Dear Liz While I agree wholeheartedly with most of the discussion on this, and I have seen the article in question, I feel I need to make a comment about your statement : < The 'baby friendly initiative' I believe, was aimed at developing countries whose children were dying of diarrhoeal disease through contaminated water, incorrect formula and lack of hygiene. > This is a not uncommon response, and it worries me greatly - I believe it's wrong. I was involved in both the Victorian and the national BFHI set-up. I am not actively involved in it now, but I support the underlying principles wholeheartedly.
I know of no reason why every maternity service in Australia should not implement the '10 steps to successful breastfeeding', and seek external assessment through the Baby Friendly Hospital accreditation process. This has very little to do with dirty water - babies die unnecessarily in Australia too because they are not breastfed. The reasons for failure of breastfeeding (most are willing to initiate breastfeeding, but the drop-off rates are alarming) are many. There is reliable evidence that practices which have for many years been common in maternity services across the developed world, such as separation of mother and baby, timing of feeds, use of artificial supplements, use of dummies and teats, advertising of alternatives to breastfeeding ... all contribute to early weaning. These are the issues that are dealt with in the global Baby Friendly Hospital Initiative. Sally's comments about babies who are brought into this world doped up to their eyeballs in narcotics are also relevant here. These babies and their mothers require special skilled support, and it can all be done within the baby friendly process. There's nothing daunting, or excessively focused on technique in the baby friendly initiative that I know about. (I'm a realist - not everyone gets it right all the time, but that's life!) Finally, we all agree that most mothers, most of the time, want what's best for their babies. Midwives who seek to provide woman centred care will do all that they can to support the mother-baby bond, working with the natural process, and only interfering when we have a good reason. That's being mother-friendly too. Protecting, promoting and supporting breastfeeding doesn't come easily. There are many deterrents in our society. Our work should be underpinned by reliable evidence, and I would ask anyone who knows of evidence contrary to the BFHI '10 steps' to speak up now. With my best wishes Joy Johnston -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
