The Opposites Game

Karin chats with Maha Mohammed Al-Madani at the International Conference.
Karin chats with Maha Mohammed Al-Madani at the International Conference.

What’s the opposite of breastfeeding? It’s easy to think of formula feeding as the antithesis of breastfeeding, right? But Karin Cadwell invited 22nd Annual International Breastfeeding Conference participants to explore this question in depth a few weeks ago in Orlando, Fla.

Here’s the game we played at the conference to brush up on our antonym skills: Working in groups, we thought of any word, then the opposite of that word, then a word that started with the last letter of the former word, then the opposite of that word. Get it?

Here’s an example: Hot, Cold, Down, Up. And another example from my group: Left, Right, Table, Chair. This is where I got hung up. Is “chair” really the opposite of “table”? I questioned nearly every antonym our group came up with. I’m certain my teammates were annoyed with me!

Behavior and conceptual framework

The Opposites Game!
The Opposites Game!

When all groups reconvened, we discussed behavioral opposites. What’s the opposite of eating meat? Not eating meat. What’s the opposite of doing vigorous physical activity? Not doing vigorous physical activity. Those seemed fair to me.

Then Karin broke down the reasons behind why people eat or don’t eat meat; why people do or do not do vigorous physical activity. The number one reason why people don’t eat meat is because of animal cruelty. The number one reason why people do eat meat is because they like it.

“The behavior is separate from the conceptual framework,” Karin pointed out.  In other words, people who eat meat don’t do so because they like to kill animals.

Richetin, Conner and Perugini’s research states that “…cognitions about not performing a behavior are not simple opposites of cognitions about performing the same behavior because they rely on separate goals.”  

Next, Karin invited us to think about the reasons why women choose to breastfeed and why women choose to formula feed.

The top three reasons women choose to breastfeed are: for their baby’s health, because it is natural, and to bond with their baby.

Women choose to formula feed because of their perception of the father’s attitude regarding infant feeding, concerns over the quantity of milk they will produce, and the perception that they will be able to return to work sooner than if they were to breastfeed.

With Richetin’s research in mind, the opposite of breastfeeding is not formula feeding. Rather, the opposite of breastfeeding is not breastfeeding, or not feeding the baby, and that’s not an option, so formula becomes the most accessible alternative.

In The impact of attitudes on infant feeding decisions, Mary E. Losch, et al point out that, in the profiles of women who decided not to breastfeed, one of the most consistent findings was that “women who decide to formula feed are not so much embracing this method of infant feeding as rejecting breastfeeding.”

Sales or customer service?

Karin posed another question to the roomful of breastfeeding advocates. Are we acting as sales reps or customer service reps?

She suggested we leave sales up to the formula companies and focus on individualized maternal care. Forget about being breastfeeding-centered; the support we offer must be woman-centered, she said.   

In fact, Karin mentioned that it takes less time to give quality woman-centered care than a one-size-fits-all approach. When lactation professionals provide woman-centered services, we are dealing specifically with the woman’s own concerns instead of going through a premeditated spiel, checking the boxes off of a list.

Similarly, while prenatal breastfeeding education has been shown to increase mothers’ breastfeeding success, Karin challenged us to provide prenatal support rather than prenatal education.

I thought back to my prenatal breastfeeding education options when I was pregnant with my first baby. My choices were an eight hour Saturday class or a four week series. Karin described the type of information typically divulged in prenatal breastfeeding classes: the advantages of breastfeeding and the “ooey-gooey” stuff like mastitis, plugged ducts and engorgement. Yikes. While trying to be comprehensive, what kind of message are we sending? What about the valuable time we are wasting?

“At 2 a.m., moms aren’t thinking, This is the healthiest for my baby. They are thinking, Who is going to help me?!” Karin explains.

Even if we as a nation fall short of our goals, there’s no doubt most moms want to breastfeed.

“We don’t ask women if they want to deliver their placenta. Why are we asking about breastfeeding?” Linda Smith commented at the conference.

She suggested we approach new mothers with something like: “Your milk is going to come in; how do you want me to help you with that?”

Results of our belief in opposites

There has been damaging backlash as a result of our implicit belief in opposites: The case against breastfeeding, Lactivism, Bottled Up, Guilt-free bottle feeding, Is breast best? Karin named a few.

