Excuse our language

During my undergraduate studies as a journalism major, I started to appreciate the power of words. My instructors emphasized the importance of strong verbs and suggested eliminating unnecessary adverbs in my writing. Show don’t tell, I remember them repeating.

Admittedly, it wasn’t until my three-year-old began experimenting with words and asking infinite questions that I finally started to understand the true power of words.

Diane Wiessinger’s famous article Watch Your Language, explains just how influential words can be in the world of breastfeeding. Breastfeeding is not best. There are no benefits to breastfeeding; rather there are risks involved with not breastfeeding, risks involved with artificial feeding.

At Healthy Children Project’s International Breastfeeding Conference this year, several speakers challenged common language used in different arenas of maternal child health. The language we use is sometimes misleading or inaccurate which makes it difficult for mothers, other caregivers and health care providers alike to communicate effectively. In other cases, there’s an outright lack of effective language.

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Kim Bugg speaks to conference participants

The following is an example of where we need to start a conversation where there is none. Kimarie Bugg,  MSN, MPH, CLC and Andrea Serano of Reaching Our Sisters Everywhere (ROSE) tell us that many health care providers assume that Black mothers will not breastfeed. What ensues is mothers left to breastfeed with virtually no support systems in place.

On the other hand, one conference participant shares that in her community, it is often assumed that Black mothers “just know how to breastfeed.” Either way, there is no conversation started with the mother, so she doesn’t get help one way or another. Simply asking moms if they plan to breastfeed has proven to significantly increase breastfeeding rates, Bugg tells us.

Bugg and Serano also suggest using the terminology Breastfeeding Clubs over Breastfeeding Support Groups to appeal to Black mothers. Bugg explains that Black mothers generally do not have interest in attending support groups, but they respond well to Breastfeeding Clubs because they imply a more informal, cheerful social gathering.

Linda Smith, BSE, FACCE, IBCLC speaks about why the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly (WHA) Resolutions still matter. She asks us to refer to the document as the Code or by its full name. Do not refer to it as the WHO Code because this is the name the formula companies have given it.

Dr. Jain chats with Healthy Children Faculty
Dr. Jain chats with Healthy Children Faculty

In regards to the way we make milk, conference speakers agree that milk production versus milk supply is more effective. Production implies an ongoing, dynamic process, whereas supply implies an eventual deficiency. Many mothers prematurely wean their babies from the breast because of perceived low milk supply. It might be helpful to help mothers looks at milk production like tear production. We don’t have a supply of tears that eventually runs out after we cry ‘x’ times.

Dr. Evelyn Jain, BA BSc MD, FCFP  FABM speaks about tongue tie management. She and other conference participants share that many parents and health care providers are reluctant to have tongue ties released. Instead of referring to a tongue tie release (frenotomy) as surgery, Dr. Jain suggests using “clip.” In fact, frenotomy is a simple procedure and poses minimal risks. I can’t help but think of how many parents and health care providers enthusiastically circumcise infant boys in our country, but oppose a simple clip to help breastfeeding outcomes. I digress.

Gill Rapley presents the latest Baby-Led Weaning research
Gill Rapley presents the latest Baby-Led Weaning research

There is a slew of inaccurate language surrounding infant feeding beyond breastfeeding. Gill Rapley points out that weaning takes on many definitions. To some, it means the introduction of solid food. To others it means that a child no longer consumes milk. To others, it’s something in between– the gradual process of eliminating milk feeds.

Rapley also mentions that we “introduce solid food” much like we “introduce a catheter” or intubator. That is, we force a foreign object into one’s orifice.

Further, when a child is allowed the opportunity to self wean onto solid food, there doesn’t seem to be an exact moment when s/he is “introduced” to food other than breastmilk. Is it when the child is first allowed to sit at the family table? When s/he first brings food to the mouth? When s/he first ingests the food? Rapley resolves that there is no consensus.

Finally, Rapley brings to our attention that we don’t have cohesive language to describe the coughing and sputtering that children (and adults) sometimes experience while eating. We sometimes say the liquid or food “went down the wrong tube.” Often though, it’s inaccurately called choking. Choking is much different than gagging, coughing, or sputtering.

The following items were not widely discussed in the sessions I attended at the conference.

The language we use to describe infant sleep causes a lot of problems! James McKenna and Thomas McDade write in Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding, “Co-sleeping takes on multiple meanings. Many researchers assume that co-sleeping is a uniform and coherent practice, hence one unsafe co-sleeping arrangement can be thought of as the caricature of all co-sleeping arrangements.”

They go on, “…it is important to begin by introducing a new taxonomy of definitions and insist that they be used.” Amen.

Alice Farrow of Language of Inclusion: Embracing diversity in birth and breastfeeding! questions the term ‘biologically normal’ in Are some parents not biologically normal? I urge you to read the post here.

Lastly, breastfeeding and breast milk feeding are not the same. Dr. Donna Chapman writes about the differences between bottle feeding and direct breastfeeding in New Insights Into the Risk of Feeding Infants by Bottle. In The Unseen Consequences of Pumping Breast Milk, Olivia Campbell also explores the differences between breastfeeding and breast milk feeding. Making these distinctions is not an attempt to further divide families who make different parenting choices. Drawing these distinctions is important so that families are able to make the best possible, informed choice for their baby and their situation.

Please share your thoughts with us. What else would you add to the list?

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