‘Words have energy and power’: exploring language in infant feeding and perinatal health Part Two

This week, we continue our examination of the language used around infant feeding and perinatal health. You can read Part One here

Photo by Anna Shvets: https://www.pexels.com/photo/tattooed-mother-breastfeeding-her-baby-3845191/

Advantages of health versus the disadvantages of risky behavior  

The infant formula shortage in the United States pushed conversations about the cost (monetary and otherwise) of infant feeding to the headlines. One article claimed the “many, many costs of breastfeeding” which can be very real for parents living in a country that values profit over human and planetary health. But we must also consider the cost of not breastfeeding which shifts responsibility from individuals to systems. Max Ramirez of IBFAN & MOH Panama has said that “Talking about the advantages of breastfeeding versus the risks of not breastfeeding is like talking about the advantages of breathing instead of the consequences of smoking.”


Language and evolving marketing tactics  

When the International Code of Marketing of Breast-milk Substitutes and some of its subsequent resolutions came about, social media and digital marketing did not exist. 

The latest Marketing of breastmilk substitutes National implementation of the International Code Status report shows that “of the 144 countries with legal measures on the Code, only 37 explicitly mention promotion of BMS on the internet, digital channels or other electronic means.” 

However, it also points out that “for many types of promotion, including advertising, retail sales devices, and direct contact with mothers, explicit mention of digital channels may be unnecessary as they are already covered by more general language” in legislation. (p. vii)  

WHA Guidance from 2016 requires the full prohibition of donations of informational and educational materials by industry, a clarification from the 1981 Code text which allowed for donation of materials if requested by the government. Similarly, the Guidance calls for a complete ban on gifts or incentives for health workers, while the 1981 Code language prohibits gifts only if they can be shown to be financial or material inducements to promote products. (p. 18)

Alejandro Morlachetti, Regional Legal Advisor, Human Rights at PAHO/WHO explains that States can be held accountable under the International Covenant on Economic, Social and Cultural Rights in the context of business for how they regulate companies. 

Morlachetti says that the industry tries to evade these obligations with claims about limits on freedom of speech and access to information but “bans on advertising and promotion does not interfere with the economic activity of buying, producing and selling products, restriction on advertising cannot be compared with freedom of speech… [and] the protection and promotion of health is far more compelling than the industry’s claim to commercial speech freedom.” [https://www.paho.org/sites/default/files/presentation-human-rights-amorlachetti.pdf]  

During a USBC session on breastmilk substitute (BMS) industry marketing, one participant questioned: “When will the WHO actualize its language to human milk and include other parents who feed human milk that are not mothers?” 

Infant and Young Child Feeding Consultant for the World Health Organization (WHO) Nina Chad, PhD responded “Advertisers promote their products to consumers that are defined by large social media companies and the language that best describes this behaviour. In this case advertisers targeted women and mothers to the exclusion of other parents.” 

The United Nations (UN) issued  Guidelines to help United Nations staff to use gender-inclusive language in any type of communication — oral or written, formal or informal, or addressed to an internal or external audience in the six languages of the Organization. Their Toolbox contains training materials on the practical application of the Guidelines, information on related training courses and other relevant resources. [Find those resources here.] 


Shaking negativity, embracing relationships and fun 

Much of our language in maternal infant health evokes negativity: failure to thrive, failure to progress, cervical incompetence, etc.

Photo by Icaro Mendes: https://www.pexels.com/photo/mother-breastfeeding-her-baby-4226827/

In Fitting Flanges for Pumping: Rethinking Sizes and Materials, Jeanette Mesite Frem, MHS, IBCLC, RLC, CCE, CD suggests we do away with the term “lazy boob” and instead shift focus to the “bonus boob”. One participant shared that they call the “bonus boob” dessert. 

“It’s always fun to start with dessert,” they offered. 

Mesite Frem also talked about replacing the word “let down” to something like “release”. 

More generally, in many spaces, breastfeeding has been reduced to a latch and how much milk is being produced. We’ve situated the lens obsessively on how the baby latches, forgetting that breastfeeding is so much more. 

In Implications of mother baby separation: Reflections from Nikki Lee, Lee explains, “It’s not about shoving a breast in baby’s mouth. The baby has to take the breast in. Mamma sets the table; the baby has to pick up the fork.”

She goes on to explore breastfeeding as a relationship.

“Another part of the problem stems from the way many lactation and medical professionals talk about infant feeding patterns, as if babies are some bizarre species with an unusual way of eating. The way an infant feeds is the same as the way adults eat. Adults take sips of water throughout the day, enjoy occasional snacks, eat light meals, and indulge in big feasts. In addition, babies breastfeed for medicine, pain-relief, fun, comfort, and an all-encompassing and pleasurable sensory experience; these are all reasons that adults eat too.

Lee offers yet another way to think about breastfeeding; she equates it to kissing your lover.  

She asks “You’d never say ‘Go away, I already kissed you twice an hour ago’ to your lover, would you?”

Photo by Subham Majumder: https://www.pexels.com/photo/toddler-in-pink-and-white-polka-dot-shirt-3614116/

For a baby who has been fed continually for nine months in the womb, who has to double its size in three or four months and whose stomach starts out the size of a marble, breastfeeding needs to be unlimited, especially at the beginning. Yet our culture does not recognize, respect nor support that relationship.

We can survive without kissing, much like we can survive without breastfeeding, but what does life look like without kissing? What does life look like without breastfeeding? What does life look like without falling in love? How happy– and can we be– without that sweetness?” Lee wonders.

Villaluna shared final thoughts in Decolonizing Language: Exploring Intent and Impact  wondering, “Where is the fun?!” 

Villaluna emphasized the importance of helping shape first food imagery to include older children as well as newborns and younger infants; celebrating nursing experiences like when Villaluna and toddler nursed in their milk and cookies Halloween costume

More OMW coverage on language in perinatal care http://www.ourmilkyway.org/considering-evolving-language-in-perinatal-care-and-beyond/ 



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