discussion that led to me being invited to speak. Then not being allowed to speak. :-)
PS If you don't think I was speaking as I would at a dinner party, best not come round to dinner!
or... How I Was Thrown Off The BBC World Service, For Saying That Unsafe Formula Feeding Kills Babies In Africa...
Disclaimer: exact sequence may be out of synch. This is memory, not documentary. Lots of conversations, in a very short time. Some of them may have been one phonecall, and not the other, etc. But it's the essence of the event. Sequences of the actual radio discussions, are in my memory as the bits I was reacting too - I may report them in a different sequence. Also, forgive the epic storytelling. I've learned this sort of detail is IMPORTANT in being heard. You can skip down to half way through, if you want to, for the actual throwing off air bit.
So, it's a perfectly normal Wednesday afternoon. I've decided that I'll go swimming with my 5 year old, for a session with us both, before his swimming lesson at 3.30pm. I've not sorted out dinner, and I'm in the middle of sifting through how to layer the rest of the day, and get some work done, go swimming, and get some sort of dinner on the table. I need to get some yeast going, to get tomorrow's bread going. I've been making our own spelt bread now for 4 days, and need to keep the momentum going, or it's back to bought. I sit down with 5 year old, and talk through that we will both be going swimming soon, he's excited!
I just check my email. A new one is in my inbox. It's from the BBC World Service: they've been phoning my old phone number, can I contact them? It was sent at 13.52. Would I be interested in taking part in a global conservation about breastfeeding, in light of That Article, this evening? At 14.08, I send them my new phone number. I then entice 5 year old out of the living room, so I can talk without interruption. I phone the BBC World Service and have a lovely chat with the lovely journalist. She does the usual, and both flatters and pushes, to see how I perform under pressure. We cover a wide ranging series of reactions to the fuss. She is delighted. Of course, her FIRST question was "Are you still breastfeeding your 5 year old?"
So I knew where we were.
But it was a really good conversation. Can I come on and be a main guest on the discussion at 6pm? The male presenter, Ros, will introduce the various women from around the world who have been booked to speak, and then back out. It's a conversation like we would be sitting around chatting after dinner. Not too many facts and figures, short points, casual conversation, if that okay? Totally, I say. She emphasises the shortness of answers required. "You want soundbites?" I say. No, she says, not sound bites, your own words, just in brief. When the other women are talking, if you want to respond, just say your name and then jump in. Let everyone speak. "Fine", I say. I have to bring my five year old. "No problem" she says.
How does my husband feel about my breastfeeding, has it affected how he sees me sexually? "Ask him yourself." I say, and hand over the phone to David. She chats with him for several moments, and then asks him to take part in the programme. He can't come up, as he's in a wheelchair, but they'll phone him on the landline. "Fine" says David.
How to get me to a studio? She had no idea where I was, so I suggest Edinburgh, about an hour's drive away. She goes and sorts out a radio studio booking in Edinburgh, phones me back, and confirms the booking. The programme will be going out world wide, between 18.00 and 19.00. However, there is a run on programme, for Africa only. It's usually 19.00 to 20.00, but because of the World Cup it's only running to 19.30. Can I stay and do the Africa only programme? Of course, that's fine, I say. But start to worry about Hugh. Mummy in the glass box for an hour and a half is going to be hard on him. But no choice, with this late a run in.
She books the taxis, and we decide times. Hugh has his swimming lesson between 15.30 and 16.00. It's now 14.40. I suggest taxi gets here at 16.15, as you never know with rush hour traffic in Edinburgh. She sends me an email confirming my booking from 18.00 to 19.30, and that taxis have been booked. I reply to her, stating I will need help at the other end, to help me carry in the Child Car Seat, and it will need to be kept safe whilst I'm on air.
I've been here before, I know BBC reception staff do nothing to help anyone: "They're not allowed to."
My afternoon dissolves into epic rush. My swimming session with Hugh is cancelled. I literally pull my coolest dress off the washing line, and put it on wet. Swimming for Hugh is rushed around packing enough things to keep him occupied, i go shopping for drinks and good quality snacks for him whilst he's in the pool, and literally rushing him back into the car in his wet swimming costume, and driving back home. Taxi turns up at 16.20, and we load myself, Hugh, car seat and bags and supplies, into it, and drive off.
Driver is from Berwick-Upon Tweed. He has no idea where the BBC studios are. He's just been given a postcode and we know how good that is, in a city, right?. BBC phones me to check I'm on my way. I confirm we are, and ask if there will be someone at other end to help with child and car seat? She phones back. No, reception can't leave, but the taxi can park "right up outside".
I have a pretty clear idea what is happening at this point, and resign myself to doing all the work.
