10 tips for nutrition (by Nestle)

On 2006-05-06 22:44:28 +0800, Sarah Vaughan said:

Brookben wrote:
why didn't they say 'at least for the first 2 years' if it weren't
simply to discourage breastfeeding.

It's actually more discouraging to think you're facing a big task
rather than a small task. Conversely, one very well-known way of
making people more likely to tackle a task in the first place is to
break it down. If you're in two minds about whether to start
breastfeeding in the first place, having two years worth of
breastfeeding presented as the minimum adequate standard may well leave
you deciding that since you can't see yourself managing that, you might
as well not bother at all.

I think there are ways of presenting the message that are better than
either 'at least six months' or 'at least two years' - it would be
better to find a way that focused on encouraging women to try for
whatever length of time they can manage. But between the two, I think
'at least six months' is a message that's more likely to reach the
women who aren't sure about starting in the first place.


All the best,

Sarah

I have women come in to hospital to have their baby, and say, "I don't
want to breastfeed when I get home but I want the baby to have the
colostrum." ... and then there are the midwives who say, "Oh, why
bother stimulating your milk if it's just for the colostrum?" Makes me
so mad. What if they have a really easy time of it in the first 3 days
and decide to keep at it?

Anyway - it sort of ties into your post, Sarah

Jo
--
Woman, Wife, Mother, Midwife

wrote:
Brookben writes:
: www.bobrow.net/kimberly/birth/BFLanguage.html

This is essentially correct, but people like Sarah, Caldonia, and Sue
either just don't get it or just don't believe it.
[...]
In doing so, I (and you, and anyone who has the
temerity to continue to hold this position in the face of their
contradiction) am (are) labelled an unreasonable extremist!

And this doesn't tell you anything about how you're coming across to
people who _aren't_ enthusiastic about breastfeeding, Larry?

Even on a strongly pro-breastfeeding newsgroup, there are still women
who find your POV to be off-puttingly extremist. So how many hearts and
minds do you think it's winning among people who aren't keen on
breastfeeding to start with? Does it not occur to you that an approach
that _doesn't_ alienate people might get further?

I've seen a lot of people respond to me, but I don't think anyone's yet
responded to this point. If we upset women, they are less likely to
come to us for advice and help. It's that simple. Regardless of how
little concern you have for the feelings of women who dare to feed
formula, there are damn good _practical_ reasons for trying to avoid
presenting the message in a way that's hurtful or offensive.

Larry, maybe you missed this, but a few weeks ago a woman said that she
was leaving this newsgroup because she couldn't face the reaction she
knew she'd get if she mentioned that she was now, due to circumstances,
feeding her nine-month-old breastfed son *some* formula. Previous posts
on this group had left her feeling this way. That's the effect that
this sort of attitude has on people. How many other women are there out
there who leave groups like this or don't join them in the first place,
precisely because they can't face such attitudes? How helpful are we
going to be to women and babies if that's the way we come across?


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

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

Brookben wrote:
I think that most women who really wanted
to be able to breastfeed are going to feel a real wrench on hearing the
stuff they give their child described as 'inferior', and being told that
their baby is not getting what he 'needs'.

When will the needs of the baby supercede the needs of the mom? Does
it not bother anyone that the babies lose when, as a society, we
devalue their preferences? Human milk for human babies... even cows
get cow's milk.

I completely support breastfeeding, but I find your rhetoric a little
off-putting. I'm not seeing how someone with pump resistance (or no
place to pump) is in turn devaluing her baby's preferences -- and
again, given that the majority of American moms with children 1 are at
work, are you actually implying that these moms *shouldn't* work?

How would we respond to a mother who wanted to feed her baby solids at
2 weeks? Just because it's done doesn't mean it's harm should be sugar
coated. Should the fact that releasing the facts surrounding the
potential harm of feeding a baby might make a mother feel guilty mean
it should be sugar coated?!
I hate hearing that breastmilk has the added bonus of this or the added
bonus of that -- that mindset makes formula the standard that
breastmilk is simply compared to. It should be formula is deficient of
this and deficient of that (I suppose they'd just pick and choose the
deficiencies as they pick and choose the 'bonuses').

