免费配方奶样品对哺乳的破坏

 

有些人会觉得很奇怪,觉得我(还有其他人)对免费派送配方奶样品给孕妈妈、新手妈妈和她们的家人这课题小题大做。医生不是都会给病人一些免费的药物样品的吗?有什么分别呢?

派送配方奶样品和药物新手包有什么不同?送出药物样品有很多原因,例如:病人或需要试试看那药物有没有效,尤其是当新的药物比旧的药物贵的时候。或许这是合理的做法。

然而,派送免费的配方奶样品(以及里面附送的“文献”和传单)的问题,就是当一位妈妈开始用配方奶和奶瓶喂过宝宝之后,就会引起种种哺乳的难题,包括奶量减少或者宝宝完全拒绝乳房。这跟送出免费药物样品是不一样的。如果药物引起反应或者药物无效,是随时可以换个药物或者换个治疗方式。可是一旦奶量开始减少,或者宝宝拒绝乳房了,哺乳就会变得很困难,甚至不可能回到原点。

在一些医生的诊所里,派送免费配方奶样品是例行公事,甚至会派送给孕妇。虽然有些时候,在哺乳进行得不顺利的情况下,派送配方奶样品看起来很合理,但我并不赞同。开始使用配方奶和奶瓶,或许就是真正完结哺乳的致命性一击。医生应该帮助妈妈哺乳(然而大部分都不懂如何帮),或者介绍妈妈给一些能够帮助她哺乳的人,而不是派送免费配方奶样品。

我看不出有什么正当的理由可以给妈妈免费的配方奶样品。即使那位妈妈完全没有哺乳的意思,或者没有哺乳,为什么身为一名医生,要为某个品牌的配方奶打广告呢?这是打广告,毋庸置疑。世界上大部分的卫生部都会规定全部配方奶公司遵从特定的营养准则,基本上,从营养角度去看,全部配方奶都是一样的,无论是奶粉还是豆粉。

许多医生的诊所都有“知识”小册子让病人拿回去看。配方奶公司代理人通常会留下他们的小册子,有时医生也没察觉他们留下了这些小册子给病人自由拿取。配方奶公司和奶瓶制造商的“知识”小册子,恶名昭彰地误导人关于婴儿喂养的讯息,尤其是误导哺乳相关的讯息。里面经常含有带着诋毁哺乳的图文,使哺乳看起来困难、疼痛和劳累,显得配方奶才是解决每一个难题的答案。如果妈妈有个好的开始、得到好的帮助和鼓励,哺乳不应该是困难、疼痛和劳累的。很遗憾地,很少妈妈有好的开始,而那些成功的,通常不是因为那些“帮助”而成功。

文:Dr. Jack Newman
译:Lily Yeoh, IBCLC

授权翻译自 Dr. Jack Newman 脸书专页的文章

 

原文: https://www.facebook.com/DrJackNewman/posts/307715789379474  

Some people wonder why I (and others) make a big deal about the giving of free samples of formula to pregnant women, new mothers and their families. Don’t doctors give patients free samples of medications to their patients? What is the difference?

How is the giving of free samples of formula different from giving a free starter pack of a medication from a health professional? There may be many reasons free samples of medication are given out; for example, the patient might try the medication to see if it is effective, especially if it is a new drug and more expensive than older drugs. Perhaps this is legitimate. However, the problem with giving out free formula samples (and the “literature” and brochures that often accompany the formula samples) is that once a mother introduces formula and bottles to her baby, problems with breastfeeding often result, including a reduction in milk supply and even complete rejection of the breast. This is different than providing a sample of a medication. If the medication results in a drug reaction in the patient, or is ineffective, one can always try a different drug or a different approach. But once milk supply starts to decrease or if the baby rejects the breast, it may be difficult, even impossible, to turn things around and get the breastfeeding back on track.

In some doctors’ offices, formula samples are given routinely, even prenatally. Sometimes, however, breastfeeding is already not going well and seems to justify the giving of the formula sample, but I disagree. Starting formula and bottles might be the coup de grace which truly finishes off the breastfeeding. Instead of giving the parents the formula samples, the doctor should be helping the mother with the breastfeeding (most do not know how, however) or referring the mother and baby to someone who can help.

I see no justification in giving a mother free samples of formula. Even if the mother never intended to breastfeed or is not breastfeeding, why should a physician with the authority s/he carries in the eyes of most patients, advertise a particular brand of formula? And it is advertising; there can be no doubt about it. Most ministries of health around the world require that all formulas comply with certain nutritional guidelines and essentially all formulas are the same from the nutritional point of view, whether they are made from cow’s milk or soy beans.

Many doctors’ offices also have “patient information” pamphlets available for patients to take. Formula company representatives often leave their own pamphlets in the slots sometimes without the doctor being aware that the pamphlets are available to his/her patients. Formula company and bottle manufacturers’ “information” pamphlets are notoriously inaccurate with regards to infant feeding in general and in particular with regard to breastfeeding. Very often they contain visuals and text which undermine breastfeeding and make it seem difficult, painful and exhausting, and formula the answer to every problem. Breastfeeding should not be difficult, painful and exhausting if mothers got off to a good start and received good help and encouragement along the way. Unfortunately few do and those who succeed usually succeed in spite of the “help” they get.