There’s also No Nursery, No Formula, No Pacifier: Are “baby-friendly” hospitals unfriendly to new mothers?, Is the Baby Friendly Hospital Initiative really the Baby Deadly Hospital Initiative, and Surviving the “baby friendly” hospital: Tips for those planning to formula feed.

1f7c8f61-77ee-4283-adde-12ae73efdd11A conference participant suggested that, with this notion of opposites at play, that all hospitals not designated “Baby-Friendly” must be “Baby-Unfriendly.” She went on to explain that in her community, many believe that Baby-Friendly Hospitals must not be friendly to formula-feeding families. She shared that this is not the case at the hospital where she practices; they support mothers’ choices.

Judging by the previous titles shared, there is a gigantic misunderstanding of what the Baby-Friendly Hospital Initiative stands for.

BFHI USA’s website states: “The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding (i) and the International Code of Marketing of Breast-milk Substitutes (ii). The BFHI assists hospitals in giving all mothers the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.” (bold text added)

But as Healthy Children’s Cindy Turner-Maffei points out in Is any progress good progress?: “Practice in health care settings does not always mirror written policy. What administrators and staff believe is happening does not always mirror the experiences reported by mothers…”

During our continued opposites discussion, another participant commented, “Breastfeeding is so hard that we need experts to help us do it. No one is certified as formula feeding consultants.”

But a 2009 revision to BFHI requires mothers show that they know how to safely prepare formula for their babies. Formula feeding can be tricky. Breastfeeding can be tricky. Implementing policies that influence the health and well-being of all babies regardless of their feeding method may help close the divide that we often perceive between breastfeeding and formula feeding.

Consider this

Other important questions that resulted from Karin’s presentation were: Do formula companies benefit from our implicit belief in opposites? Do they want consumers and lactation providers alike to believe that formula feeding is the opposite of breastfeeding?

Also, if Karin is suggesting that we leave the sales business behind and focus solely on providing mother-centered, customer service, how can we combat formula companies’ marketing strategies?

How can we navigate the fine line between denouncing formula marketing while still supporting families who formula feed? (To start, check out Best for Babes’ article We Support Formula-Feeding Moms AND We Fight Formula Marketing.)

In this Leadership Pittsburgh presentation about “Milk Money,” Todd Wolynn proclaims, “Economics dismantled us as a species.” He’s referring to formula companies.

The Analytical Armadillo writes in Stick Your “Mummy Wars” Advert Up Your…..:

“The news can report that formula cans are overloaded with aluminium at unsafe levels for babies, or that the excessive iron in follow on milk (only ever invented to get around the marketing restrictions of first milk) is linked to developmental delays.  Yet loyal users still believe the formula companies give an actual damn about anything but billions in profit. This ‘faux empathy’ is sucked up and in turn it builds a trust between supplier and customer, and further increases the divide between parents – who by now all believe the ‘mummy wars” exist.’”


Formula companies do phenomenal work profiting off of our inherent belief in opposites! Formula companies do phenomenal work pitting us against each other in the sneakiest fashion. We have the power to dismantle them.

Breastfeeding promotion during soap operas

I used to watch General Hospital with my mom when I came home from morning kindergarten back in 1994. Even though I was started on the show at such a young age, I can’t say I’m an enduring fan. To be completely honest, I think soaps are obnoxious. That was until I learned that GH recently aired a positive storyline about nursing in public! You can watch a short clip here. And another one here.

Hardcore GH fan and Healthy Children faculty Donna Walls exclaims: “My dreams have all come true. So proud to be a General Hospital fan!”

Healthy Children’s Elyse Blair, also a hardcore GH fan, exclaims, “I loved that GH brought breastfeeding to the forefront!”

Walls describes the scene when GH character Olivia “was about to nurse [in public] and the mayor pitched a fit and had her arrested.”

The episode continues with “a lively conversation” about breastfeeding being legal and how important it is for mothers to be able to breastfeed whenever their babies need to, Walls goes on.

While at the police station, Olivia’s baby cues that he needs to nurse, so she demands that the officer help her because she is handcuffed. Ultimately, the baby begins to breastfeed (although covered) and Olivia’s lawyer takes a picture of them. Lovely! Of course, the scene would have been even more wonderful if the baby hadn’t been covered with a blanket.