True, formula is deficient of several things that are
naturally-occurring in breastmilk (although the antibody thing was new
to me, given that I had a more limited view of lymph nodes), but I
think if the end *goal* is to increase bf rates, browbeating people is
often less successful than making bf something that they'll try.


In America, the press is *finally* discussing that high fructose corn
syrup sets up a child for childhood obesity.
Does the fact that moms
will STILL give their kids sodas make them feel guily or whatever
everytime they hear this fact? Well, bless their hearts... If it does
- GOOD. It's high time we take an educated approach to feeding our
babies/children. (hmmm... I wonder what the #1 ingredient is in
formula... hmmm... I wonder why childhood obesity rates have
skyrocketed in the past 40 years...)

So...just to be clear, here, you're saying that obesity skyrocketing is
due entirely to formula feeding? I always thought it was because
people are more sedentary and consumed too many calories...

And whomever made the comment that millions of babies thrive of formula
is seriously diluted. I guess the fact that the growth charts were
recalculated to reflect the slower growth pattern of formula fed
infants is lost. On a ff growth chart, my 4 mo old is 99.99%ile (she
was off the chart). On a bf growth chart, she's 75%ile. She's
considered healthy by bfing standard, but is by ffing standards, she's
overweight. And, I guess we also ignore the fact that incidences of
childhood illnesses rates are up. Just because we have the science to
help the kids (at least, we think it helps them), doesn't mean they
should have been sick in the first place. Out of 1000 ff babies, 77
will be hospitalized in the first year. Out of 1000 bf babies, 5 will
be. hmmm, doesn't really sound like thriving, does it? We are a
generation of Mylanta -- does that not mean anything?!

I think that if the generation of mylanta is taking mylanta for stomach
ulcers, they'd be better served by taking an antibiotic (Sorry, I
*still* find the whole ulcer/bacteria thing startling...)

Again, though, your ff/bf hospitalization rates are like comparing the
mortality rates between Facility A (general hospital) versus Facility B
(Cancer Center) -- I'm guessing that many of the factors that cause
babies to be ff are the same factors that influence future
hospitalizations...But hey, I may be wrong.

I don't expect a formula company to give out literature to potential
clients warning of the dangers of their products -- but, then again,
cigarette companies have to. Isn't it fair? Why don't we see PSAs
about the danger of ffing? Oh, wait, I forgot. It might make someone
feel 'guilty'...

I really can't compare smoking to ff -- is this what you're proposing?
I lack a scientific bent (but I do waste time at pubmed), yet believe
that the harms of smoking are pretty well documented and pretty darn
direct (b/t/w your link regarding smoking and low IQ for children is
not considered valid -- the biggest determinates of IQ are financial
situation and maternal education; smoking was confounded with low
finances and low education..)

See, I think that at the point of saying that smoking and ff are
equivalent you've basically alienated a large part of the audience (and
would you rather be right, or effective?), and aren't helping to build
a case for bf, but are instead just bent on chastising moms for ff,
which I don't truly believe will raise bf rates.

Caledonia

Caledonia wrote:

Brookben wrote:
When will the needs of the baby supercede the needs of the mom? Does
it not bother anyone that the babies lose when, as a society, we
devalue their preferences?

I completely support breastfeeding, but I find your rhetoric a little
off-putting. I'm not seeing how someone with pump resistance (or no
place to pump) is in turn devaluing her baby's preferences -- and
again, given that the majority of American moms with children 1 are at
work, are you actually implying that these moms *shouldn't* work?

It seems to me that women forced to work out of economic necessity while
their babies are very young, and being unable to breastfeed while
working, or having no place to pump while at work, is an absolutely
prime example of we, _as a society_, devaluing the preferences of both
babies and mothers.

Lara

Since you are responding to Amy, I will let her respond directly
to your points. I will only clarify comment relating to comments
you make regarding my points.

Sarah Vaughan writes:

: Jo and Larry were not objecting to formula advertisements per se, but to
: the fact that a commentary on child nutrition aimed at mothers in
: general didn't refer to formula as 'inferior'. I was objecting to that
: point.

Lest I leave the wrong impression, I am totally opposed to "formula
advertisement per se." And I will point out that further, it is a
violation of the WHO code.

