By Rita Brhel, managing editor and attachment parenting resource leader (API)

Breastfeeding has seen the gamut in terms of public support. For centuries, it was the most natural thing to do, and then in the mid-20th Century, it suddenly became taboo and nearly disappeared from Western civilization. Through La Leche League International and other breastfeeding advocates, it has steadily made a comeback into mainstream family culture. But, in some respects, breastfeeding still has a long way to go — in normalizing public breastfeeding and breastfeeding for working mothers, and improving access to lactation services for all socio-economic classes by enabling lactation consultants to be reimbursed by health insurance and Medicaid.

“It’s very important that people realize they have a voice and that people will listen to that voice — and you don’t have to have a lot of letters after your name,” said Dr. Laura Wilwerding, MD, IBCLC, FAAP, FABM, a pediatrician in Plattsmouth, Nebraska USA, and a pediatrics professor at the University of Nebraska Medical Center in Omaha, where she lectures on breastfeeding medicine, child advocacy, antibiotic overusage, and obesity prevention.

In addition to being a fellow of the International Academy of Breastfeeding Medicine, Wilwerding is involved in the Nebraska chapter of the American Academy of Pediatrics as the breastfeeding coordinator, the Nebraska Breastfeeding Coalition on the leadership team, and as a member of the Nebraska Nutrition, Physical Activity, and Obesity Prevention Advisory Board. Wilwerding spoke during the La Leche League of Nebraska Annual Breastfeeding and Parenting Conference in May 2011 in Omaha, Nebraska USA.

“Particularly locally, you do have power, and not just with elected officials but also hospital administrators and human services program directors,” she said. It’s all in your approach.

When talking to elected officials:

• Arm yourself with information
• Put your argument into a written letter form
• Identify yourself as a parent or concerned citizen, rather than an activist
• Show how breastfeeding saves money
• Use own experiences to illustrate your point
• Talk about the effects of marketing (formula companies disguising advertising as education), rather than debate infant-feeding choice
• Normalize breastfeeding
• Talk about the risks of not breastfeeding, rather than the benefits of breastfeeding
• Talk about formula-feeding as being “not normal” or “subpar,” rather than that breastfeeding is perfect or ideal
• Reframe feelings of guilt as anger or grief.

“You have to figure out a way to educate without preaching and to bring people to the table,” Wilwerding said. And along the way, you need to work on building a network of supporters among different facets of society, so that those in charge of policy- and law-making are influenced by others who also support your agenda.

Wilwerding remembered when she first began talking to Nebraska lawmakers about changing public breastfeeding laws, 10 years ago. “At first, there were lawmakers in the room who would visibly cringe every time I said the word, ‘breast.’” Finally, after several [legislative] sessions, there was a young woman lawmaker who stood up and said, ‘All of my friends are breastfeeding, so obviously we need to support this,’” Wilwerding said. “At first, it was seen as fringe. We were referred to as ‘those crazy breastfeeding women.’”

Approach to the Formula Gift Bag in Hospital Maternity Wards

It’s important to point out to hospital officials that by handing out free formula gift bags, hospitals are engaging in unethical marketing. Evidence-based medicine fully supports breastfeeding and therefore should support full disclosure of the risks of not breastfeeding; therefore, by handing out formula gift bags — which are, by the way, always either Enfamil or Similac, never a smaller formula company — hospitals are going completely against medical recommendations. In addition, hospitals can’t overlook that when they have employees hand out these formula gift bags, not only are health care providers going against their medical ethics, but they are being used as pawns by formula companies: they are, in essence, unpaid salespeople for a company not invested in their patients’ well-being.