Blair comments that the NIP situation was “very realistic.”

“Unfortunately, this occurs all too often,” she comments on the discrimination of mothers NIP. She also points out one great example of support for mothers discriminated against: Jill Miller’s The Milk Truck.

The use of soap operas to promote breastfeeding is not a new idea. Healthy Children’s Cindy Turner-Maffei points out that “promotional pieces during soap operas was part of Brazil’s breastfeeding campaign in the 1980s.”

Through its National Breastfeeding Promotion Program launched in 1980, Brazil increased the median length of breastfeeding from 2.5 to 10 months over a period of 25 years.

The second phase (1982-83) of Brazil’s National Breastfeeding Promotion Program included a popular soap opera that aired “pro-breastfeeding messages and celebrities appeared in TV PSAs in further attempts to reach the intended audience.” [Retrieved from: Updating the USDA National Breastfeeding Campaign: Workshop Summary]

Commercials with breastfeeding content were then added, Turner-Maffei continues.

The book Nutrition and an Active Life: From Knowledge to Action includes more information about Brazil’s 1980s breastfeeding campaign.

Brazil continues to feature pro-breastfeeding and pro-human milk messages on soap operas.

For example, a 2014 article, Brazil’s Maternal Milk Banks A Global Model, reports that “public awareness campaigns feature the stars of prime-time soap operas urging new mothers to give milk.”

Back in America, Walls reports that there’s more breastfeeding to come on GH.

“The magazine owner (Nina) got an idea to write an article about nursing in public,” she says.
Brazil as our model, soap operas seem to be an effective avenue to promote breastfeeding and human milk. Although the National Breastfeeding Promotion Program took over two decades to see significant progress in breastfeeding duration rates, imagine the impact strong women breastfeeding on television (and breastfeeding support) might make for all of the kindergarteners coming home to watch soaps with their moms!

Thank you for a wonderful conference!

A couple of weeks ago, I had the privilege of attending the 22nd Annual International Breastfeeding Conference. Every year I participate, I come home with a profuse amount of information and insight to digest. I take pages and pages of notes, and it usually takes me quite a while to process them into something coherent to share on the blog. This year isn’t any different in that regard. This year though, I have a newfound appreciation and respect for the conference organizers, participants and presenters.1f7c8f61-77ee-4283-adde-12ae73efdd11

I’ll start here: I arrived at the conference Wednesday morning, groggy and morning sick. Those unpleasant feelings immediately disappeared when I was greeted by the amazing Healthy Children faculty with smiles and big bear hugs. Nikki Lee writes on her Facebook page Nikki Lee Health: “I’ve been going to every International Conference since the first one in 1995; that’s one reason it is my favorite breastfeeding conference because I always feel as though I am returning home.” Exactly my feelings! While I’ve only been attending for three years, I still feel like I am returning home.

Former Milk Duck Queens Sheri Garner and Nikki Lee crown the 2016 Milk Duck Queen Cathy Holland.
Former Milk Duck Queens Sheri Garner and Nikki Lee crown the 2016 Milk Duck Queen Cathy Holland.

When you’re home, someone is always looking out for you. The dearest Cathy Holland offered me fresh ginger each morning of the conference to combat my early pregnancy queasiness. Then, when Cathy’s workshop filled before I could find a seat, one of my fellow participants scrambled to get me a chair, and another insisted I take hers. Another day, I watched Karin Cadwell gently help a presenter place an ice pack on her neck to combat a headache. These little things matter.

Dr. Cristiano Boccolini
Dr. Cristiano Boccolini

During one of his presentations, Dr. Cristiano Boccolini showed a set of satirical graphics that illustrated the perseverance and hard-work it requires to do and present research. I am so grateful for the presenters’ generosity in sharing their work with us. The work of maternal child health advocates is a labor of love; they do it to elicit positive change, to save lives and to influence our quality of life.

This year, the generosity and kindness of the conference participants was confirmed by a record sale of famous milk ducks. The milk ducks raced for their friends, the Lucky Iron Fish to fight anemia. By Thursday morning the ducks were sold out, a first in milk duck history.  Conference-goers raised enough money to purchase over 107 Lucky Iron Fish, enough for an entire village!