I phone David, and he looks on the map. Taxi driver and me and David, work out roughly where we are going. We get there, and stop a lady leaving the hairdressers, with expensive shopping bags. Does she know where the BBC studios are around here? Yes, she gives us direction. Hugh falls asleep in car seat, 3 minutes before we get there. *sigh*
We find the hole in the wall studio. It's a good 100 feet, downhill, from where we can get the taxi to. I leave asleep Hugh in car with taxi driver, cautioning him not to run off with my child :-), and carry the three bags of gear down to the BBC Alba, two room studio, under a shopping centre. I look wistfully at the Pizza Express next door.
Reception man lets me in, and I dump the bags and explain I have to return for child, and car seat. A total of 3 other people are in the very small studios. I ask who is going to look after Hugh when I am on air? They say I'm booked to take the child, and the car seat, into the studio with me. Female journo working on shared computers, says she's leaving in 5 minutes. Of course, this is what I really feared. I'd just been drop kicked into any free studio they could find, and that was that. I've worked in radio, it wasn't a surprise!
I return to the taxi, and we find a way to get within 30 feet in the front door, without being in the main traffic, and I wake up Hugh and carry him on my hip with one hand, and the car seat in the other. Hugh wakes up grumpy.
We sit in reception. No one offers tea, or a drink. it's about 17.40. Eventually, I ask if I can just go into the studio, which is about 8 feet by ten feet, and set up amusement for Hugh. I go in, and set up a dvd on my laptop, settle him on his very comfy car seat on the floor, with the laptop perched on a chair seat, settle him down, and put some apple juice by him. He's perfectly happy. I point out the red light, and that he can't speak to me when it's lit. He knows how radio works, and the lights, since the researcher who took care of him when I was on R4's "Today" took him through it.
I get out a pad, and a pen, a drink for me, opening it to make sure it doesn't fizz on the microphone, and put the silent head phones (cans) on, and twiddle my thumbs.
At least it's cool. Air conditioning for small radio booths is essential!
At about 2 mins to 18.00, someone called Chloe, introduces herself on the cans and says "Hi" from the London end. Takes me through the process again, quickly, and says we'll be joined with women from Argentina, Somewhere I've Forgotten And Didn't Write Down (USA? Boston?), and Nairobi. Reinforces the informal chat between women point. Says there is a recorded interview with Kathryn Blundell, as she couldn't be on live, so could I listen carefully to it, and then respond with my reactions. I ask her the name of the women I'll be chatting too. She sounds nonplussed, then recovers. It's Lee, Adriana and Bilac. I write down the names of my fellow women.
The interview rolls out with Ms Blundell. I hear how subdued she is, and how this has shaken her. I also hear her say outrageous things, like the "wonderous" miracle science of formula. When she's asked why she feels so creeped out by the thought of a baby feeding on her, she replies she had "not thought about it too much". I write this quote down, as I think it speaks volumes, and is the point I'd like to react to, as requested by Chloe.
Ros takes the air, and slowly and methodically plods through the list of the four women, around the world, being kept in order by the power buttons in Bush House. I am frustrated. This is not the free chat between us that I was told would occur. I'm also dismayed at Ros's clear attempt to get each and every one of us, to slag Ms Blundell off. I am delighted when Lee in Argentina makes it clear that Ms Blundell's views of her own body, and are hers and hers alone. I feel I have so much in common with these women, and I'm truly excited by the thought of being able to chat to them. Ros gets to me, and the same ponderous "give us your reaction to that" occurs, and I give my reaction. Ros them continues on with controlling the mike, and all the discussion, and lobbing in comments from emails. At no point is the micophone open to the four or us. We cannot talk to each other at all.
Ros tells me he's never noticed any pressure to formula feed. I ask if he's ever watched television, and after talking about the glowing babies 'supported' by follow-on milk, move on to the point that isn't it interesting that follow on milk only appears in countries where formula ads are banned? Ros has talked over me, and I persevere, sure that as it's bad radio, to overtalk, he'll back down. I'm confused, but continue to maintain my subject. He's overtalking me, and moving onto to another caller, even as I'm describing how much money is made by pressure selling formula to mothers around the world.
Yes, I was being a dunce. I can only blame the adrenaline. And that my experience is 'live in the same studio', where they can't do what they were doing so easily.
Lee in Argentina commends me for carrying on breastfeeding Hugh, as she couldn't get past two years. I make sympathetic noises, and hope to feed back that I understand that feeling and to discuss how hard it is sometimes, and one of the problems is you are never allowed to say sometimes that it is work, and you do struggle. I hope to reassure her that I think two years is marvellous, and she should look to what she achieved. I try and speak up, but no one seemed to respond to me, no matter how hard I tried to be heard. No, I still hadn't twigged.
I was getting very frustrated.
