Talk:Breastfeeding/Archive 6

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Info on latching

Really great to see the new details on good versus poor latching. Some of the points added, e.g. "140 degrees", don't seem to be in the cited source, so it appears additional citations are needed. Something to consider is that when text is embedded in photos, it isn't accessible to people who use screen readers and isn't easily translated into other languages. I suggest adding the text to the body of the article in addition to being in the photos. Then you can cite each claim within the body of the article. Clayoquot (talk | contribs) 05:25, 6 November 2021 (UTC)

That's a great suggestion! I'm starting to edit that section today, so I'll make sure to incorporate those things in the text. I'll also add a citation for the 140 degrees. Kporter0918 (talk) 15:42, 8 November 2021 (UTC)

Making Contraindications to Breastfeeding its own separate section

Hi all, What are your thoughts on making contraindications to breastfeeding its own separate section, rather than a sub-heading of "Process". I've been finding that it doesn't really fit well with the rest of the content in this section. I think this would make the section more readable for parents and providers. I'm not sure which Manual of Style is being used for this page, but when it comes to the Medicine-Related Articles, it seems like contraindications warrants its own section. Would appreciate input Kporter0918 (talk) 21:22, 11 November 2021 (UTC)

I agree. Good idea :) Clayoquot (talk | contribs) 22:42, 13 November 2021 (UTC)

Sourcing - Little Green Book

Kporter0918, you've been doing fantastic work. I have a couple of general comments on sourcing:

• When citing a book, if you could include the chapter number or ideally the page number/range for each claim, that would be great.Over time, content is sometimes re-edited or vandalized and drifts away from its original meaning, and it's much easier for other editors to notice when this has happened if we have specific page references.
• I'm not sure if The Little Green Book of Breastfeeding Management for Physicians & Other Healthcare Providers is compliant with WP:MEDRS guidelines for biomedical information. Can you tell us more about why this book should be considered reliable? E.g. what are examples of institutions that use it as a textbook? Clayoquot (talk | contribs) 23:03, 13 November 2021 (UTC)

Thanks for your questions. I'll try and go back and add some page numbers, although given that much of this page now uses this source, it may create a very redundant bibliography. Let me know your thoughts on this. As for the validity of the Little Green Book - this is a textbook used for instruction for the CLC exam. I personally used this textbook for my own studies and found it to be very comprehesive. Although the first line title is "The Little Green Book," its subtitle is "Breasfeeding Management for Physicians and Other Healthcare Providers," which may provide some idea of its intended audience. It is written by two doctors (MD), who both are IBCLC certified (international board certified lactation consultant, and fellows of the Academy of Breastfeeding Medicine. Additionally, the book is published by the Institute for the Advancement of Breastfeeding and Lactation Education (IABLE). The Guidelines for Biomedical Sources according to your link includes "academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." This book fulfills all aspects of this requirement: it is an academic book written by experts in the field of Breastfeeding Medicine, comes from a respected publisher in the field of Breastfeeding Medicine, and includes guidelines and policy statements from IABLE and the Academy of Breastfeeding Medicine. I can't speak to what other institutions use this as a textbook, but Michigan State University, where I completed my CLC course, does use it, and my course was instructed by Family Physicians who were CLCs and IBCLCs working in the MSU Breastfeeding Clinic. Let me know if you have any other questions about the book! Kporter0918 (talk) 13:51, 14 November 2021 (UTC)

Clayoquot I just finished adding the page numbers for all my citations from the green book! Kporter0918 (talk) 14:46, 15 November 2021 (UTC)

Thanks for adding page numbers. You're doing really great work.

Regarding the Little Green Book, the facts that 1) Michigan State University uses it in a graduate-level medical course and 2) its authors are Fellows of the Academy of Breastfeeding Medicine are strong arguments for MEDRS compliance. The ABM is a great source of position statements (not sure about IABLE) - but the fact that a given book includes position statements from the ABM isn't an argument for MEDRS compliance for the book. Books can reference excellent position statements and still be low-quality books themselves.

