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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When <a href="http://www.huffingtonpost.com/2014/07/18/school-principal-gives-letter-breastfeeding-mom_n_5600505.html" target="_blank">Andrea Scannell</a> took her children to eat at a summer lunch program at Mount Logan Middle School in Utah, she decided to nurse her infant while there. Before leaving, a school employee handed her a complaint letter from the principal, which went viral after her husband <a href="http://www.reddit.com/r/pics/comments/2aw6ob/my_wife_was_handed_this_formal_complaint_about/" target="_blank">uploaded a photo of it to Reddit</a>. The letter asked Scannell to "discretely feed the baby, whether with a small blanket or in a more private area while the lunch program is taking place." After garnering a lot of online support, Scannell organized a nurse-in at the school.
Renee Villatoro was nursing her baby at the Kentucky Kingdom amusement park when <a href="http://www.huffingtonpost.com/2014/07/18/kentucky-kingdom-breastfeeding_n_5591909.html?utm_hp_ref=breastfeeding" target="_blank">an employee told her to move to the bathroom</a>. After the incident, she and her fellow mothers' support group members flooded the park's Facebook page with comments and questions about its breastfeeding policy.
Employees at a Walmart in Greenville, SC verbally harassed and mocked Shawnee Colabella when she nursed her child in the store. When the mother told her breastfeeding support group about her experience, the members of the Facebook group "Upstate SC Breastfeeders" <a href="http://www.huffingtonpost.com/2014/07/09/breastfeeding-group-plans-walmart-nurse-in_n_5570535.html?utm_hp_ref=breastfeeding" target="_blank">organized a nurse-in</a>.
When Karen Penley tried to nurse her son in the Oahu homeless shelter Institute For Human Services, <a href="http://www.huffingtonpost.com/2014/07/01/homeless-mom-faces-discrimination-for-breastfeeding_n_5548351.html" target="_blank">a worker reportedly told her to either cover herself or relocate</a>. Penley described the exchange to <a href="http://www.hawaiinewsnow.com/story/25901442/homeless-mother-fights-to-breastfeed-in-public" target="_blank">HawaiiNewsNow</a>: "He's like, ‘You must cover to nurse your baby.' And I was like, ‘I have the right not to cover.' And he goes, ‘I have the right to refuse services.' In other words…kick me out, make me leave."
When Karlesha Thurman posted a photo of herself breastfeeding during her graduation from The California State University, Long Beach on social media, <a href="http://www.huffingtonpost.com/2014/06/09/mom-shamed-by-internet-for-breastfeeding-at-graduation_n_5474420.html" target="_blank">she received a lot of negative comments on Twitter</a>.
Kristina Gray was breastfeeding her son while waiting to be seated at a Bob Evans in Tampa, Florida. <a href="http://www.huffingtonpost.com/2014/06/06/bob-evans-breastfeeding-apology_n_5460744.html?utm_hp_ref=breastfeeding" target="_blank">A female employee approached her and asked her to cover up.</a> After the incident, Gray posted her complain on the restaurant chain's Facebook page and organized a nurse-in.
While at a Victoria's Secret in Texas, <a href="http://www.huffingtonpost.com/2014/01/16/victorias-secret-breastfeeding-mom-_n_4611310.html?utm_hp_ref=breastfeeding" target="_blank">Ashley Clawson</a> asked an employee if she could nurse her child in a dressing room. She was not only denied, but directed to go to the nearest alleyway.
Brittany Warfield, a mother of three from Texas, <a href="http://www.huffingtonpost.com/2013/01/07/hollister-nurse-in_n_2425541.html" target="_blank">was nursing her 7-month-old outside of a Hollister store in a Houston mall, she says a manager forced her to move</a>. “He said, ‘You can’t do this here. This is not where you do that. You can’t do that on Hollister property. We don’t allow that.’ I said, ‘It’s Texas. I can breastfeed anywhere I like.’ He said, ‘Not at Hollister. Your stroller is blocking the way. You have to go,’” she recalls.
Mom and breastfeeding advocate <a href="http://www.huffingtonpost.com/2012/01/12/emma-kwasnica-breastfeeding-mom-facebook_n_1203198.html" target="_hplink">Emma Kwasnica</a>had posted over 200 photos on Facebook of herself nursing her own three children and told the Huffington Post that her account has been suspended at least five times as a result. She organized a nurse-in in front of Facebook headquarters to challenge the company's policy that says photos depicting breastfeeding are "inappropriate."
