Tuesday, November 4, 2008

Breastpumps, a risk factor for breastfeeding failure

photo by Jessie McClain
Are breastpumps a risk factor for breastfeeding failure? What is the cause of so many women initiating breastfeeding but then quitting within a short period of time? There are certainly multiple causes in our society for breastfeeding failure. We are a society enthralled by our gadgets, our things. Our social lives seem to be based on our monetary standing in the community. Our knowledge is based on what certain powerful and monied groups want us to know. We are dependent on the media for our knowledge and the media is owned by powerful interest groups. So women believe what they have been "educated" to believe. If you are going to have a baby, you either need that product called a breastpump, or that other product called infant formula. Life is about products. If you are wealthy, you get the expensive pump. If you are poor, you buy what you can afford or use a second-hand pump. You take the two-hour breastfeeding class (maybe, if you have time), and often those classes show you the wonderful array of breastfeeding equipment you can buy or rent. The pregnant mind becomes fixated on the belief that gadgets will solve any breastfeeding problem. Sore nipples? Get a pump. Engorgement? Get a pump. Need time away from baby? Get a pump. However did those women breastfeed in those olden days when pumps didn't exist? So every pregnant woman intent on breastfeeding gets a pump--good pumps and bad pumps. And the sad fact is that women don't understand that there are risks. What are the risks? Some women get a poorly working breastpump and believe that the reason they aren't getting any milk or a specific amount is because something is wrong with their body. How could this wonderful technology be the reason for little or no milk? I once did a home visit in which the $20 battery operated pump (yes this was about 10 years ago) the mom was given had no suction. The mother was basicly hand expressing into the pump to get any milk. She thought she was doing something wrong--nope. She was doing something very right--hand expression. It was the device that was defective, not her. But had she not called for help, would she have continued pumping? Would she have quickly given up on breastfeeding believing her body was defective? Technology/gadgetry without good consumer information and knowledge creates enormous problems. When I first started working in the WIC Program in 1994, I found that pumps were being given out to anyone who asked for them. I talked to my supervisor about it, and we instituted a requirement that in order for a pump to be given to a client the pump had to be taken out of its package, shown how to assemble it, and shown how it worked. The client was given information sheets on cleaning the pump, storing milk, and anything else that pertained to her request. Breastpumps like infant formula were kept out-of-sight from WIC clients because the priority in the Program was to have women breastfeeding. Breastpumps like infant formula require access to refrigerators for storage (meaning the client had to have electricity and we had pregnant women who were living in cars), access to running water and stoves for cleaning and heating. Teaching hand expression was far more valuable for women whose access to modern conveniences was limited.
Over the years, I saw women get damaged nipples from pumps, abrasions on the areola from pump flanges to small or not centered correctly, mastitis--from pumping excessively and then stopping, pumps put together incorrectly, moms focused on pumping rather than breastfeeding, and mothers assuming that pumped milk is a good indicator of milk supply. How many women quit breastfeeding because of these issues? Are we willing to look at this technology and realize the risks? Or is this situation imitating childbirth in the USA, where moms opt for the technology without realizing the risks? Epidural classes? Breastpump classes? What do we believe? Breastpumps are aids to helping moms sustain breastfeeding. There are risks whenever we step between a mother and her baby. Breastpumps don't solve breastfeeding problems, mothers and their babies resolve these problems by learning to be together. We are living in a culture that does not support mothers and babies being together. Women are made to feel that to be a worthwhile member of our society, they must go back to paid employment as rapidly as possible. There is a belief that babies don't miss their mothers. And that mothers shouldn't miss their babies. The priority is economics not the mental and physical well-being of mothers and babies.
So some breastfeeding advocates believe that the WHO Code has nothing to do with breastpumps and the only concern is baby bottles and nipples that breastpump company markets. Thus, the WHO Code document is examined and we do not look at the "intention" of the Code (which is to sustain breastfeeding not human milk feeding). Instead, the belief is that we only look at the precise wording of this document and not the intent. Maybe the document should be changed to humanmilk feeding rather than breastfeeding. Maybe the reality is that in our society the best we can hope for is humanmilk feeding and breastfeeding is a wonderful but impossible goal.
copyright 2008 Valerie W. McClain

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