I think you've made a strong-enough argument for using this book for the kind of information you've been using it for, which is information the article had very much needed. Going forward, something to keep in mind is that if you can cite the ABM directly, it is preferable to do so because that makes it much easier to see how old each position statement is and whether position statements have been updated. Again, great work filling in important gaps. Clayoquot (talk | contribs) 17:53, 15 November 2021 (UTC)

Who Wrote That gadget

FYI, there's a useful gadget here that highlights exactly what parts of an article come from a given editor: https://www.mediawiki.org/wiki/Who_Wrote_That%3F . This is handy for reviewing others' work in big articles like this one. Clayoquot (talk | contribs) 19:04, 18 November 2021 (UTC)

WikiProject Medicine: Work Plan

Hello fellow Wikipedians --

My name is Katie. I am a fourth year medical student pursuing Obstetrics and Gynecology as my desired specialty. Additionally, I'll be taking by Lactation Counseling (CLC) Exam tomorrow, so hopefully by the time this work plan is complete, I will be a Certified Lactation Counselor. As part of my 4th year of medical school, I am enrolled in a WikiProject Medicine Course, and hope to improve this page as a part of my coursework. Below, you can find my workplan to be completed over the next month. Please feel free to reply with any questions, comments, or concerns, and I'll try to work your feedback into my edits :)

Work Plan

- Areas of Focus:

---Lead/Intro Section: I hope to streamline this section and make it more concise to highlight the main focuses of this article. Additionally, there are some components of this section, as currently written, which are concerning for plagiarism, so I will plan to fix those. Additionally, given my role as a medical provider, I plan to clarify the medical information in this section to ensure that it is all factual and not misleading.

---Lactation: This section is fairly complete already, and is supported by an entire article on lactation. I think it may be helpful to change the title of this section to Breastfeeding Physiology, as "lactation" is a nonspecific term that can refer to anything in the breastfeeding realm. I will clarify the stages of lactogenesis, and the role that hormones play in milk production. This will help simplify the description of the changes that occur in the breasts throughout pregnancy and postpartum.

---Breastmilk: As currently written, this section has both some grammatical and also some medical errors/misleading statements. I plan to correct the medical content of this section, taking into account guidance from the American Academy of Pediatrics (AAP), CDC, WHO, and the Academy of Lactation Policy and Practice (ALPP), which is the governing body of lactation counselors.

---Process: This section is fairly long, and will be the main focus of my work. As currently formatted, the information that would be most pertinent to parents is difficult to find. I hope to reformat this section, so that the pertinent information is easier to find. This may require renaming sections to be more descriptive in the table of contents, reformatting into step-wise or Q&A style sections, and relocating some of the information into different sections where it may be better suited. In the "Exclusivity" section, I will also add a commentary on supplementation, as this is one of the most commonly asked questions on the Postpartum ward - "when should I supplement my milk?" or "I feel like my baby is not getting enough to eat." I would like to use this section to more explicitly address this concern.

---New section on pumping-and-dumping: It is a common misconception of parents and healthcare providers alike that pumping-and-dumping is required after consumption of a large variety of medications and substances. However, this is not the case. In fact, there are only a few, select situations which require pumping-and-dumping. I would like to create a new section on the Pump-and-Dump concept, and provide accurate/reliable resources for parents and healthcare providers to reference, should they visit this page for that information.

- General Changes:

I plan to alter the format of the above sections to be more accessible for readers. Especially for moms and parents who may be coming to this page for information, guidance, and support for their breast/chestfeeding journeys, this page is quite text heavy. I would like to simplify the format so that the information can be more easily found at a quick glance, while also keeping the page as comprehensive as possible.

