The Voldemort effect

(Photo: Ralph Fiennes as Lord Voldemort, aka ‘He Who Shall Not Be Named)

‘’The scientific world is that part of human society that has as sharply defined goal to systematically gather knowledge. Science has an own character, which are shown in her methods and convetions. The thus developed scientific knowledge forms a specific reconstruction of a part of reality and is built with the aid of certain scientific methods. […] Science is the organized knowledge of reality. Her ideal is objectivity and universal validity. An ongoing intention to test opinions and hypotheses onto science.’’ (Wikipedia, Dutch) In the scientific world the use of Wikipedia as source is deemed a unscientific way of working. The scientific world, of course, is a real different world, with own laws and rules and, contradiction in terminis, only those who embrace the principle may ignore them. Especially two principles apply to this: objectivity and starting from the norm. A scientist who is going to study anything will start from the norm and from there does some experimenting, adds interventions or influences. the study outcomes are qualitative or quantitative positives or negatives compared to the norm, the normative basis, the null-value. In some scientific niches, for reasons not scientifically researched yet, but may very well have working hypotheses in the ‘’follow the money’’-range, it seems to be rather systematical to not be based on the norm. One of those niches is infant feeding. Based upon medical-scientific, anthropological-scientific and biological-scientific the norm in infant feeding ought to be breastfeeding. Study questions to be answered could have forms like ‘’What is the influence of {breastfeeding substitute} on the normal development of children?’’. Smith & Elliott-Rudde describe a phenomenon that they named the Voldemort Effect. The ‘’F-word’’ (not the one-syllable one) is as ‘He Who Shall Not Be Named’ as the devilish wizard in the popular book and film series Harry Potter. The majority of infant feeding research does not start with breastfeeding as norm and they rarely name the substitute, which they do take as the norm, as an exposure increasing health risk in publication titles or abstracts.
http://nl.wikipedia.org/wiki/Wetenschap
Smith JP, Dunstone MD, Elliott-Rudder ME:  ‘Voldemort’ and health professional knowledge of breastfeeding – do journal titles and abstracts accurately convey findings on differential health outcomes for formula fed infants? ACERH Working Paper Number 4, 2008

Newsflash becomes *flash

More than half a year I wrote a Newsflash nearly every office day.  Scientific news en combinations of studies as basis for a daily serving of breastfeeding science. But I’ve noticed that I’ve kind of had it with science: bit by bit instead of scientific news my writings conversed into little articles with an opinion. What is my problem with science? Don’t I want to practice evidence based? To have evidence based breastfeeding support and advice? Well, yes, I guess, but above all I want breastfeeding support to be given by engaged and compassionate health care persons who use their own logical thinking skills and who care for the well-being of their clients. And even more I do not want to keep on defending and proving breastfeeding. Breastfeeding is. Period. Just let the alternatives and interventions prove themselves; just prove to me that the alternatives and interventions are safe, effective and necessary. To introduce and illustrate the new course of the Flashes two short entries from my blog Lactavision.
‘’Breastfeeding - an inborn ability for nearly every woman, but a skill to be learned. Our modern society is very skilled in blocking natural abilities and preventing them from becoming skills. Instinct, reflexes, trust in the own body - all disposed of or put away in a little corner called ''alternative-strange-possibly dangerous''. Breastfeeding: an inborn ability – a cultuarally disgarded skill.’’
‘’ OK, I admit: I’m a huge Twilight fan. Twilight could be described as a romantic-horror genre. Horror, because it is all about vampires, werewolves, but above that, it is about love, unconditional love. The lover that makes you go through fire, makes you sacrifice yourself for the other’s well-being. And about compassion, love for your fellow-humans. In these books and the movies this compassion is personified by a vampire (Dr Carlisle Cullen), who trained himself to be able to stand the smell of blood in order to be able to help people as a physician. He puts himself above his intrinsic impulses and instinct to be good and do good. This is the kind of compassion I would so love to see in more health care providers: the care for your patients/clients without the prevalence of your own agenda. The bloodlust some HCP’s may have to overcome could be own previous experiences, learned concepts or whispered-in concepts from third parties with even more pushing agenda’s.’’

Many health care people are around who, in my not very humble opinion, could use some of the actor Peter Facinelli’s skills to switch from the egotripping, brawling prat dr. Fitch Cooper (Nurse Jackie) into the empathic, compassionate dr Carlisle Cullen (Twilight Saga).

Science and practice

Gonzalez et al analyzed all issues in one year of every five years since The Journal of Human Lactation, the peer-reviewed journal of the International Lactation Consultants Association, first issued in 1985. An important finding was that were in the early years articles mainly consisted of those targeting the Lactation Consultant Practice, through the years focus more and more was put on scientific articles. According to the researcher this shows that lactation Consulting has evolved into a more medical profession, which improves its credibility as a new healthcare profession. But is medicalization of breastfeeding something worthy striving for? And does medicalization lead to better breastfeeding numbers, as in more mothers and babies enjoying breastfeeding for longer durations? No, knowing that another 10-syllable ingredient of human milk has been identified doesn’t make more mothers start breastfeeding, nor more babies being breastfed for the recommended time. Studies around the experience of breastfeeding and reasons for early discontinuation for decennia have shown similar outcomes: mothers do not need more scientific evidence, nor more pushing and promoting to start breastfeeding (most moms want to breastfeed anyway). What they do need is support, help and encouragement. Brand et al compared 2 groups of early postpartum mothers with problematic breastfeeding. The mothers who continued breastfeeding despite problems were those who felt to have a support system, professional and/or lay. Hegney c.s. concluded similarly. they found in both their cohorts that women started out with idealistic expectations. Those who continued breastfeeding despite problems were women who felt they had a health care professional they could trust on breastfeeding matters and had a social network with peers to exchange experiences. They also found that mothers who did not continue felt alone and had feelings of guilt and inadequacy. Mothers and babies need health care professionals who can empathize with them, have a solid knowledge of basic breastfeeding physiology and normal infant and toddler behavior.  They do  ot need HCPs who can reproduce all hundreds of ingredients of human milk.
Gonzalez PA: The Development of Professional Healthcare Support for Breastfeeding: A Content Analysis of the Journal of Human Lactation. Poster Presentation. University of South Florida, 2011
Brand E, Kothari C, Stark MA: Factors Related to Breastfeeding Discontinuation Between Hospital Discharge and 2 Weeks Postpartum. Journal of Perinatal Education, 2011 , 20(1):36-44(9)
Hegney, D., Fallon, T. and O’Brien, M. L. (2008), Against all odds: a retrospective case-controlled study of women who experienced extraordinary breastfeeding problems. Journal of Clinical Nursing, 17: 1182–1192.