My apologies for not getting back to the debate until now.

wrote:
Sarah Vaughan writes:

[...]
There need to be two messages. The first message
is intended for all women and should be transmitted universally.
"Breastfeeding is the best thing for you and your child, it is superior
to any other feedign method,

This whole debate started because Jo and you objected strenuously to a
message that said this.

and you should breastfeed unless you are
physically unable."

Larry, you seem to think that telling people what they should do is a
great way to get them to say "In that case, I'll do it." It's actually
a great way to put people's backs up and alienate them.

[...]
Now, what do you do about the women who are unable to breastfeed. You
use targetted messages to these women. Yes, they will hear the message
above, and they will know that breastfeeding is really best. There is
nothing the can (or should) be done about that! Even if these women
cannot breastfeed, they should also be advocates for breastfeeding and
convincing their friends who have not had babies yet to breastfeed.

When these women run into problems, (and not before) the medical
professionals who are dealing with them need to focus a targetted
message to them saying "If breastfeeding were available it would be
preferable, but in the circumstances, by feeding what the professional
recommends you are doing absolutely the best for YOUR child." She
needs to be made aware that she is performing an exception action
because of exceptional circumstances, and that by doing so, she is
doing the best for her child.

So, what about the women who don't contact any medical professionals
before starting to feed formula because messages of "Formula is inferior
and your baby needs breastmilk" have left them so sensitive on the
subject that they're scared of criticism and just want to avoid talking
to anybody about it? What about the women who are scared away from
seeking help by this approach?

First, regarding
women who could have breastfed, but received bad advice. I would posit
that your suggestions perpetuate the dissemination of bad advice, but
that the steps I outlined above eliminate or mitigate it by making the
good advice socially pervasive. It becomes common wisdom.

In fact, the steps you've outlined above have nothing to do with advice.
They have to do with instruction, which is not the same thing.

What women need is not advice to breastfeed, but advice about _how_ to
breastfeed. Given that there are people out there who still believe the
earth is flat, I'm sure that if you looked long enough and hard enough
you could find someone who genuinely believes that there really isn't
any quality difference at all between formula and breastmilk, but I'm
also sure that the numbers of such people are vanishingly small. In
general, women don't formula feed because they've failed to get the
message that breast is preferable; they formula feed because they don't
know how to overcome the practical problems associated with breastfeeding.

Many times
these women who have gotten bad advice (for example, with their first
child,) will have another child. We want the opportunity to reach
these women with the correct message in time for that subsequent baby.

And the correct message is that those women can seek out help and advice
without fear of judgement or criticism for their previous actions.
Women who didn't breastfeed because of bad advice already know
breastfeeding is better, or they wouldn't have been trying to breastfeed
in the first place. The reason these women didn't breastfeed is not
because they actually believed formula feeding was just as good, but
because they received bad *practical* advice - they were told that they
couldn't breastfeed when in fact they could, or they were given
inappropriate advice about how to breastfeed that sabotaged their chances.


[...]
Finally, I think your moral conclusions are, at the least, inaccurate.
I have already pointed to several clear reasons why my suggestions are
a BETTER strategy, regardless of the guilt issue.

I don't think this is the case. The only reason I can see that you've
given is your claim that "Formula is inferior" makes a more persuasive
argument than "Breastfeeding is superior", and, as I said, this is in
direct contradiction to what I've learned in psychology.

However, regarding
that question, you have to ask WHY are "pro breastfeeding cousellors"
viewed as judgmental. It is because formula feeding is viewed as
normal, and they are trying to convice women to do something abnormal.

No, it's because some breastfeeding counsellors actually are judgemental.

It's not about what you try to convince women to do, but about how you
convince them. Some breastfeeding counsellors can be very critical of
women's choices. I think that this is a case of a small minority
getting the rest a bad name, but, unfortunately, the problem does exist
and will only be exacerbated by messages that are critical of women who
formula feed.

If breastfeeding were viewed as the norm, they could simply be viewed
as helpers, rather than police(women).

Not getting blind drunk regularly is viewed as the norm, but there are
still alcoholics who don't seek help because they're scared of getting
criticised for their behaviour.

: Larry, that just isn't true. I know this because I've _done_ a
: psychology course which specifically covered the topic of public health
: messages and how they should be presented. So if you want to know what
: the equivalent of Psych 101 actually does teach - well, it taught me
: that research shows people to be more motivated by aiming for benefits
: than by trying to avoid harms.

Based on what you argue above, I would suggest than in addition to you
public health psych courses, that you also take some advertising and
advertising psych classes. This not just a question of phrasing the
message regarding aiming for benefits rather than avoiding harms. It is
a question of deviating from the norm or not. Human beings have a very
strong herd instinct. They are usually very unwilling to deviate from
the norm unless there is a strong reason to do otherwise.

If you phrase the message so that formula feeding is viewed as the norm,
even if you portray breastfeeding as "superior" it is very easy to say
"Yeah, it may be a little bit better, but since formula feeding is the
norm, the benefit probably isn't that great, so it is good enough for
me. On the other hand, if you phrase the message so that breastfeeding
is the norm, even if you only portry formula feeding as adding only
small risks, it is much easier to say "Breastfeeding is the norm,
everybody is (or should be) doing it, so I better do it too. This is
the point where attitudes get changes.

Larry, I think the problem is that you're confusing two subtly different
meanings of the word 'norm'. What you've been talking about here is
establishing breastfeeding as the norm in the sense of the approved
standard that we should all be aiming for. However, this is not the
same as the 'everybody else is doing it' sense of the word.

If anything, I'd say that messages about the inferiority of formula *or*
about the superiority of breastmilk both make breastfeeding seem *less*
like the norm, because they leave people with the subtle message that if
the point needs to be argued in this way, then clearly lots of people
*aren't* breastfeeding. It's a 'protest too much' kind of effect - it
draws attention to the problem.

A much better way, both psychologically and practically, would be to
skip the whole "Breastfeeding is best because yadda yadda yadda"
paragraph entirely (regardless of whether it's phrased as "Breastfeeding
is best" or "Formula is inferior"), and instead have something like
"Although nearly all women want to breastfeed, many wrongly believe that
they will be unable to do so. Here's some useful information that may
help you breastfeed correctly", followed by some brief information on
how to cope with common problems, or on common myths and why they're myths.

Now, this does several things. In practical terms, it's a darned sight
more help than yet another bang on the breastfeeding-is-best drum. In
psychological terms, it gets the message across that pro-breastfeeders
are actually there to *help* rather than lecture. And in more subtle
psychological terms, it starts from the premise that women usually want
to breastfeed, stated almost in passing as an obvious fact. That's far
more effective in getting the breastfeeding-as-norm message inculcated
into people.


Sarah, I hope I have been clear and logical enough so that you think
my arguments have merit.

Not remotely, I'm afraid. I still don't see how "Formula is inferior"
is meant to inspire women to seek help with breastfeeding problems. If
you're a woman who's feeling guilty over having struggled with
breastfeeding and who's worried about being criticised, to whom are you
going to turn? To the people who are telling you what you should do,
telling you how inferior your course of action is, telling you that the
stuff you're not managing to give your baby is the stuff it needs, who
are generally making you feel so much worse than you already feel? Or
to the people who tell you that it's just fine to give formula and who
make you feel OK about what you're doing?


All the best,

Sarah

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"That which can be destroyed by the truth, should be" - P. C. Hodgell