- Illustrations:

I plan to incorporate some better images to illustrate a good latch. I do not feel that the current pictures adequately/completely describe the components of a good latch, which is another common problem parents report. I feel that adding additional guidance for parents by way of pictures will be extremely helpful.

Again please pass along any feedback you might have; it is greatly appreciated!

-- Kporter0918 (talk) 18:47, 26 October 2021 (UTC)

Hi Katie. Welcome, and am I ever glad to see you. These ideas sound great overall. I'll follow up with more detailed thoughts and questions shortly. Cheers, Clayoquot (talk | contribs) 14:43, 27 October 2021 (UTC)

Kporter0918 this is an excellent plan overall. Regarding pumping and dumping, I suggest expanding the current https://en.wikipedia.org/wiki/Breastfeeding#Drugs section, rather than creating a new section. It doesn't make sense to name a section for a concept that has too much prominence in popular belief already.

Note that our style guidelines discourage writing in a "how to" style; see https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Medicine-related_articles#Writing_for_the_wrong_audience . When it comes to the process of latching and nursing, this can be hard to avoid. Just do your best on style, and other editors can fix it up later.

Thanks again for offering to do all this work! Cheers, Clayoquot (talk | contribs) 16:17, 28 October 2021 (UTC)

Hi Katie. The content you've been adding is high-quality. Since you're working on the first few paragraphs of the article, which we call the lead section, I suggest taking a close look at the Wikipedia:Lead section guidelines. In particular, the lead section should be up to four paragraphs long and cover all major aspects of the topic, so a lot of work goes into curating which pieces of information go in and which stay out. A recommended practice, especially if you're new to editing Wikipedia, is to update the body of the article first and then the lead.[1] Cheers, Clayoquot (talk | contribs) 18:14, 2 November 2021 (UTC)

Kporter0918Hi Katie, Great work on your workplan. here are my thoughts:

Lead: The lead seems very detailed and provides a very concise explanation as to the practice of breastfeeding, the epidemiology, contraindications, as well as benefits and drawbacks.

Content: The content is relevant to the topic and up to date. See "Organization" for a few suggested changes.

Tone and Balance: The content seems to be more on the side of pro-breastfeeding than formula feeding. It may help to add some potential negatives of breastfeeding including: discomfort/pain that some women experience (cracked/sore nipples), potential interruptions with sleep/work schedule, father/partner may feel excluded due to inability to help feed the baby unless milk is pumped and saved for later.

Sources and References: Very thorough and numerous sources. Very impressive!

Organization:

Breastfeeding Physiology: It would be helpful to explain why Lactogenesis is divided into three stages and how this classification was determined in the lead paragraph in the section. I would also briefly define the first use of the term colostrum in the article so that laypersons understand what it means. The section on 'Lactogenesis III' seems unclear what separates it from 'Lactogenesis II'. Also, from my understanding pregnancy doesn't have to occur for breast-feeding to be possible (i.e. a wet nurse), so perhaps that can be mentioned. Breast Milk: Great section. Foremilk and hindmilk, used in the image caption, could be defined in the section as it is unclear where they fit into this process. Process: In one subsection, it states "as of October 2016". Since this was greater than 5 years ago, perhaps this can be updated with the current knowledge? Other than that, very detailed and elaborate section. Contraindications to Breastfeeding: Similar to how substance use was made its own section, it might help with organized to place all the viral illnesses under a common section perhaps labeled "contagious viral illnesses" to illustrate similarities. Also, untreated TB is a contraindication. Methods: Great subsection Health Effects: Very thorough section. Social Factors: Healthcare subsection could probably be moved elsewhere. Doesn't seem to belong. Prevalence: Good section History: some citations are needed Society and Culture: For the language subsection, a citation is needed for that statement. Workplace: Great discussion about US policies. May help to include a few other countries outside US and their position on breastfeeding in workplace. Research: Good section; albeit brief.

Images and Media: No changes needed! Great images!

General info Whose work are you reviewing?