The woman from Jamaica comes on, and pulls the "I did it for X time, and if you past when I did it, you are weird." card. When she states that after one year, milk has no nutritional value, I interrupt her, and say "That's not factually accurate." She carries on. I repeat this 3, maybe 4 times, and am getting very annoyed that she criticised me, and when I respond that she is refusing to let me speak, and what she is saying is not factually accurate... I finally twig.
Yes, I am a dunce.
No one had been hearing what I was saying to her. I was being controlled, and censored, by the buttons and sliders at Bush House. There was no discussion space between the women on air. I had no idea what of mine had been heard. As I had clearly been carrying on after I was silenced, I didn't have any idea what had actually been said by me.
Realising this, I say into the the microphone "Morgan here, I wish to respond to that comment." I'm livid.
Not at the women in Jamaica, I'm livid that I had been taking part in a two way conversation and escalating the urgency of my own voice, in order to get the space to finish speaking, and I'd been speaking into empty air.`
Ros returns me to a live mic, tightly controlling the intro, and I repeat to the woman what I'd been saying non-stop for a few moments. It still really hadn't sunk in that although I was annoyingly repeating the 'facts' things, and the WHO stuff, that probably, it was the first time it was being heard, not the third or fourth!
And, of course, she gets to criticise me personally, whilst I have to bend over backwards not to criticise, or comment, on anyone else.
Because I'm the weirdo woman.
And Ros goes off on one about there not actually being a lot of 'facts' about breastfeeding, and sidelines the entire discussion back to emails. With me on the other end saying "There are lots of facts about breastfeeding, the science is undeniable..." But you didn't hear that, did you?
So I sit, in the cool empty space of the studio in Edinburgh, with my 5 year old behaving impeccably on the floor, watching a dvd, and I listen to every opportunity for a proper exchange of views, being slammed down and controlled by the presenter. Again and again, points that could be picked up and expanded upon, discarded and closed down, in favour of just spouting on the same point again and again. The actual meat of the debate, the pressure on women to do what society wants, and how we polarise the issues, and ignore how much women need support... trying to be heard, and being strangled at birth.
This is the programme that did something so unthinkable, so mind bogglingly obscene, I cannot contain it. They ask a breastfeeding support in Nairobi, if a mother came to her and asked for support to formula feed, would she support her? What would she say? A women who lives next to the Kibera slum.
Bilac answered the question with grace (as did all the women being goaded to criticise other women). But I could not get my head around what was being said. I just could not deal with the level of Western centric arrogance that was being displayed. That was constantly, and consistently, positioning this debate within the cosy secure world of the London chattering classes. How on earth could you ask a mother in Kenya, that question, without any reference to the dangers of formula feeding there?
I sat and fumed on this, as I was completely removed from the programme. Half way through a sentence, Ros told me he was having to move the discussion on, as I was arguing or something, and I was completely closed down.
I really wanted to get up and leave. I knew how I was being painted, and just as I didn't want my windows put through after "Today"... I just didn't want the aggro. But I knew some of you would be listening, and cheering that things that should be heard, were being said.
So I sat, in silence, listening to the inane presenter carry on with their own reduced agenda. Chloe came on the cans, to explain that I was acting inappropriately, and I clearly didn't understand the type of show I was on. That they had wanted personal stories and opinion, not 'set speeches'. I replied that everything I'd said was personal, and she cut me off and said she understood I was against formula, and pro-breastfeeding, but formula wasn't the issue. I was biased, and they couldn't have that bias on air. I said they had the bias, not me, and this was the World Service, and they had a duty to act globally, and not act as if the whole discussion was taking place in West London. How could they ask a women in KENYA if she would support formula feeding? She replied that they were a global service, and that was why my views were not suitable, I was biased. I said how would a woman sitting in the slums in Nairobi tonight, sitting in a tin shack with a sick child, feel about us wittering on about breastfeeding without discussing the risk of formula feeding? Did she know how many babies would die tonight in those slums, from being formula fed?
(WARNING: NAIROBI SLUM VIDEO BELOW CONTAINS FOOTAGE OF DEAD BABY IN OPEN SEWER PIT.)
Chloe went BALLISTIC. She told me up front I'd made her REALLY ANGRY and that was it, I was off the programme and a taxi would be called to take me away RIGHT AWAY. The one that was booked would be cancelled and I could go NOW.
"You just said that formula kills babies!" It was a mantra, a safety talisman: I could be dispensed with, since I'd uttered those words, which she kept quoting back to me, as evidence of my bias and agenda.
So I was out, gone, away, no more. I would not be on the Africa segment of the programme.
I tried to reason with her, and referred her back to what I'd said on air, about how 4000 babies die every day from UNSAFE formula feeding, and she needed to apply that to Africa, and how does she think the African woman had felt, being asked if she'd support formula feeding? They had to be responsible for the global context, and think it through.
