Category Archives: media

Thoughts on World Breastfeeding Week 2014

I have been on a bit of a blog hiatus; in November last year I gave birth to a beautiful baby and I have been experiencing the roller-coaster of parenthood ever since. I am still on maternity leave and hadn’t particularly intended on blogging while off work, but a couple of things have appeared in the media over the last week or so which started to get the rusty braincells stretching again. For this post I want to concentrate on World Breastfeeding Week 2014, which is this week.

I hadn’t particularly given awareness days/weeks/months any critical thought up till a couple of years ago, probably because I have not been particularly affected by the issues demanding awareness. However, I remember reading a blog piece (I think on Feministing although I can’t find the exact post now) one October about the onslaught of pink that Breast Cancer Awareness Month brings each year. This piece, from the perspective of a woman who (if I recall correctly) had had breast cancer herself, pointed out that for people like her, and her loved ones, they were all more than aware of breast cancer, that merely giving something a pink wrapper will change nothing, that buying pink products may make people feel they have ‘done their bit’ even though they don’t know where their money is being donated, or what proportion of their money is being donated, or whether the charities receiving the funds from the pink goods are focused on research, treatment and/or ‘awareness’. Not to mention the infantilising and gender-dubious nature of a lot of the pink products themselves. I also saw comments from a friend (now cancer-free) who talked about hating the annual promotion of ‘Race for Life’ as it was a constant reminder of the cancer she had experienced and could potentially face again. In addition I think that Dr Margaret McCartney’s concerns in the BMJ about the annual Movember campaign are a useful contribution to the debate about ‘awareness’ and what it is trying to achieve, as well as potentially unintended consequences: BMJ.

As a health visitor I was (and am) always totally committed to supporting breastfeeding. This year though I have the extra experience of being a mother, and not only that, but a mother who has had real struggles with breastfeeding. Without getting into too many personal details, I had poor milk supply from the beginning (I suspect a combination of medication I had to take antenatally till about 8 weeks postnatal, recovery from Caesarian section, stress and who knows what else) meaning that from day 2 I had to start mixed feeding. I have never ever felt guilty about this, as I know that it was the right thing to do for my daughter (watching your baby not thrive is not an experience I’d wish anybody). I have though, always felt so very disappointed – breastfeeding was the one thing I so so wanted to do and for it to go well, and it not going well still makes me really upset. It didn’t help that I beat myself up for it – as a health visitor I have supported I don’t know how many people with breastfeeding, including having mothers telling me they would have given up without my help; I have done the UNICEF Baby-Friendly training; I know what to do, and yet it just wasn’t happening for me. I had a ton of help and support from health professionals (and have to say that the staff at Forth Valley, both in the hospital and community, are an absolute credit to the NHS, I was so impressed with them) and also a breastfeeding support group which was, and remains, a lifeline. It seemed like the whole world had observed me feeding and thought that the positioning and attachment was fine, but even despite the supplementation with formula it took a few months before my daughter started putting on decent amounts of weight, which was a real worry. Although I never experienced problems like mastitis or thrush I did experience awful pain for the first few weeks, and all in all it has to be said that it was nothing like the beautiful Zen-like experience that I had hoped for and (if I’m honest) expected.

Eight and a half months later, against the odds, I am still doing some breastfeeding at each feed. I am also topping up with formula milk at each feed, but I am really proud of myself for getting this far and still giving some breastmilk (most of the people I have talked to have said that they would have given up long ago). I have though been doing a lot of thinking about the messages we send as health professionals about breastfeeding, and I hope that this experience will make me a better and more thoughtful (and critical) practitioner.