Houston mother Michelle Hickman says she was <a href="http://www.bestforbabes.org/target-employees-bully-breastfeeding-mom-despite-corporate-policy" target="_hplink">harassed and humiliated by Target staff </a>when she found a quiet space in the store to breastfeed her infant. She organized an international "nurse-in" at several Target locations on Tuesday December 28th. Pictured above is mom who participated, Brittany Hinson and her 4-month-old son, Kennedy, in front of the Super Target store, in Webster, Texas.
<a href="http://www.huffingtonpost.com/2011/12/16/breastfeeding-flash-mob_n_1153963.html?ref=parents" target="_hplink">Claire Jones-Hughes wrote</a>: "After being verbally attacked for not covering up while feeding my four-month-old, I decided it was time to make a statement to show that mothers will no longer tolerate being harassed for feeding our babies in public." She then staged a breastfeeding flash mob at the Clock Tower in Brighton, UK.
Simone dos Santos was breastfeeding her four-month-old in the hallway of a D.C. government building when <a href="http://www.huffingtonpost.com/2011/12/14/simone-dos-santos_n_1148455.html#s542782&title=McDonalds_" target="_hplink">two female security guards told her to stop</a> because it was indecent. "I was shocked, upset and angry that by providing food for my son, I was being treated like a criminal," she wrote in a blog post for the <a href="http://www.washingtonpost.com/blogs/therootdc/post/dc-guard-no-breastfeeding-in-public/2011/12/12/gIQA2xYvtO_blog.html" target="_hplink">Washington Post</a>.
In November, Natalie Hegedus, a Michigan resident, was <a href="http://www.huffingtonpost.com/2011/11/14/natalie-hegedus-courtroom-breastfeeding_n_1089271.html" target="_hplink">asked to leave a courtroom</a> by a district judge. Her post on the community forum, <a href="http://community.babycenter.com/post/a30189175/bf_inappropriate_judge_thinks_so" target="_hplink">BabyCenter</a>, caused a national uproar.
In August 2010, Nicole House was asked to leave the courtroom because a bailiff noticed her breastfeeding.
This past June, a mom was <a href="http://blogs.babycenter.com/mom_stories/07052011breastfeeding-mom-harassed-on-city-bus/" target="_hplink">harassed by a bus driver</a> for breastfeeding on a Detroit-area bus.
Back in 2006, 27-year-old mom, Emily Gillette, was <a href="http://www.msnbc.msn.com/id/15720339/ns/travel-news/t/woman-kicked-plane-breast-feeding-baby/#.Tr2Eh1ZSmGg" target="_hplink">removed from a Delta flight</a> for breastfeeding. Watch a news clip about this story <a href="http://www.youtube.com/watch?v=q0r6gbJpc18" target="_hplink">here</a>.
Ohio mom Rhonda claimed that she was <a href="http://consumerist.com/2011/02/woman-says-mall-made-her-leave-for-breastfeeding-in-public.html" target="_hplink">kicked out of her local mall</a> for breastfeeding, back in February. Mall security even called for back-up.
We've heard about <a href="http://blogs.babble.com/strollerderby/2011/07/21/mom-asked-to-leave-ymca-pool-while-breastfeeding-it-made-others-uncomfortable-and-breastmilk-is-considered-a-contaminating-bodily-fluid/" target="_hplink">these incidents</a> from coast to coast. In 2001, a mother nursing her 9-month-old was told to <a href="http://www.komonews.com/news/archive/4015441.html?tab=video" target="_hplink">move away from the edge of the pool</a> so as to avoid contaminating the water with her breast milk.
One mom <a href="http://www.mothering.com/community/t/567001/basically-forced-out-of-church-for-breastfeeding" target="_hplink">posted a frustrated essay</a> in November 2006, detailing her pastor telling her that photos of her breastfeeding were equivalent to pornography. She and her husband decided to leave the church after this incident.
Clarissa Bradford was <a href="http://www.abc15.com/dpp/news/region_phoenix_metro/north_phoenix/nursing-mother-kicked-out-of-mcdonald's" target="_hplink">kicked out of a McDonald's</a> by an assistant manager for breastfeeding her 6-month-old child in August 2010.
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.