It was just making her angrier, and she retorted I had no right to speak for African women. She just could not get past her own anger, and engage. She finally snapped that she was running an on-air live programme, and she could come back and argue with me later, but she had a programme to run! And she pulled the plug.
So I sat there, with Hugh, feeling that if I'd been in Bush House, not in Edinburgh on my own, my bags would be being picked up and I would be being escorted to the door, via security. I had been thrown off air, and as soon as they could get a taxi to me, I would be out of the building.
Which, by the way, cost them a lot of money. They actually phoned a black cab, to get me out of there as fast as possible. A handsome cab for a 60 mile trip!
I simply picked up my mobile phone, and started phoning people. Whilst I was still in the studio, waiting my Taxi of Doom, I phoned people and let them know what had happened. Why I was being turfed out. I phoned Patti Rundall, at Baby Milk Action, who happened to be in Brussels, and told her I'd been thrown off the BBC World Service, for saying that unsafe formula feeding killed babies in Africa.
I told everyone, very clearly, that I has been told precisely, by Chloe, that the reason I was no longer on the Africa programme, was that I'd said "formula kills babies." I do think the phrase "4000 babies die of UNSAFE formula feeding" did get out on air.
I calmly packed up my things, Hugh played with the revolving chair, listening to how they thanked me ever so much for taking part, and making it sound like I was still on the programme! My mobile rang, and it was the cab driver, outside on the main, busy, road. I asked Hugh to stay in the studio on his own with his chair, explained to the reception man, who was quite bemused by everything, and took the car seat out, rather excited to see the black cab.
I walked past the pizza again, rather more wistfully.
I fixed in the car seat, and then went back for Hugh and the bags. Hugh was still waiting patiently, on his own, in the tiny glass booth. Hugh said he needed to pee. Reception man said the toilets were up on the second floor. The taxi was in the street, and I had three heavy bags. I took Hugh outside, and allowed my five year old, to pee up against the wall.
It was total coincidence he was peeing on the walls of the BBC. But the image pleased me. :-)
We then climbed into the taxi and took the long road home.
I didn't want to write this blog. Not really a choice, .... it is a far, far better thing I do, than I have ever done before... I may expand on it after I post.
As we sit there, blood pressure pounding, ears numb from the screeching, eyes bleary from article after article after article, painting us as nuts, nazis, anti-woman, ant-feminsit and just plain obsessed and bossy... as we sit, whincing, about another person smugly leaving an article about how Breast Is Not Best anymore on our desks... and they've conveniently stopped reading before they get to... Formula Is Flawed... in the bottom in small print...
In short, as we sit there, grateful that another awful week of vitriol is past, and work on our resilience to cope with next's year's onslaught... read this.
The following is an advocacy statement prepared for a preemie baby, a couple of months ago. The young teenage mother, had been told Social Services wanted her in a Mother & Baby Unit when the baby was born. For no other reason that she, and the teenage father, had both been raised in care. Therefore they were lacking essential parenting skills.
Think that through for a moment.
Rock and a Hard Place, non?
Having been deemed to lack essential parenting skills, and both having 'difficult' relationships with care home workers and their own social workers, a unit place was set up for the Mother & Baby. But not the Father, of course, her main support.
But at least they had somewhere to go, after the birth.
However.
Baby had the temerity, the sheer gall... the proof that it too was not capable of working with Social Services.. . to birth itself 5 weeks premature. This threw everyone into a panic. Baby was here, in the preemie ward, but the place in the Unit, was timed to the due date.
What to do?
Well, obviously, the correct answer was to remove the baby from the mother, when it was discharged from the neo-natal ward. And keep it in a foster home, until the placement came up, 4 weeks later. Simples! No problem there.
The sad thing is, the Social Workers didn't think there was any problem with the plan, at all. When the midwives, and the lactation support people, all pointed out the disaster in this plan, not least from a viewpoint on the new mother actually bonding with her baby, the Social Workers scratched their head and went "eh?".
In this, we should be considerate of the dreadful position Social Workers are in. In the UK, there are no guidelines for the care of the breastfeeding baby in care situations. There are no tick boxes on the forms, no training, no protocols, no guidance. So it's not surprising, that a Social Worker isn't going to think "breastfeeding" in these situations. They only have their own personal experiences to go on. And what's so important about keeping a mother and her baby together, for the first 4 weeks? They can bond afterwards, surely? Formula never hurt anyone...
So the following advocacy statement was put together, on behalf of the premature infant.
The mother and baby were kept together. The combined effort of the NHS staff on the ward, the lactation specialist for the area, and the advocacy statement. All Hail The Midwives!
Ignore the screams this week, and next, and the week after.
They wouldn't be trying so hard to pummel us into the ground, if we weren't being heard.
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RE: XXX XXX DOB: XX/04/10
We are advocating on behalf of Xxx, a breastfeeding premature newborn. We would like to bring to your attention several pertinent points about Xxx, and his specific needs. These facts need to be taken into consideration when you discuss care arrangements for Xxx whilst care arrangements for the family are being discussed.
