Letters highlight breastfeeding conflicts.

The letters published in the December/January 2006/2007 issue of Koi Tiaki Nursing New Zealand (p3-4) in response to Wendy Hicks' Viewpoint on breastfeeding choices (Respecting breastfeeding choices, October 2006, p23) highlight conflicts and ideologies underlying the way in which we promote breastfeeding.

In her letter, Rooming-in promotes breastfeeding [p3], Gabi England makes a connection between the non-enforcement of rooming-in and the "high incidence of child abuse and neglect in New Zealand", and implies that a woman who does not have her baby with her continuously is "neglectful". I am disturbed by her suggestion that when a woman is struggling, "staff will gain insight into how she is coping" by leaving her alone with her baby. This sounds like a recipe for exacerbating problems, not solving them.

The letter from the Hawke's Bay International Board Certified Lactation Consultants Group, Erroneous presumptions in article [p3-4], argues that "best practice and current research" prove that it is wrong to give a mother "time out" from her baby, and uses scientific jargon to justify claim. It might be more constructive to reflect on why the mother asks for "time out". Both these letters are chillingly authoritarian and judgemental of women and caregivers; surely their writers would do better to criticise and suggest system changes to the inpatient settings in which women's needs are not always adequately addressed. "Rooming-in" is sometimes a euphemism for isolating a woman and her baby from the supportive presence of others, particularly extended family, who are too often excluded. If it is abusive to separate the baby from his/her mother, it is equally so to separate the mother from those best able to sustain her.

By contrast, Ruth DeSouza's letter [p3] in the same issue, Experiences of migrant mothers, resonates with authentic caring and focuses on women's reality rather than current ideology. The co-editors' decision to place it before the other two gives it the emphasis it deserves. I am unconditionally committed to the promotion of breastfeeding and the enhancement of the mother/baby bond, but I believe the best way to achieve this is by genuinely supporting women, which means listening to them and responding to their needs. If a woman asks someone else to hold her baby, that's OK! If we do not know a way of managing such a request, without either flatly denying it or by compromising "this initial metabolic adaptation of the dyad", we need to think a bit harder! By treating every woman with respect and care, we create an environment in which she will naturally give the best of herself to her baby.

Andrea Dawe, RN, RM, Auckland