: To clarify - I'm not objecting to the idea of trying to get
: breastfeeding more into the mainstream as the accepted norm (something
: I'm all in favour of). I'm objecting to the idea of describing formula
: as *inferior* and breastmilk as something babies *need*, because that
: can be very painful for women who were unable, for whatever reason, to
: breastfeed.

And I will again point out...
1. To get "breastfeding more into the mainstream as the accepted norm,
it MUST be treated as the norm, not as something above the norm.
Consequently, formula feeding MUST be viewed as something LESS
than the norm. It won't work otherwise!
2. Special needs women who cannot breastfeed must be addressed via
exception. It is counterproductive to re-tailor the general
messagge for this exceptional group!

I think these are the most valuable points worth making and restating
from this thread.

Larry

Sarah Vaughan writes:
: wrote:
: Sarah Vaughan writes:
:


: : How? They're not going to divide themselves neatly into separate
: : groups. Women who couldn't breastfeed (either due to biological reasons
: : or to poor advice) are going to be reading about children's nutrition as
: : well, and are going to come across posts like that.

: Firstly, before addressing some of the separate points in your reply, I
: would like to point out that it totally failed to answer this question.
: All you've done is reiterated the same point you were making.

: So I will ask the question again: _How_ do you propose to put out
: messages about formula and breastmilk that won't be read by women who
: can't or couldn't breastfeed?

Let me try to be clear. "You can't and you should not." Now, let me
explain what I mean. 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, and you should breastfeed unless you are
physically unable." Not just every mother, but every potential mother,
and in fact every member of society should hear this messages undiluted
until it become ingrained as second nature into their consciousness.

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.

: And women who could have breastfed with better advice but couldn't do so
: because they received bad advice are, unfortunately, a huge part of the
: audience. They are, what's more, one of the parts of the audience we
: most need to reach, because many of them will be having further children
: that they _can_ breastfeed - with the right advice.

: So thinking in terms of not upsetting women who didn't breastfeed isn't
: just something that's morally appropriate, it's also good strategy.
: Women are less likely to seek help from pro-breastfeeding counsellors if
: they're afraid of being judged.

I think these two paragraphs totally miss the point. 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. 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.

Further, these women need a targetted message, too. "You are not at
fault because you didn't have the information you needed to make an
informed choice.

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

: 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.

Sarah, I hope I have been clear and logical enough so that you think
my arguments have merit. I myself am convinced, both intellectually
and emotionally, that this is a key element in convincing mothers to
breastfeed. You are in a uniquely infulential position as a medical
professional to help raise breastfeeding rates, and I hope you can use
this discussion to accomplish that goal.

Larry

Sarah,

I was hoping we could have this discussion on the merits of the points
we were trying to discuss with resorting to ad hominums.

Sarah Vaughan writes:
: wrote:
: Brookben writes:
: : www.bobrow.net/kimberly/birth/BFLanguage.html
:
: This is essentially correct, but people like Sarah, Caldonia, and Sue
: either just don't get it or just don't believe it.
: [...]
: In doing so, I (and you, and anyone who has the
: temerity to continue to hold this position in the face of their
: contradiction) am (are) labelled an unreasonable extremist!

: And this doesn't tell you anything about how you're coming across to
: people who _aren't_ enthusiastic about breastfeeding, Larry?

: Even on a strongly pro-breastfeeding newsgroup, there are still women
: who find your POV to be off-puttingly extremist. So how many hearts and
: minds do you think it's winning among people who aren't keen on
: breastfeeding to start with? Does it not occur to you that an approach
: that _doesn't_ alienate people might get further?

Sarah, I have truly thought this through from both a personal, and from
a mass sociological prerspective. There will be a wide range of people
in every social circle holding a wide variety of views. I am constantly
endeavoring to make the suggestions that I think will have the widest
positive social impact.

: I've seen a lot of people respond to me, but I don't think anyone's yet
: responded to this point. If we upset women, they are less likely to
: come to us for advice and help. It's that simple. Regardless of how
: little concern you have for the feelings of women who dare to feed
: formula, there are damn good _practical_ reasons for trying to avoid
: presenting the message in a way that's hurtful or offensive.