Xxx was born at 35 weeks gestation. Breastfeeding, is therefore even more vital for his normal development, than a term born newborn. In particular, his cognitive development and immune system has already been threatened by a premature birth. Breastmilk is the only substance that will provide Xxx with the nutritional benefits he is now missing from appropriate womb development.
Breast milk contains components to promote amyelinization which increases development of brain synapses. It has higher anti-oxidant activity than infant formula and pre-terms a have lower anti-oxidant capacity. In addition, human milk helps neutralize oxidative stress. Ezaki et al. J Clin Bio Nutr 42;133-137. 2008)
Breastmilk also contains sialic acid-containing oligosaccharides, vital to brain development, which is significantly lower (20%) in infant formulas. This cannot be synthesized by the infant and therefore interruption of breastfeeding to transfer to infant formula, directly reduces Xxx’s ability to recover the brain growth he has lost due to his premature birth. Higher brain ganglioside and glycoprotein sialic acid concentrations have been conclusively shown to lead to enhanced developmental outcomes (Wang et al. AJ of Clin Nutr.2003;78:1024-1029). Preterm Infants (ELBW) who were exclusively formula fed had a 5 point deficit in their subsequent IQ development. Pre-terms infants that had the most human milk had an increase of 5 IQ points compared to their formula fed counterparts. (Vohr et al. Pediatrics. 2006: 118;e115-123)
Of significant concern, is that the risks of SIDS doubles in late preterm (Walker M, Breastfeeding the Late Preterm Infant in Clinics in Human Lactation 4. Hale 2 Publishing: Amarillo ,Tx; 2009) Breastfeeding can decrease the risk by 50% (Pediatrics.2009; 123 (3):e406-410).
In terms of general health issues, for every 10ml/kg per day increase in breastmilk ingestion the likelihood of re-admission decreased by 6% (Vohr et al.Pediatrics, 118;e115-123) “Risk Ratio for Infant Mortality in Late Preterm vs. Term Infants (J Pediatr 2007;151:450-6)” shows that newborns such as Xxx are at increased risk for SIDS, Sepsis, Influenza, NEC and are more likely to die from these diseases. If you removed Xxx from his mother’s breast, you increase his risks of significant harm. These risks are very real, widely known and understood, and clearly underpin breastfeeding policy from the NHS, NICE, UNICEF and the World Health Organisation. Therefore these significant risks must be present in any risk assessment discussion, concerning Xxx and his access to his mother’s breast.
These risks are in addition to the normal risks associated with lack of breastfeeding for a full term infant. Lack of breastfeeding is associated with higher rates of illness for both baby, and mother. Again, this is supported and promoted by the NHS, NICE, UNICEF and World Health Organisation. Under Article 24 of the Convention on The Rights of the Child, Xxx has the
“right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.”
Access to his mother’s breast for actual breastfeeding, and not just receiving pumped human milk, would come under this convention, and The European Court of Human Rights has recognized this dynamic – the right of the child to the breast as long as the mother wishes it, as a basic Human Right, and this is recognized in the English courts:
"Local authorities also had to be sensitive to the wishes of a mother who wants to breast-feed, and should make suitable arrangements to enable her to do so, and not merely to bottle-feed expressed breast milk. Nothing less would meet the imperative demands of the European Convention on Human Rights."...In the matter of unborn baby M; R (on the application of X and another) v Gloucestershire County Council. Citation: BLD 160403280; [2003] EWHC 850 (Admin). Hearing Date: 15 April 2003 Court: Administrative Court. Judge: Munby J. Abstract. Published Date 16/04/2003
Perhaps of more crucial importance, given the significance of the need to assess care arrangements for Xxx, within his mother’s arms, the role that the lack of breastfeeding has in increasing risks of child abuse, should be highlighted. Breastfeeding supports a secure attachment between mother and child, and disrupting the bond that has already been established between Xxx and his mother, significantly reduces their chances of forming a successful, long term, relationship, as well as the harm abrupt cessation of breastfeeding could inflict on Xxx.
Within attachment theory, attachment behaviours are actions that a child uses to maintain proximity to their caregiver in order to obtain reassurance and experience feelings of safety (Sutton, 2001). Attachment theory is the dominant framework within which early relationships are understood (Thompson, 2000) and the development of a secure attachment between primary caregiver and child is deemed the most beneficial type of relationship (Schore, 2001). Securely attached children use their caregiver as a base from which to explore the world and are therefore able to more effectively deal with challenges (Drury-Hudson, 1994). Thus, breastfeeding may promote the development of a secure child-mother attachment. However, the importance of breastfeeding as an attachment behaviour also means that if breastfeeding is abruptly terminated it may have a serious adverse impact on the child-mother relationship.