Kporter0918

Link to draft you're reviewing Link to the current version of the article (if it exists) Breastfeeding Evaluate the drafted changes

(Compose a detailed peer review here, considering each of the key aspects listed above if it is relevant. Consider the guiding questions, and check out the examples of what feedback looks like.)

- LessonsInSpencer (talk) 01:16, 18 November 2021 (UTC)

I disagree with the framing of the comment that "The content seems to be more on the side of pro-breastfeeding than formula feeding." We don't consider it to be a problem that our article on Oral hygiene presumes that oral hygiene is a worthy goal and underemphasizes the point of view that it's not worth the effort. We already make it clear that breastfeeding is a time commitment, that nipple pain happens, and I don't think the reader needs us to tell them that fathers can't breastfeed. We should probably add something about cracked nipples.

Instead of framing these issues as disadvantages of breastfeeding and promoting formula as a solution to problems, the high-quality literature on breastfeeding frames these issues as challenges to overcome. Nipple pain and cracking can in almost all cases be fixed if skilled and timely breastfeeding support is given; employers and governments need to ensure that good maternity leave is available to everyone; and dads need to find other ways to participate (a good division of household labour with a newborn is one parent does the breastfeeding and one parent does everything else). Communities with high breastfeeding rates tend to take the view that it takes a village to raise a breastfeeding child, rather than the view that it's solely mom's job and if she can't make breastfeeding work with the circumstances of her life then it's time to switch to formula. Clayoquot (talk | contribs) 17:24, 18 November 2021 (UTC)

Hi LessonsInSpencer: Thank you so much for your feedback!

In terms of the balance of the article. I think something that can be a little bit confusing about the tone of the article is that the article is supposed to be about Breastfeeding specifically, not about the different ways to feed a child. Unfortunately, this may come across in peer-review as an unbalanced article. However, it is important for me to emphasize that the goal of the article is the highlight the benefits of breastfeed (which is highly evidence-based), as well as the process of breastfeeding, problems during breastfeeding (including indications for NOT breastfeeding), and different components of breastfeeding that are important in today's society. The goal of the article is unfortunately not to talk about all the different ways mothers can choose to feed their babies, an article in which I think it would be very important to have a point of view that is more balanced between the different methods.

I will definitely be adding a section on nipple pain, and relate it back to the information on shallow latch, as this is the most common cause of nipple pain. However, given the importance of evidence-based medicine on wikipedia, I cannot discuss the other cons you mentioned, as these are not supported by evidence. In fact, the evidence is to the contrary - mothers who pump and have their partners feed the infant overnight tend to have decreased quantity and quality of sleep. With regards to the Father feeling left out, this is an unfortunate consequence; and unfortunately having the partner feed overnight or at other times of the day actually leads to decreased time of exclusive breastfeeding.

Perhaps a future addition to the page Clayoquot would be a "Common Breastfeeding Myths" section, where these concerns may be addressed in an evidence-based manner, without giving undue space to the most common breastfeeding myths?

Re: Breastfeeding physiology, I will clarify what separates the three stage of lactogenesis, as well as the events that separate lactogenesis II and III. Regarding induced lactation - this is covered later down in the article in its own section, however I will reference it under breastfeeding physiology as well (unfortunately this section is very underdeveloped).

Re: Breast milk section - will make these edits

Re: Process (as of 2016): I'll be taking out this sentence all together. I went back and read the study, and whoever wrote that sentence completely misinterpreted the findings. Thanks for pointing this out.

Re: Contraindications - I did not separate it into a separate section because there are only 2 virus that contraindicate breastfeeding. By adding the heading Contagious Viral Illnesses, I didn't want to confuse mothers into thinking that any contagious virus (such as a cold or COVID) would contraindicate breastfeeding. That's a good point, I'll add a section on TB as well.

Re: Methods, Health Effects, Social Factors, Prevalence. History, Society and Culture, Workplace, and Research sections : I did not write these, so I don't feel comfortable making any changes.

