Abstract
The subtleties of abuse and neglect have smoldered culturally for decades with the work of anthropologists studying internationally confirming the problem worldwide. There is information to suggest that breastfeeding mothers do not abuse their breastfed infants, but abuse and neglect are of major concern for some mothers themselves who have been abused as children or who are living as adults in constant fear of abuse and neglect. As we search for reasons why women do not breastfeed, we need to explore delicately and carefully the possible impact of abuse, especially in impoverished environments. Abuse, however, is not only the scourge of poverty but has been inflicted in the most “enriched” homes.
In this issue of the journal we publish a review 2 of the impact of childhood abuse on childbearing and breastfeeding by Phyllis Klaus, MFT, LMSW, who is a licensed psychotherapist and social worker who has worked for over 30 years on family issues during the perinatal period. She reports the fruit of her works with abused women and provides guidance and direction for perinatal caregivers.
We cannot but ask ourselves if some form of abuse is not the underlying cause of some of the angry pushback from a few very vocal women who do not want to breastfeed and do not want to hear another word about how good breastfeeding is for mother and baby.
This article provides a solid understanding of some of the issues demonstrated by victims of childhood abuse and gives suggestions for supporting breastfeeding by the perinatal caregivers. The issue does not end there; this article may trigger other approaches to the study of failure to initiate breastfeeding and failure of the breastfeeding process. Further exploration is necessary to understand why some women do not wish to fulfill their biologic role of lactating following normal successful pregnancy. The most common reason provided for not breastfeeding is the mother's lack of desire to do so. The next step may be to thoroughly examine the thoughts, reasons, and explanations behind this choice.
Other provocative research reported in this issue includes the assessment of the resurgence of the use of nipple shields and the professional attitudes behind this change evaluated by Eglash et al. 3
The significance of early newborn weight loss patterns and their value in predicting further problems, an issue that has been intensified by discharge from the hospital earlier and earlier, are also described in an article by Flaherman et al. 4
This issue also provides the ABM protocol Model Breastfeeding Policy (revised), 5 which has served as a valuable model for all hospitals striving to enhance their breastfeeding services.
Torun, Poland, the site of the 2009 international ABM meeting, is elegantly described by the President of ABM, Gerald Calnen, in his President's Corner. 6 Don't miss it.
Our next issue will be the report of the Second Annual Summit on Breastfeeding, “First Food: The Essential Role of Breastfeeding,” held in Washington, DC, June 16 and 17, 2010.