The observation that breastfeeding can be an attachment behaviour in young children and that abruptly refusing breastfeeds in harmful is not a new idea. It was first observed by the eminent attachment theorist Mary Ainsworth over 35 years ago who stated, in relation to her research in Uganda with breastfeeding toddlers, that “amongst those children who had had easy access to the breast on their own initiative, both day and night, the feeding behaviours become organised into the whole system of behaviours that constitute attachment, so that when the feeding relationship was destroyed by weaning the whole attachment relationship was severely threatened and made very anxious.” (Ainsworth & Tracey, 1972). Withdrawal of breastfeeding during a substantial portion on the day would be interpreted by the child as a rejection of the child and similarly pose a serious threat to the child-mother relationship. I would also like to point out that withdrawal of a child’s comfort strategies and attachment behaviours at a time of stress is extremely difficult for the child. It could be described as cruel.
In at-risk dyads breastfeeding should be supported not just because of its impact upon the child but because breastfeeding impacts the physiology and physical circumstances of mothers in such a way as to assist them to sensitively care for their children (Gribble, 2006). The hormone oxytocin is known to be essential for expression of maternal behaviour in some mammals (Insel, 1997; Keverne & Kendrick, 1992), and although the research is as yet scant, there is some evidence that oxytocin is also involved in the development of maternal love in humans (Bartels & Zeki, 2004). Oxytocin is released during breastfeeding (Matthiesen, Ransjo-Arvidson, Nissen, & Uvnas-Moberg, 2001). Prolactin is another hormone associated with promoting mothering behaviour that is released as a child suckles (Uvnas-Moberg, Widstrom, Werner, Matthiesen, & Winberg, 1990).
Finally, the relaxant hormone cholecystokinin is released in the intestine of mothers during breastfeeding (Uvnas-Moberg et al., 1987). As a result of these hormonal effects breastfeeding women have decreased cortisol levels and blood pressure and respond less to stress than non-breastfeeding women (Groer, Davis, & Hemphill, 2002; Heinrichs, Neumann, & Ehlert, 2002; Uvnas-Moberg, 1998). This decreased responsiveness to stress is apparent in a “relaxation response” measured in the brain during breastfeeding (Cervantes, Ruelas, & Alcala, 1992). Mothers who are less stressed are able to be more responsive to their babies (Feldman, Eidelman, & Rotenberg, 2004; Rosenblum & Andrews, 1994) and there is a positive correlation between maternal sensitivity and the security of attachment in children (Pederson, Gleason, Moran, & Bento, 1998).
Breastfeeding also requires mothers to remain in physical proximity to their babies and to interact with them on a regular basis in a positive and intimate manner (Blass & Ciaramitaro, 1994; Epstein, 1993; Smotherman & Robinson, 1994) which can only assist in promoting a healthy mother-child relationship.
The role of breastfeeding in allowing an at-risk mother to develop a healthy care-giving role with her infant, cannot be overstated:
“We clearly demonstrated that lack of breastfeeding increased substantially the odds of maternal (but not non-maternal) maltreatment, specifically child neglect. After adjustment for multiple confounders, there was a nearly fourfold increase in the odds of maternal neglect for non-breastfed children, compared with children
who were breastfed for _4 months. These findings suggest that breastfeeding may play a protective role in helping to prevent maternal neglect.”
Does Breastfeeding Protect Against Substantiated Child Abuse and Neglect? A15-Year Cohort Study DOI: 10.1542/peds.2007-3546 Pediatrics 2009;123;483-493 Lane Strathearn, Abdullah A. Mamun, Jake M. Najman and Michael J. O'Callaghan
To make that point again, if you remove Xxx from his mother’s breast, you significantly increase his risk of neglect by her, and significantly reduce her chances of proving she is a competent mother. In short, if you do not support Xxx’s access to his mother’s breast during the deliberations on his care package, you are greatly increasing the risk that his mother will be found incompetent. Given that plans are already in place to allow Xxx and his mother to maintain their contact in a mother-and-baby unit at a later date, any decision to separate them prior to this, would be difficult to justify.
This is particularly true when you examine the effect it could have on Xxx’s mother. Sudden cessation of breastfeeding so soon after the birth, will cause Xxx’s mother’s body to react as if the baby has died: her hormones will go into mourning:
“Opting not to breastfeed precludes and/or brings all of the processes involved in lactation to a halt. For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother’s decision to bottle feed unknowingly simulates child loss.”