Checking out the World Breastfeeding Week tweets on twitter has been a bit depressing, I’ve thought. I appreciate that a 140-character medium isn’t going to be the best for subtle and nuanced consideration of the issues and the message is distilled down in the most part to ‘it’s wonderful, with the right support and correct positioning anyone can do it, breast is best’. But I had tons of support, from both health professionals and certified lactation consultants, got positioning and attachment right (bad habits crept in later, not least thanks to De Quervain’s tenosynovitis which meant that I had trouble bringing the baby to the breast and it is infinitely less painful to do it the other way round), I knew all the tricks in the book (having studied the damn book enough!) but it still just didn’t work the way it is always presented. I never had the sensation of my milk ‘coming in’ on day 3 (or at any point after that), I have never felt any sensation of milk ‘let-down’ at the start of a feed, I never managed to express more than a few mls at any one time (yet another disaster to make me feel even crappier!). In the worst first few weeks I looked up all I could about breastfeeding problems, and found a research paper on breastfeeding idealism which was basically the research project I would have loved to do if someone hadn’t already done it: Hoddinott et al 2012. This research talks about the gap between education messages about breastfeeding and the messy reality. More recently I read Burns et al 2012 which is about how midwives talk about breastfeeding and the effects of the language used. Both have got me thinking about how I could best as a practitioner support women who want to breastfeed without resorting to one-size-fits-all messages or trite soundbites. I think we do parents a great disservice by presenting breastfeeding as easy, natural and ‘best’ while denying that many women find it difficult, heartbreaking, painful and stressful. If nothing else, I really hope that my less-than-ideal experience with breastfeeding leads to me being more use to families I may work with in the future.

But what about breastfeeding awareness and World Breastfeeding Week? This piece by Hollie McNish is a reflection for World Breastfeeding Week on some of the reactions she got to her poem on breastfeeding going viral online earlier this year. I am lucky that I have never (to my knowledge) faced any disapproval for breastfeeding in public, but know that negative attitudes are still common. And while anyone thinks that it is acceptable to compare breastfeeding with sex or urination/defecation, or that breastfeeding will turn baby girls gay and baby boys sex-crazed, then yes absolutely we need breastfeeding awareness, and not just for one week a year. There is work to be done on so many fronts. Let’s just think about how we can do it in a way that doesn’t trivialise, or infantilise, or fetishize, this complex, beautiful, difficult, wonderful process.

Using blogs as sources

I’ve been musing about writing a post about following up tangents encountered during research which aren’t strictly relevant to the research project but are interesting and worthy of further attention; I might come back to that at some point. However, whilst musing about this my mind went off on a tangent (did you see what I did there?!) and I was reminded of an issue which came up during my PhD, namely the use of blogs as sources.

As part of my PhD I did a pretty extensive media review, concentrating on online newspapers and other mainline media (such as TV/radio station websites and local news agencies). I also came across a number of blogs which were relevant to my topic, but although I collected quite a lot of relevant blog posts I chose on that occasion not to include them in my final analysis – they were useful to give me a feel for the various views of people on the street, but I felt that the writers of a personal blog would not necessarily have any expectation that their blog would be used and quoted beyond the scope of the blog audience. On the other hand, I had no problem using the personal comments made under articles from online newspapers – it seemed to me that in a national more public forum like that people would feel differently about the use of their comments (they strike me as being in a similar vein to ‘letters to the Editor’) than they would a blog post or comment. In fact I even remember one comment on a TV station website discussion under the article which directly said “someone should collect these comments and write an article about it”!

However, I am now collecting data for a journal article I have wanted to write since I came back from my PhD fieldwork, which I used a bit in my PhD but nothing like to the extent that the amount of data could have merited (I think this is my link to my original musings about following up tangents), and as well as the extensive online newspaper, TV stations etc articles I am coming across a significant number of relevant blog posts which if I were to include them would, I think, make a significant contribution. I did read one article (a chapter by Shannon Woodcock in this book) which used a lot of blog posts as part of the analysis, and it seemed to make a lot of sense using them (I highly recommend the book, by the way, for anyone interested in issues around sexuality in central and eastern Europe).

So my questions are, how do you feel about using the personal blog posts of strangers as part of your data? Am I being over-cautious in limiting myself to online public newspapers etc? Have you come across any good sources arguing convincingly one way or the other? What would *you* do?

