Reports have been circulating on the
Internet: researchers find that the recommendation to exclusively breastfeed
babies for six months is just too hard for modern women and is making mothers
feel bad. The study author suggests the advice is fine for the developing
world, but should be changed to “breastfeed as long as you can and introduce
solids as close to six months as possible”. There are several health literacy
lessons to be learned from this questionable reporting on questionable
research. The
evidence is exceptionally clear and strong FIrst, we should note that the
recommendation to feed infants only breast milk for at least six months is not
just a suggestion from some guy in a diner. It is the evidence-based consensus
from the U.S. Centers for Disease Control, American Academy of Pediatrics, the World Health Organization, and
virtually all health agencies on the planet. This level of consensus is rare
and requires an extremely strong evidence base. Is
the recommendation unhelpful for mothers? The evidence exists for a long list of
health benefits to mother and child that last a lifetime and save
billions in healthcare costs. The study’s author says the recommendation is
“idealistic” and “unhelpful” as an
individual goal and calls for balance between these “theoretical” long term
benefits and immediate family well being. Fair enough. But that can be done at
the individual level without undoing worldwide policy making and without
concluding that women are incapable of (or just too busy) for this womanly
skill. The
perfect food is free The big problem for breastfeeding is
this: it’s free. This study feeds a broadly-held perception that breastfeeding
is for poor people in backward countries that cannot afford or reliably use
formula. With this twisted thinking we are
willing to disregard all the science behind the global breastfeeding
recommendation in favor of the belief that in 30 years scientists have made a
better formula than what Mother Nature developed over millennia. Health
Literacy Lessons According to the World Health
Organization, Maternal Health Literacy means the cognitive and social skills which determine the motivation and
ability of mothers to gain access to, understand, and use information in ways
that promote and maintain their health and that of their children. Part of health literacy for mothers,
health promoters and clinicians alike, is reading critically, asking where is
this information coming from and how reliable is it? What does it mean to me in my situation? How can I use it
for health? Read it for yourself. The study is published in BMJ Open -
that’s British Medical Journal Open, an open access journal. BMJ ought to be a reliable source. But
here’s the detail that matters (it’s in the abstract): 541 pregnant women in
Scotland were invited to participate in monthly interviews; 72 volunteered to
participate. Of these, 36 were interviewed along with some of their partners
and relatives. This
is not a representative sample. People who volunteer to participate in
surveys typically feel very strongly one way or the other. We need to ask, how
are these 36 women different from the 505 who declined? Further, the sample is too small to draw any conclusions beyond the
individuals involved. Telling
them what to do does not work Breastfeeding advocates, health
educators, parent educators, home visitors, clinicians can learn an important
lesson re promoting maternal health literacy from this article. When education
is perceived as “unrealistic, overly technical and rule based”, it is not going
to motivate anyone to take action for health. But you already knew that... The problem here is not the breastfeeding policy; it’ s the
delivery of information. Stay tuned for a model reflective conversation to
promote breastfeeding. To balance the oft quoted Scottish
mothers who were not well served by their lactation consultants and who
struggled with breastfeeding, see our Facebook Poll for comments from
our volunteer sample of mothers who work in women’s health. We asked: Do you think recommending breastfeeding for
a minimum of 6 months is unrealistic or unattainable? No one said Yes. |
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CategoriesHealth LiteracyMaternal Child Health Test |
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