Recently I had an exchange with a lactation consultant colleague about a training she will shortly follow. She reported to me that she had felt really awful about what she had been reading while preparing for that training. She had the feeling that the interest of the baby was fully inferior to the interest of the adults. This is in line with the Adult Supremacy concept we have written extensively about here before. I would like to give an impression of what we discussed.
C(ollegue): I just read the literature for a webinar I will follow and in which all sorts of things made me raise my eyebrows. It was about a particular problem in the breastfeeding relationship, and what I was very concerned about with most of the topics dealt with was: ‘Who has the problem and who has to adapt here: the adult/parents, or the child? How do we view this in our culture? Who is able and responsible to approach a problem with empathy – the newborn or young child, or the adult?’ Another question that arose is: ‘Is it ethical to force children into something that is not developmentally included in their evolutionary nature, their biological blueprint, and which is mainly focused on serving the adult interest? Are you not sending the message to the baby that they are not good enough? In the preparatory literature it was mentioned that one third of all infants do not go to the breast just like that. How am I supposed to understand that…? Is the statement that about 30% of children naturally tend to starve themselves by not going to the breast…? In other words, is not breast feeding natural behaviour or is it the result of how we handle situations? To top it all off, it was suggested that a child should not be offered the breast for 24-48 hours if necessary in order to force a certain different behaviour. In my opinion, you are actually saying to the completely dependent baby: ‘If you don’t do what we want, we will punish you.’ I was so angry… I experience this as psychological torture of the child. Those are heavy words – I realise that, but with the knowledge I have, they feel appropriate.
M(arianne): Oh, that sounds very intense…
C: Yes, it was… Sometimes I get so tired of these kinds of views, which I still see far too often… How come society changes so slowly and leaves children so unbelievably in the lurch?
M: Yes, that is a huge problem indeed… Do you do something with this feeling? Do you express it in a professional, constructive way? Do you write about it?
C: I find that difficult. I also see that it actually concerns two disciplines, namely anatomy and physiology and their impact on the breastfeeding relationship on the one hand, and the psychology of (parenting) views and their impact on the child on the other hand. That is the tricky part about it.
M: Hmmm… well… but if you look at it holistically, then there are no different disciplines around the child. Then we are only talking about this new little person who has needs in all kinds of ways, which ideally are well met by the parents/caregivers/society. Unfortunately, that is often not the case. It seems to me that unity of these fields should be at the heart of everything we do regarding the care of children.
C: Yes, I completely agree. I’m just afraid those who host the webinar do not look at it that way. And it is probably not even something conscious. That is why I have asked a number of questions about this, for the sake of raising awareness. This does bring up the question, however, of who we are there for as lactation consultants: for the needs of the parents (with the result that an attempt is often made to ‘fix’ the child) or to support the parents, but with the perspective and the needs of the child as a basic starting point?
M: Opinions probably differ on that one, too… 😉 Personally, I never think it is okay to put the child’s perspective aside, in any role! And of course this primarily concerns the relationship between the child and the primary caregivers, usually the parents. I just think that in many settings the attitude of being child-oriented is not yet as powerful as it should be.
C: No, I think so, too, so the question is how to get a good picture of both needs and how to satisfy them. Because it is so important that certain needs are fulfilled in childhood, I think that the best interests of the child deserves to be leading. At the same time, society asks so much from people that personal wishes and choices are often at odds with societal ‘demands’. As a result, daily practice is often at odds with the needs of children. That is a serious statement, but a true one nevertheless.
M: Absolutely, totally agree! How we organise society has such a big influence on parenting! Have you read ‘The myth of normal’ by Gabor Maté yet…? There does not necessarily have to be a conflict between the well-being of the parents and that of the child. If the parents could first (learn to) look with compassion at what they themselves missed and where they suffered pain… that would already be so helpful!
C: Oh yes, and that is exactly the hardest part. I really tried to raise my kids with child-oriented approaches, but I made a lot of mistakes in that too. That is an observation; I do not feel guilty about it, but it does make me sad. The result is partly that one of my children struggles with major psychological problems. You never know how things would have turned out differently, but it keeps me wondering. Fortunately, the other children are doing well.
M: Yes, I recognise what you mention. At the same time, it is also important not to view and approach our children as ‘the result of our own mistakes’. No one likes to be seen like that. Most parents do the best they can for their children. What we can see is that many parents lack assets and there are many reasons for this, including a lack of knowledge about the influence of early experiences on later life. It is therefore important to ensure that that parental competence can develop as well as possible, so that parents have a good understanding of how they can lovingly guide their child into adulthood. When parents dare and are able to explore what they missed in their own childhood (with some therapeutic support if necessary), it usually helps enormously to understand why some things in life are so difficult. If they do that before the birth of the first child, that is of course beautiful, but it is never too late to increase your insight. Understanding the difference between reacting impulsively from a trigger on the one hand and responding intuitively from awareness on the other hand is the essence. For that you have to dare to look at those own triggers, as well as at the explosive charge underneath. That is a big, but crucial task for adults.
We talked a bit further about the details of what she had been reading. I know this colleague as a very involved lactation consultant. I was pleased to hear that she felt so much resistance to the child-unfriendly suggestions and that she felt the question about the power relationship bubbling up. What I regretted was that in 2023 lactation consultants (and also other healthcare providers, for that matter) are still being given this kind of advice. From neurophysiology and interpersonal biology, we now know an incredible amount about the impact of disconnection from the child on brain development. Ignoring, threatening, neglecting, punishing, intimidating… they leave deep traces in the stress landscape of the body. They are not trauma sensitive at all and do not do justice to the child’s complete dependence and need for authenticity. Given the state of present day science, such practices do not (or no longer) belong in youth health care advice.
I hope that the colleague receives satisfactory answers to the questions she has asked and that she nevertheless keeps having the courage to put a child-orientated approach at the heart of her own work. Knowing her, I have every confidence in that!