Qualified to advise?

Looking at Twitter yesterday between marking essays, I happened to look over at the UK ‘Trending Topics’ (something to which I usually pay little attention) to find that ‘Gina Ford’ was trending. Gina Ford, for those who don’t know, is the author of a number of parenting books, the most famous of which is ‘The Contented Little Baby’. Her methods are controversial and contested, and with my health visitor hat on I have to say that I am absolutely and resolutely not a fan. There are a couple of newspaper articles here and here which discuss her methods, and I think this post on the Every Child Matters blog sums up very neatly my own concerns and more besides about her particular proposed methods of establishing an early routine with young babies and children. Gina Ford herself rebuts some of the criticisms of her methods here. She was trending on Twitter yesterday as she had been on a morning TV show promoting her latest book (called ‘The Contented Mother’s Guide’), and also was the subject of an article (apologies, it’s a Daily Mail link) in which she is reported to be suggesting that women have sex with their partner within 4-6 weeks of giving birth, regardless of whether or not they feel ready for it. [Update 8.3.12: see end of post]

What I want to discuss here though isn’t Gina Ford and her particular methods and views, as these articles show there are plenty of other places on the internet discussing these at great length. What struck me yesterday when I was looking at the comments on Twitter about this, and also the comments on the articles I linked to, was the large number who are focusing on the fact that Gina Ford does not herself have children, and using this as a reason to dismiss her views. I need to give a disclaimer here: I am a qualified health visitor so have been in regular contact with her target audience, and I do not have children. So I am aware that this is pushing some personal buttons. However, that aside, there is something I think quite troubling about comments such as ‘bah, it makes me sick that someone who hasn’t even had children can spout all this nonsense!’ (the first comment on the Every Child Matters blog post linked to above) or ‘”The divorcee, who has never had children..” says it all. Not been there, have no right to offer advice.’ (one of the comments on the Daily Mail article). I tweeted in response the following:

“shouldn’t have clicked on Gina Ford trending topic. Grrrr – Daily Mail *and* GF (but also troubled by ‘if not had baby don’t advise’ trope).”

and one person (@Superleelee80) tweeted back:

“why troubled? I could research climbing mountains and spout advice but why would anyone listen when I’ve never climbed one?”

It is of course a good question, an obvious one even, and to be honest I was surprised she was the only one who questioned my discomfort. My two part reply was this:

“Worked with some great HVs who’ve never had kids (some who can’t), and terrible ones who have. Person more imp than life exp.”

“my probs with GF about rubbish she says/claims and damage it does, rather than if she does/doesn’t have kids.”

On one level I think this is about the old mantra “attack the issue not the person”. There is enough to criticise in what Gina Ford is saying without having to resort to personal attack (as well as criticising her lack of children, there were a lot of comments making very personal remarks about Gina Ford’s appearance), and I think that by focusing on personal details the argument against the aspects of her methods people are troubled by is weakened.

I also though think (and this bit still requires some thinking on my part, but I will throw the hunch ‘out there’ so I have something to come back to later and flesh out) that there is something here about the elevation of mother/parenthood which is particularly illustrated by the ‘Not been there, have no right to offer advice’ comment. I remember when I was first qualified as a health visitor, I was chatting with a friend online when she asked me pretty much the same thing – how could I possibly help a struggling breastfeeding mother when I have never breastfed myself? To which I was happy to give the example of the client who had told me that if it hadn’t been for me taking the time to watch her feed and help her with positioning and attachment then she would have given up. I have come across similar arguments about male health visitors (and male midwives, an even rarer breed), yet one of the best health visitors I ever worked with was a guy, and my mentor when I was training (still the best health visitor I have ever worked with) was childless. I have worked with great people, several of whom would have loved to have children but sadly it didn’t/couldn’t happen for them, and I have also worked with people who were parents but who in my opinion had terrible skills when it came to relating to the people they were meant to be helping. I maintain that it is not motherhood which primarily qualifies someone to give parenting advice – of course it might help, but it is not inevitable (if an advisor themselves had a perfect parenting experience they may not necessarily be able to advise or relate to someone who is struggling, after all), and I cannot be more categoric that mothers/parents do not have the monopoly on empathy. The talk about ‘right to advise’ particularly troubled me, not just on the personal level, but also that elevation of motherhood reminded me of (small c) conservative debates around family being the basal cell of society (a trope which appeared often in my PhD media review of coverage of issues relating to sexuality and reproduction). Families come in all shapes and sizes and makeups, with or without children or partners – elevating one type above others is dangerous and exclusionary and does nothing to promote healthy, happy children and well supported parents.