Bottle feeding simulates child loss: Postpartum depression and evolutionary medicine Medical Hypotheses, Volume 74, Issue 1, January 2010, Pages 174-176 Gordon G. Gallup Jr., R. Nathan Pipitone, Kelly J. Carrone and Kevin L. Leadholm
To summarise: continued, unrestricted access to his mother’s breast is a key component in Xxx’s subsequent health and normal development, particularly given his 35 week gestation. Any decision on Xxx’s health and well-being, within care guidelines, should include proper assessment of these risks. If decisions are made to separate Xxx from his mother, due care must be taken to ensure the breastfeeding relationship is not severed. WHO and NHS guidelines would require that Xxx’s ability to breastfeed should not be compromised by the introduction of bottle teats, or a dummy. The foster care-giver would be expected to cup-feed Xxx, his expressed mother’s milk.
In addition, in line with current medical understanding, we feel it important to point out that formula feeding itself is not benign, particularly for Xxx. Formula has a different ph balance to human milk, and it destroys the natural flora and fauna in the human gut. Xxx is at particular risk from developing ill-health, if formula is introduced to his gut, as he has several risk factors already:
*The gastrointestinal (GI) tract of a normal fetus is sterile
* the type of delivery has an effect on the development of the intestinal microbiota
- vaginally born infants are colonized with their mother’s bacteria
-cesarean born infants’ initial exposure is more likely to environmental microbes from the air,other infants, and the nursing staff which serves as vectors for transfer
- the primary gut flora in infants born by cesarean delivery may be disturbed for up to 6 months after birth (Gronlund et al, 1999)
* babies at highest risk of colonization by undesirable microbes or when transfer from maternal sources cannot occur are cesarean-delivered babies, preterm infants, full term infants requiring intensive care, or infants separated from their mother
Supplementation of the Breastfed Baby “Just One Bottle Won’t Hurt”---or Will It? Marsha Walker, RN, IBCLC NABA 2003
Therefore, if Xxx is separated from his mother, we would advise that as a medical intervention, medical permission would need to be obtained from Xxx’s mother or obtained via a court order, before formula could be given. Likewise, parental, or court permission would need to be sought before introduction of either a bottle teat, or a dummy, as both can immediately affect the attachment of the baby to the mother, and the baby’s subsequent ability to breastfeed.
If separation does occur, Xxx’s mother will require qualified lactation support, to sustain and maintain Xxx’s milk supply, and to guard her against developing mastitis or engorgement. Social Services would have to supply appropriate pumping equipment, storage and transport for the milk. This places a burden on Xxx’s mother, and that should be recognised when her care is being discussed, as I understand that Xxx’s mothers is, herself, under the care of Social Services.
All of the above factors should be present in any discussion of Xxx’s well being. We can, of course, supply more detailed information if required, as well as extend our support to Xxx at all times. Many lactation specialists within the international lactation community are aware of Xxx, and his specific needs, and we are confident that Social Services will support his health and well being in an appropriate fashion.
Please don’t hesitate to contact us for more information or expert witness.
As the new coalition Government settles down at Westminster, and gets to work bringing in the joint agenda of Freedom, Fairness and Responsibility... we'd like to ask David Cameron and Nick Clegg to consider the babies in England & Wales, and Northern Ireland.. They don't have much to be responsible about, in their young lives... but they would very much like some freedom and fairness of their own. Simply, they'd like equality with the babies in Scotland: they'd like to be protected from harassment when they feed.
They are protected in Scotland. Scotland has a Breastfeeding Bill, which protects the right of any child who is in a public space where that child has a right to be, to feed uninterrupted on milk: breast or from a bottle. Any mother, father, care-giver, can feed a hungry child milk in Scotland, anywhere the child has a right to be. If someone tries to stop the feed - the police can be called, and the person trying to stop the milk feed, can be charged and fined.
In England and Wales, and Northern Ireland, no such protection exists.
If this fair, David? Is that freedom, Nick? Is that encouraging and supporting individual and social responsibility? That you can be thrown out of a public park, in England, for feeding your hungry baby, but not in Scotland? That a baby can get hungry without fear, in Scotland, but not anywhere else in the United Kingdom? That if a breastfeeding baby is asked to leave a cafe in Belfast, in Cardiff, in London... the mother must stop the feed and she must leave. But if she's asked in Edinburgh, she can call the police and they will come and deal with the moron trying to stop her feeding a hungry, crying baby?
In the current financial crisis, the coalition has stated its first priority is to reduce the deficit and restore economic growth. Protecting mothers who are breastfeeding, will directly support these aims. Lack of breastfeeding costs the NHS millions of pounds every year: 5 times more formula fed babies are hospitalised every year, for severe stomach infections, than breastfed ones. Babies who are formula fed, get sicker more often. They have higher rates of many minor, and some quite serious, illnesses. Formula fed babies have higher rates of heart disease, diabetes and apnoea as adults. On average, a formula fed baby has 5 IQ points less than it would have had, if it had been fed normally: at the breast. Formula feeding costs society, and parents, a great deal of money. Money spent on formula, is money handed over to multi-national conglomerates, such as Nestle and Danone, who are clearly exploiting the poorest mothers and babies on the planet, and breaching Code around the world, endlessly.