Thanks again for your comments and review LessonsInSpencer

Kporter0918 (talk) 22:22, 18 November 2021 (UTC)

Thanks for your incredibly hard work on this. Regarding this sentence: "Nipple pain is exceedingly common among breastfeeding mothers, with over 95% reporting it while breastfeeding. " I was not able to find support for this claim in the page range given, but it's a long page range so I might easily have missed it. Could you please check and provide a single page number?

When reporting statistics like this, it's important to be clearer about what exactly the statistic is measuring. Is this the percentage of mothers who breastfeed for any length of time and experience nipple pain at any part of their journey? Is it the percentage of currently-breastfeeding mothers who say that breastfeeding makes their nipples hurt? Is it the percentage of time that nipple pain is experienced by breastfeeding mothers - i.e. are we saying that nursing hurts 95% of the time?

I'm going to remove the sentence for now because while I'm sure it wasn't the intention, it makes breastfeeding sound like self-torture. Clayoquot (talk | contribs) 01:02, 21 November 2021 (UTC)

Induced Lactation: Adding Information

Hi everyone! I was looking over the page and noticed how little is spoken of in the induced lactation section. I think there is a lot more info that could be added, including that of induced lactation in trans women. Here are a couple articles I found that could be worked off of. Unfortunately, there is only one research project on trans female induced lactation, but there is still plenty of literature regarding induced lactation or relactation in cisgendered women. Any thoughts?

Induced Lactation: Gaining a Better Understanding

Case Report: Induced Lactation in a Transgender Woman

The Breastfeeding Sourcebook (specifically pages 143-148) Sneezygirl (talk)

The section could probably be expanded by few sentences, but more would probably be undue weight. You could also start an article on Induced lactation if you want to write more. Regarding sourcing, please review WP:MEDRS. For biomedical claims, we do not generally use case studies as sources and we usually use university-level textbooks or professional-level books, not books that are aimed at the baby shower gift market. Clayoquot (talk | contribs) 05:29, 3 December 2021 (UTC)

BTW the reason I'm concerned about due weight for this section is that the article already is over-weighted towards talking about the U.S. and other rich countries. Inducing lactation with electric breast pumps and domperidone is something that only people who are relatively rich, in global terms, can do (additionally, surrogate parenting, which is one of the main reasons for inducing lactation, is something only the very rich can do). However, I've heard of things like grandmothers breastfeeding in non-Western cultures, and that this is an important option in places where bottle-feeding is unsafe. If you could find some good sourcing on that it would be great to include. Clayoquot (talk | contribs) 17:16, 3 December 2021 (UTC)

Understood. I'll see if I can find more global sourcing on it, but I'm doubtful I'll really be able to find anything. Thank you for your suggestions! Sneezygirl (talk) 19:30, 3 December 2021 (UTC)

When editors are Wikipedia:Balancing aspects of articles, it's sometimes useful to think about the numbers. Globally, a couple billion people have breastfed a baby. Globally, maybe a few thousand people have been able to breastfeed exclusively without first being pregnant, and almost all of them were assigned female at birth. That suggests that 99.9% of this article shouldn't be about non-puerperal lactation (because that's not how 99.9% of breastfeeding goes), and what little content is merited should probably focus primarily on biological females.

This rough rule-of-thumb also aligns with what Rberkow says: "there is not a ton of medical or journal writing on inducing lactation, especially in trans-lactation". The lack of attention to this subject by reliable sources means that there shouldn't be much, if any, content in this article on inducing lactation, especially trans-lactation. WhatamIdoing (talk) 07:07, 7 December 2021 (UTC)

I think adding global sourcing on induced lactation and non-puerperal induced lactation would be really important to add as well to more info on induced lactation, of which this page has little to no mention. I have found a few other sources diving into different techniques for inducing lactation for transgender women, such as the Newman-Goldfarb protocol, among other methods. I think because there is not a ton of medical or journal writing on inducing lactation, especially in trans-lactation, a lot of data is taken from dissertations and case studies of these experiences. I have linked some potential sources of use below.

