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We Get It, Breastfeeding Is Important

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The call for more education about the benefits and safety of breast milk in the wake of last week's story about a couple suing Alberta Health Services for giving their baby another mother's breast milk is not only typical, it's also off-mark.

Celeste and Jeffrey Fleming's baby was accidentally fed another mother's breast milk while in neonatal intensive care at the Royal Alexandra Hospital in Edmonton. It was staff error. The Fleming's concern wasn't just that their baby had been fed another mother's milk. It was that their baby had been fed milk from a mother infected with hepatitis C, and that it took nearly a year before tests were able to confirm that there had been no transmission of the disease to their child. The Flemings are suing, they say, because they suffered nervous shock as a result of the error and as a result of delays in confirming their son was healthy.

The well-worn and highly favoured "lack of breastfeeding education" message is once again being paraded about to deflect the error and redirect attention. The lack of breastfeeding education mantra is easy to identify because it almost always has the same three elements: 1) reiteration of the message that breast is always best; 2) reiteration of the message that formula is worse than whatever breastfeeding issue is currently under discussion -- even if the particular issue under discussion has nothing at all to do with formula feeding; and 3) it is parents' lack of education about the previous two points that is the real cause of the problem.

Expert quotes from recent coverage of this story illustrate the point. First, we correctly learn from Dr. Shirley Gross, director of the Edmonton Breastfeeding Clinic at Misericordia Hospital that the risk of transmission of hepatitis C through breast milk alone is "infinitesimally small." Added to this is also the reminder that in most cases an infant is still "better off to receive breast milk -- even if not from the child's own mother -- than no breast milk at all." Reaffirm message that breast is always best. Check.

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We then learn from Kirsten Goa, president of the Breastfeeding Action Committee of Edmonton (BACE), that it is therefore primarily a "lack of knowledge" that is to blame for the couple being concerned about the health implications of this mix up. Make the call for more education about the safety of breast milk and the multiple benefits of breastfeeding. Check.

BACE further reassures us that the risk of spreading illness through breast milk is extremely low and "less risky than other alternatives like infant formula." Reaffirm the message that formula is always worse than whatever breastfeeding issue is currently under discussion, even if the particular issue under discussion has nothing at all to do with formula feeding. Check.

The message we are meant to absorb is clear: if this couple had had the 'proper' information about the 'real' risk of transmission, they would have realized that the error was basically a non-issue, and wouldn't have suffered undue stress and anxiety. Framing it this way positions their alleged nervous shock as little more than irrational paranoia.

Yet, in a modern parenting climate that prides itself on creating a parenting mindset hyper-attuned to risk and danger, where we are continually reminded of how any number of seemingly small infractions create the potential for harm and damage to our children, nervous shock doesn't sound like a totally unreasonable response to the situation the Flemings were faced with.

Maybe it wasn't only their "lack of knowledge" about the fact that hepatitis isn't transmitted through breast milk that had them so amped up. Maybe they already knew this. Maybe it was learning that hepatitis C can be transmitted through blood, meaning that if the infected mother had bleeding or cracked nipples when she expressed her milk (not exactly a rare occurrence for many breastfeeding mothers), the possibility of transmission was perhaps no longer "infinitesimally small."

It is also important to remember that any person's conception of risk isn't only about knowing the probability of something bad happening, it's also about the seriousness or consequence of that bad thing, should it actually happen.

The core issue here is not a lack of education, it's a lack of quality control. It's about ensuring that the health care providers and institutions in which we put our trust and to whom we are vulnerable will take good care of us and our babies, that they won't keep making these kinds of unavoidable mistakes.

The last thing we need is more education on why breast is best. We already know why breast is best. And we agree. This incident is not going to make breastfeeding mothers suddenly stop or reconsider their decision to do so. If there is one thing new mothers are not, it's fickle -- especially when it comes to what and how they feed their babies.

If there is any kind of message in this story about where more education is needed, it is for the need to better educate ourselves about the possibilities, realities and consequences of hospital error, and to learn more about how we can ensure such errors are minimized and prevented.