Formula feeding is a risk to the health of the baby, and the mother.
Yet it is welcome anywhere. Whilst breastfeeding, which supplies the basic building blocks of human life to human babies.... is rejected and taboo. This is not freedom. It is not fair. It is not responsible.
It will not build a strong and fair society: this inequality. The issue is not even the harm that formula feeding will do financially, although that's important to signal, in the current climate. The issue is not breastfeeding, versus formula: it never has been. All mothers may choose not to breastfeed their baby: that is their right. It is their breasts: they choose who has access to them. It's not even about the mother: it's about the baby. All hungry babies have a right... to be fed. There and then. Formula or bottle. Mother or father. It doesn't matter.
What does matter.. is that a baby is hungry. Hungry babies get fed: end of. Well, in Scotland, anyway.
And it's not just the newborn, for whom hunger is a sharp knife piercing their flesh. Breastfeeding is a total comfort system, for the young of all mammals. As well as food and drink, it is safety, warmth and comfort. It is a salve for aches, pains and fears. A child may have fallen and knocked themselves: they may be in pain. They may want soothing and comfort. They may want cuddled and to suckle themselves out of their distress. Every mother wishes to comfort and console an injured child... but the mother of the breastfeeding child, unless she is in Scotland, can often feel too intimidated to comfort the child. They do not wish to be attacked, belittled or ejected from the premises, for offering their breast to their crying child: they wish to feel safe from abuse.
Protecting hungry babies... is about fairness, it's about freedom, and it's about responsibility. Our responsibility, to the most vulnerable amongst us. Our responsibility, to the mothers who are breastfeeding, and who feel pressured to stop, pressured to hide, pressured to feed their babies in toilet stalls. No one should be fed in a toilet stall, least of all a newborn. No mother should feel that she might be attacked, or interfered with, when giving food and comfort to her child. What's a right to be protected in Scotland, is a right to be protected in England & Wales, and Northern Ireland.
Bring your baby, your children, a picnic, and Invite Your MP.
Hopefully, it's time for change....
A word about inviting MPs.....
An MP represents their constituents. This is regardless of their party politics, or any other role they have in Government. Your MP is duty, and honour, bound, to represent your views in Parliament. Invitation to events like the Breastfeeding Picnic, need to come from a constituent, in order for the MP to take it seriously. Not a letter to David Cameron, or to Nick Clegg. But to your MP. This is particularly important if David Cameron of Nick Clegg is your MP. If they are, please invite them NOW to the Westminster event: they will not respond to an invite from anyone not in their constituency.
Parliament works on the merits of the individual MPs in the parties. Even if you have an MP you don't like, or who is not the MP you would have chosen... please invite them. Especially if they are a new MP, joining the House for the first time this session. The timing of the picnic is for the last few days of the Summer sitting. There will be a lot of 'new' MPs who will be anxious to meet their constituents, and to hear their views. Write to them, invite them, speak up for the rights of babies in the UK.
If they are not going to be in Westminster that day, see if they can attend a local picnic. That's the whole point of local picnics, to make the point that this is about the whole of the UK.
We know from previous picnics, that many of you hesitate to write your own letters. So we offer the following outline, for you to consider. But please remember that your words, will hold more weight, than an obvious 'stock' letter. Use the letter by all means, if you really can't face the thought of writing one yourself... but your own words, in your own style, allows your MP to respond to you. Give it a try! :-)
In order to find your MP, hit this link, put in your postcode, and the UK Parliament search engine will do the rest. If you then hit on your MP's name, contact details will come up, including a hit link on their eddress.
-o0o-
Dear .....
As a constituent, I'd like to invite you to the Annual Breastfeeding Picnic, in Westminster on Monday July 19th, 2010. This year's event is being run under the banner - Fairness, Freedom and... Equality - as mothers once more ask that the babies of England & Wales, and Northern Ireland, have the same legal protection to have a milk feed as they do in Scotland. The previous Government have ignored the inequality faced by hungry babies in England & Wales, and Northern Ireland, for too long. The nonsense that is clause 17 of the Equalities Bill, only proves to show how little the previous Government listened to mothers on this issue. Mothers are hoping that the coalition will see the financial sense in affording hungry babies throughout the UK, the same rights as in Scotland. The picnic is being held in Victoria Tower Gardens, adjacent to the Palace of Westminster, from noon until 3pm. Please come and meet mothers and babies and children, and see how needed a Breastfeeding Bill is. If a member of the public approaches a breastfeeding baby and mother in the park whilst you are there, and demands they stop what they are doing... there is no legal protection in place to protect the baby's right to food. Why should the baby be protected in Scotland, and not right outside the Houses of Parliament?
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