On my way back to my hotel one evening after the conference, my taxi driver informed me of another conference being held down the road from the Breastfeeding Conference. He told me that the people he had driven from that conference seemed miserable, and they told him that they hated attending every year. How sorry I felt for those conference-goers! I feel so lucky and proud to have the opportunity to network with such a brilliant group of maternal child health advocates. Thank you all for making the 22nd Annual International Breastfeeding Conference such a special experience.

New baby, new concerns

When I was pregnant with Iris, I was so confident about becoming a mother of two. I was proud of the way I had parented Willow and figured I would be an expert the second time around. In some aspects, I was, like nursing for instance. That came really easy. But the majority of the other time, I felt like I was completely losing my mind.

Friends told me: “One to two is the hardest. Two to three is a piece of cake.”

“Ha! Three, I thought. That’ll be the day…”

And that day will be sometime this July when we welcome a third little hooligan into our family. It seems I have completely lost my mind.

This time, I’m unconfident about virtually every aspect of parenting a third child. Oddly, even with 5 years prior experience, I find myself most anxious about nursing again.

Unlike when I anticipated breastfeeding my firstborn, I’m not worried that I won’t produce enough milk. I know enough now to trust my body. I’m not worried that my baby won’t latch. I know enough now to trust my baby.

Instead, I’m concerned about developing nursing aversion as I did with both of my daughters. (Our weaning and burnout stories here and here.) I’d love for my breastfeeding relationship with this baby to be pleasant enough for me to allow child-led weaning like I wished I could have done with my daughters. Even more, I’m worried that the aversion will onset before an “appropriate” time to wean. By appropriate, I mean the standard I’ve held myself to to nurse my children until at least two years old as recommended by the World Health Organization.

When Willow overheard me express my concern, she reassured me: “It’s OK Mom, we can give the baby chocolate milk instead.” At least I have options.

I have options when it comes to nursing in public too. The thing is, I’m not actually worried about nursing in public. I’m worried that if someone were to discriminate against me for feeding my child, I would respond so ferociously that I’d be setting a terrible example for my children and fellow breastfeeding moms.

Quite honestly, Willow and Iris might not even be in sight when this hypothetical, discriminatory situation occurs. Mostly likely, they’ll be scurrying through grocery store aisles on their own agenda, leaving me to panic. How do mothers wrangle multiple, mobile children while NIP?! I’ve never been fond of child leashes but come July, I just might be in the market for a couple.

Finally, I’m concerned about how I’ll make time for my husband when the new baby comes. When Willow was born, I was so occupied with being a new mom that I completely forgot that I had a husband who needed me to nourish our relationship too. It wasn’t any different when Iris was born. With a third on the way, I don’t anticipate Addison and I finding much free time to spend watching House Hunters and gazing into eachother’s eyes.
All of my concerns considered, I should mention that I’m thrilled to be growing our family. It’s just that, we mothers, we never stop worrying, do we?

Energy medicine and breastfeeding

unnamed-1It’s been just over a year since I first spoke with Cathy Holland, RN, BS, IBCLC, FACCE about her 2015 International Breastfeeding Conference presentation on Emotional Freedom Technique (EFT) for Our Milky Way.

The first time we spoke was also the first time I had ever heard about EFT. Admittedly I was initially skeptical about its effectiveness, and as someone who identifies as a “Crunchy Skeptic,” I almost immediately wrote it off as pseudoscience. But the more I spoke with Cathy, the more intrigued I became.

I was excited to participate in her presentation, but found myself in the back of the room, nursing my sick tot. While tending to Iris, I observed Cathy guide a roomful of well over 50 participants experience EFT, most for the first time.  

The energy in the room changed within only a few minutes; tense and restless to calm and engaged. It was as if the room precipitously and collectively exhaled. Incredible!

I don’t expect anything less from Cathy’s upcoming International Breastfeeding Conference presentation Breastfeeding and Energy Medicine: A Brief Introduction.

Energy medicine has been around for far longer than medical doctors.

“There were homeopathic doctors, acupuncturists and countless healers of all kinds,” Cathy says. “When I was in nursing school, we were taught that everyone from the Osteopath through the Chiropractor were quacks, just like witch doctors and medicine men/women throughout history.”