Again, I think it is an unwarrented attack to characterize me as not
having concern for people who dare to feed formula. (see comments below)
I think that I have also made it clear in another response in this thread
how I would use targetted versus universal messages to deal with the
feelings of those would could not breastfeed.

: Larry, maybe you missed this, but a few weeks ago a woman said that she
: was leaving this newsgroup because she couldn't face the reaction she
: knew she'd get if she mentioned that she was now, due to circumstances,
: feeding her nine-month-old breastfed son *some* formula. Previous posts
: on this group had left her feeling this way. That's the effect that
: this sort of attitude has on people. How many other women are there out
: there who leave groups like this or don't join them in the first place,
: precisely because they can't face such attitudes? How helpful are we
: going to be to women and babies if that's the way we come across?

The person you were referring to is Betsy, otherwise knows as oregonchick.
If you will google through the posts including our responses to each
other, I think you will find that 1) I never attacked or belittled her
choices, and 2) there are several occasions where she had thanked me
for my support and helpful advice in her situation I think that belies
your labelling me as an extremist! On the very thread you mentioned,
my advice was to ramp up the formula slowly over the next few months
so she wouldn't have to transition suddenly. Maybe you didn't read my
replies in the thread, or her responses to me. BTW, this is a good
example of a targetted message.


: All the best,

: Sarah
: --
: http://www.goodenoughmummy.typepad.com

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

Sadly,
Larry

are you actually implying that these moms *shouldn't* work?

Are you actually implying that stay-at-home moms *don't* work?

if the end *goal* is to increase bf rates, browbeating people is
often less successful than making bf something that they'll try.

I am incredibly compassionate to women who made the decision to formula
feed, for whatever reason - even if that decision was made for them by
bad information or because of a physical reason. It is not my intent
to browbeat, or whatever. I just want the women who are or will be
making a decision to breastfeed to have good, factual, widespread
knowledge as to the drawbacks of the decision to introduce artificial
human milk. I don't think that, at the end of the day, it serves
anyone to downplay the dangers of artificial feeding. I think that
women who received bad information and, as a result, stopped
breastfeeding, should be on the top of the advocate list for
breastfeeding, so that this doesn't happen to anyone again.

So...just to be clear, here, you're saying that obesity skyrocketing
is
due entirely to formula feeding? I always thought it was because
people are more sedentary and consumed too many calories...

High fructose corn syrup, just so's you know - alters the way the body
processes calories. Even if a person intakes fewer calories, if they
are also ingesting high fructose corn syrup, the person has been
clearly shown to gain excess weight. It's pretty interesting, really.
I'm simply drawing the blatantly obvious conclusion that if we're
feeding our babies this ingredient, let's not be surprised if they
battle weight issues later on. Being sedentary and obese is a vicious
cycle... there are many factors, but high fructose corn syrup is
finally making news in the US as being a cause in childhood obesity, so
it does have a place when talking of the harmful effects of formula.
And, just btw, I didn't say it was entirely due to formula feeding...
but I do think it is just another consideration as to why parents
should take another look at continuing breastmilk so as to not
introduce formula.

(b/t/w your link regarding smoking and low IQ for children is
not considered valid -- the biggest determinates of IQ are financial
situation and maternal education; smoking was confounded with low
finances and low education..)

I didn't mention IQ in my post. So, I'm a bit confused about this
part...

But, please allow me to clarify. I brought up the smoking companies
because they have to give out a lot of literature to educate the public
about why cigarettes are harmful. Why not require the formula
companies to do the same? Someone posted on here something to the
effect of 'why would the formula companies want to tell their customers
the dangers of their product?'. I wanted to bring up the fact that
there have been situation where companies are required to badtalk their
product, in order to educate the public, so that the public can make an
educated decision about using them.

Formula companies should be required, in a strict way, to educate the
public on the potential dangers for using their product. Instead of a
nonchalant attitude about using formula, maybe women would take a real,
hard look at the damaging effects of using formula - and only use them
in dire cases, where no other options exist.

"Brookben" wrote in message
Are you actually implying that stay-at-home moms *don't* work?

Stay-at-home moms get paid now?? I must have missed the memo on that. Where
do I sign up.
--
Sue (mom to three girls)

Good reply, Larry. You have more patience and a way with words that my
lactating brain can't deal with right now

Jo