We are many professionals who sit every day in a primary care consultation with our white coat to try to offer mothers our knowledge and our advice to give their children what is considered best for them and their health and many those who are trained and informed so that our knowledge is up to date and consistent with what science has demonstrated (or is demonstrating at that particular moment).
But nevertheless There are many professionals who also sit with their white coats to give advice that was valid in their day but has now become outdated, colliding on many occasions with the knowledge of many mothers, more up-to-date than those of these professionals.
In such cases there is not much problem, because these mothers and fathers who surf the Internet and who read and study books that sometimes even the professionals themselves read can hardly be convinced to follow a contradictory advice, however there are many other mothers who fully trust the professional in front of them and who may be harmed if they heed the advice offered to them and for that reason, when we see that something is very out of place, we should do something.
This is what Mar has done, a mom who made a month ago contacted me to explain what had happened to her and wondering what my opinion was about it.
As he explained to me, in the four-month review the nurse who attended him He recommended that she start giving him fruits and juices. Given this she told him that she wanted to continue breastfeeding until six months exclusively, as recommended, and the nurse said yes, that breast milk is the best, but that you have to give them fruit to grow and to provide them with the nutrients they need.
He also told him that he would have trouble giving him cereals because "of course, if you have never given him a bottle", but the same nurse offered him the solution of mixing them with the fruit.
Asking about the breast milk shots he made, Mar told him he was giving demand, to which the nurse asked: "On demand but never before two hours, right?"
Before this and other questions, this mother decided to stop arguing in her favor and listen to what the nurse was saying while observing that on the shelves of the consultation there were samples of artificial milk in sight of any mother (something that, as we have said on other occasions, is illegal).
All this made him consider file a complaint with the center, not for her anymore, that she was very clear about how she would act, but for all those mothers who will come after her and that after four months they will begin to give fruit, cereals in bottles and tit on demand but never before two hours .
Mar's claim
When he had it written, Mar sent me the claim to read it, in case something had to be added, and he did the same with the lactation consultant with whom he has more confidence, Nohemí of the Mimos and Teta blog.
How I liked the writing and how I think it could serve other mothers who are in a similar situation I leave the claim below, with the permission of Mar (references to the nurse and the health center have been omitted):
On Wednesday, July 27, 2011 I went to an appointment with the pediatric nurse xxxx in the xxxx consultation of the xxxx Health Center, for the visit of the four months and vaccination of my son. I appreciate the professional work of all health personnel, I appreciate the good treatment of the health center staff and their effort to serve us as well as possible and ensure the health of our children. As recommended by the main health authorities such as WHO, AAP, AEPED, UNICEF and the Government of our Autonomous Community from their infant feeding program, the ideal is to feed the newborn with breast milk: “Exclusive breastfeeding is the ideal food during the first 6 months of life and should be continued until twelve months of age, while introducing complementary feeding. Subsequently, it should be extended as long as the mother and child wish (recommendation A) ”. Therefore, at each visit, exclusive breastfeeding should be encouraged for the first six months of life, and breastfeeding should be on demand, this means whenever the child wants, without schedules. Throughout the successive visits to the nurse I have been checking that she does not follow these recommendations, since she recommends breastfeeding every three hours, giving her water from two months (breast milk contains the water she needs), at four months He tells me to start with the gluten-free fruit and cereals to give him the nutrients he needs. At no time have I been supported by my decision to exclusively breastfeed until six months, nor have I seen that it encourages breastfeeding. Also during the visit I could see that on a shelf there were commercial samples of artificial milk. There are two regulations * (1,2) that prohibit the distribution of artificial milk samples in health centers, especially starter milks. I feel that all this can affect other mothers who want to breastfeed but do not receive the indications or adequate support from the professionals in whom they place all their trust. The midwife of the center does a great job promoting exclusive breastfeeding on demand during the first six months and informing about all its benefits from maternal education classes for pregnant women, it is a pity that all her work is of no use if when you arrive with Your baby at the nurse's office tells you that you should give her every three hours, give her water and start with the complementary feeding at four months. I hope that they take the necessary measures so that all their staff is updated on the recommendations of the health authorities: WHO, AAP, AEPED, UNICEF and the Government of the Canary Islands and promote breastfeeding. Say hello carefully:
Article 6.2 of the International Code: "No installation of a health care system should be used for the promotion of preparations for infants or other products included in the provisions of this Code ...".
The distribution of free samples, coupons or promotional brochures by formula manufacturers is prohibited by that code and subsequent resolutions of the World Health Assembly.
The International Code aims to eliminate all commercial pressure in favor of the infant formula and protect pregnant women and recent mothers against the distribution of biased information.
- (2) · Royal Decree 72/1998, of January 23 (BOE February 4, 1998, No. 30/1998 p. 3772).
This Royal Decree establishes that:
Article 6. Advertising.
1. The advertising of infant formulas shall be limited to publications specialized in childcare and scientific publications.
2. The announcements of infant formulas shall comply with the conditions set out in sections 3.2; 4.c; 4.1; 4.2, 4.3 and 6.b of Article 5 and shall contain only objective information of a scientific nature.
Such information should not imply or make people believe that bottle feeding is equivalent or superior to breastfeeding.
3. Advertising is prohibited in the places of sale, distribution of samples or the use of any other means of propaganda, aimed at promoting sales of infant formula directly to the consumer in retail establishments, such as special exhibitions, discount coupons , bonuses, special sales, promotional sales or coupled sales.
4. Manufacturers or distributors of infant formulas are prohibited from providing pregnant women, mothers or members of their families to the general public, products below the cost price or by symbolic price, samples or any other promotional gift , either directly or indirectly through health services or health personnel.
Article 7. Information.
1. Health Administrations shall ensure that information on feeding infants and young children in planning, provision, conception and dissemination of information, as well as control, is provided to families and people related to the nutrition of The same, be objective and consistent.
2. Health Administrations shall ensure that informational and educational material, written or audiovisual, related to the feeding of infants and intended for pregnant women and mothers of infants and young children, includes clear information on the following points :
- Advantages and superiority of breastfeeding.
- Maternal nutrition and how to prepare for and continue breastfeeding.
- Possible negative effect of partial bottle feeding on breastfeeding.
- Difficulty of rectifying the decision not to breastfeed.
- Where appropriate, the proper use of infant formula, whether industrially manufactured or homemade.
When these materials contain information on the use of infant formulas, they will include the social and financial consequences of their use; health risks arising from improper foods or feeding methods and, in particular, health risks arising from the inappropriate use of infant formula. Such materials will not use any image that can idealize the use of infant formula.
The preparations mentioned indicate that the advertising of infant formulas:
- (Must contain) an indication concerning the superiority of breastfeeding and the recommendation that the product should be used only by advice of independent persons qualified in medicine, nutrition or pharmacy, or other professionals responsible for maternal and child care, preceded by the mention "Important notice" or other equivalent. (art.5. 4. c)
- No images of children or other illustrations or texts that can idealize the use of the product will be included. (art. 5. 4. 3rd)
And here ends the claim of this mother. You know, if you ever feel bad or if you think they are not offering correct information, ask for it. It is the logical way to express our discontent with something and the way it is taken into account by those responsible for the center, as they read the claims and respond to them and also must record the claims received in the center's report.