Cathy shares this quote from Plato: “Strange times are these in which we live when old and young are taught in falsehood’s school. And the person that dares to tell the truth is called at once a lunatic and fool.” (I’m reminded that our planet was once flat.)

While alternative medicine has been criticized for lacking supportive evidence, Nikki Lee, RN, MS, IBCLC, CCE, CIMI, ANLC, CST points out in Complementary and Alternative Medicine (CAM) in Breastfeeding Therapy that this is no longer true.

“Evidence-based healthcare is defined in the Cochrane Collaborative’s online course, Understanding Evidence-Based Healthcare: A Foundation for Action as ‘the integration of best research evidence with clinical expertise and patient values’ (Dickersin & Mayer, 2009),” Lee writes. “According to this definition, CAM is evidence-based healthcare.” [Read more here: ]

Further, The Association for Comprehensive Energy Psychology states that “Energy psychology (EP) modalities have been researched by more than 100 investigators in at least 7 countries. As of 2014, over 60 research studies have been published on EP modalities; out of these only one has not shown efficacy.”

“Things like essential oils, epigenetics, craniosacral therapy, osteopathy, homeopathy, EFT, music therapy, exercise, yoga, Feldenkrais, Bowen work, Lymph Drainage, Reiki, Therapeutic Touch, etc. all are valid modalities that help as many as, or more than standard American style medical treatment,” Cathy explains.

Actually, she says that most physicians intuitively do some sort of energy medicine after performing procedures; a soothing with their hands for example.  

Energy medicine isn’t limited to trained professionals. Cathy points out that we are all energy medicine practitioners, and we’ve all performed energy medicine intuitively.

What do you do when you get a bump, a bruise, or some other sort of injury? she asks. Immediately put your hand on the site of the injury, she replies.

“This is a natural…self healing response.”  

Donna Eden and David Feinstein write in Energy Medicine: “Your body is designed to heal itself.  The ability of the body to maintain its health and overcome illness is, in fact, among nature’s most remarkable feats.  But, you’ve been placed in a world that systematically interferes with this natural capacity, and your conscious involvement in your health is required if you are truly to prosper.” (p. 17)                                             

When we last spoke, Cathy shared her best story about energy medicine and breastfeeding. A mother struggling with mastitis for seven months had tried everything she knew to do holistically and within the traditional medical model. (Mind you, Cathy reports this was not a crisis case of mastitis.)

Almost at a loss, Cathy asked the mother to have her two year old put her “healing hands” over the troublesome spot on her breast.

A few days later, the mother called back laughing and reported that the mastitis had healed and did not return.

Everybody has those healing hands and everybody can do it,” Cathy says. “I want people to wake up to their own innate powers.”

Many of the puzzling challenges new mothers encounter, including infant feeding challenges, can easily be resolved with simple, non-invasive energy medicine applications, Cathy explains.

Not only can breastfeeding challenges be treated with energy medicine, breastfeeding itself is energy medicine.

Breastfeeding is an all-around sensory experience where babies and mothers use all of their senses.

Babies themselves epitomize energy medicine, because “they’ll do everything they need to do to help themselves,” Cathy says.

Yet, so many of us still think of babies as helpless beings. (Of course, they aren’t.)

The same holds true regarding our culture’s general consensus of mothers’ abilities. Women are often made to believe that we are dependent on medical professionals to do birth to us, and after, we’re reliant on lactation professionals to show us how to feed our babies. I am not undermining the work of lactation professionals, certainly not. In this climate, lactation professionals are of utmost importance; however like our babies, mothers can help ourselves too.

The mother is the world in which the baby lives; accordingly, “if momma ain’t happy, ain’t nobody happy.”

Lyn Milum, blogger at Energy Medicine for Life, has a three part series called Breastfeeding Your Baby which details how energy medicine support can influence mothers’ and babies’ well-being and happiness.

During her upcoming presentation, Cathy will further share her knowledge and experience on how to create balance and ease and make the motherhood journey one of joy and peace.

If conference participants would like a copy of Cathy’s Powerpoint presentation, please send your request to
Register for the International Breastfeeding Conference here. It starts this week!