Update, 8th March 2012: this morning via Twitter a representative from Gina Ford’s publishers sent me this announcement, refuting the reported claim that she was suggesting parents should have sex within a few weeks of birth. I would like to make it absolutely clear that nowhere in this post did I make any comment on this particular claim (much as I was tempted to), other than that it was reported and had therefore made Gina Ford trend on Twitter, and the substance of this post was my concern about the oft-repeated claim that as Gina Ford does not have children she is not qualified to advise about parenting.

The media, statistics and shock headlines

Oh dear it has been nearly a month since I last posted, sadly the combination of marking, tutorial preparation and my day job in clinical practice got the better of my good intentions! However I will be reducing my clinical hours from the beginning of March so intend to catch up on writing then.

I did have a blog post brewing, inspired by a piece in the Moldovan media, but (much like the early days of my PhD) I kept finding myself wandering down lots of intellectual side roads with it and losing focus somewhat. However last weekend I came across some media reports, again in Moldovan online media, which whilst interesting in their own right also raised more general questions for me about the reporting of statistics and research findings in the media. One of the academic blogs I like to read is by Dr Petra Boynton who is meticulous in detailing the shortcomings of media reporting of research findings, and in particular the sloppy way in which research is evaluated beforehand. One of the issues she frequently encourages of journalists is to ask questions about the research – rather than accepting it at face value, question the methods and the findings. Can the conclusions be justified given the methods, what (if any) are the shortcomings of the research, how have the figures quoted been reached?

Last week I noticed a few articles on some Moldovan media sites reporting that “the majority of young people in Moldova have prostituted themselves at least once” (Unimedia). The reports (also repeated here by ProTV) use the words “shocking” and “scandalous” and at first glance seem to imply that 70% of Moldovan women have prostituted themselves. The source for this figure is a quote from French media from the Scelles Foundation, a coalition of NGOs in France working in the area of sex trafficking and exploitation. Their president was reported here as saying “In Moldova for example, an extremely poor country, 70% of women between 15-25 have prostituted themselves at least once”. However, the ProTV article above states that the research being cited was actually saying that 70% of Moldovan prostitutes are between the ages of 15-25, which is considerably different. I am encouraged that, unlike much of the media according to Dr Petra Boynton’s blog or French media going by the Europe1 article quoted above, the Moldovan media is showing at least at a basic level of understanding of the need to get the facts right behind the statistics and not twist them (there were a number of times during my PhD when I was doing my media review when I despaired of what I was reading, so this was encouraging to see). There is understandable outrage at the misquoting of the statistics (and perhaps misquoting of the Scelles Foundation president?) to imply something very negative about Moldovan women, something which is also discussed in this Vox Publika article, albeit with a rather stereotypical and idealistic alternative presentation of Moldovan women. That article also points out what I had found when I had a poke round the Scelles Foundation site, which is that the original report/research on which the 70% figure is supposedly based is nowhere to be found. It does not say where or when or who was interviewed/surveyed to come up with these figures, or what methods were used, so there is no way at all of verifying or questioning them.

What I think this shows is that, as well as the responsibility of the media to report research responsibility and accurately, it is important for those of us wishing to disseminate our research to ensure that it is accessible, and not open to blatant misinterpretation.