Rberkow (talk) 19:24, 6 December 2021 (UTC)rnberkow

Terminology

The terminology that this and related articles use is the subject of ongoing discussion in the real world, particularly wrt LGBTQ+ inclusivity. Sometimes these discussions get very heated and are adopted by those who engage in culture wars for political point scoring. I think we should try hard to avoid bringing those culture wars onto Wikipedia, and particularly the language of culture wars with its group insults. One way of doing that is try to avoid arguing whether a term is good/bad/better/worse from our own opinions and understandings. An example of that would be explaining all humans have breasts and therefore 'chestfeeding' is an unnecessary neologism, or that therefore 'human milk' is an unnecessary alternative to 'breast milk'. While arguments for and against terms can be interesting I don't think those arguments should form the basis of article talk page discussions. Our purpose is to write encyclopaedia articles for readers, not to debate social issues and language change. Language will change because society adopts that change, regardless of whether that change is entirely sensible or a bit daft.

When Brighton and Sussex University Hospitals published their Gender Inclusive Language in Perinatal Services: Mission Statement and Rationale in February this year, the UK press went a bit crazy. One thing the press often claimed was that "Breastfeeding is now chestfeeding". In fact the document took a generally additive approach to terminology and their suggested phrase was "breast/chestfeeding". They also noted "There is no known UK precedent for the additive use of gender-inclusive language in perinatal services. In this respect, BSUH are leading the way." which is a big flag to us that this issue does not carry much WP:WEIGHT. Aside from the press response, there was an Editorial in the BMJ.

As noted further up this page, PMID 32330392 could be a source for mention some of the language issues around LGBTQ+.

Some editors argue that we should follow the terminology used by high quality sources. I think that should certainly guide us, but I don't think we are slave to our sources. French Wikipedians writing their equivalent article use mostly English sources, but may get upset if you ask them to use English terminology. We rely on our sources for facts, but what we write and the words we pick are ours. Another source of guidance is style guides. These often need to be read with consideration that their audience is different to us (newspaper readers, say). While one may find advocates with strong views on the internet, it doesn't mean those views have influenced the style guides of more generalist publications. For example, the Guardian style guide merely notes that "breastfed, breastfeeding" are single words, unhyphenated.

Be careful about claims such as 'majority of non-binary individuals prefer...' or 'a great many "gender non-conforming" individuals still identify as'. It is easy to accidentally expand one's own personal experience or group of contacts or recent reading material and assume this is widespread or widely held. When language is undergoing change, the terms people use can be highly associated with age, class, geography, politics and other groupings. If such a claim is relevant, sources please, and remember that English speaking readers come from all over the world, not just Brighton, England. -- Colin°^Talk 19:07, 7 December 2021 (UTC)

Changing title to Human Milk rather than 'Breast Milk'

In efforts to increase language inclusivity, medical comprehensiveness, and awareness that chestfeeding is not restricted to solely cis women, I have gone ahead and changed the title of the 'Breast Milk discussion to 'Human Milk'. It boils down to a critical need to increase inclusivity and awareness that this is not just a cisgender woman's experience, that trans and nonbinary folks chest feed, lactate, and produce human milk to nourish their children. The focus should not be explicitly on the 'breast' but on the delivery of human milk and absolutely the experience of the person chestfeeding, to which the majority of non-binary individuals have preferred the terms human milk and chestfeeding to describe this experience.

. doi:10.1097/ANC.0000000000000436. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help)

Rberkow (talk) 17:29, 2 December 2021 (UTC)

Use of the uncommon term "human milk" accomplishes none of that. It's just an unusual term that distracts the reader. Every human has a breast, and even cis men can get breast cancer. Your linked source is to a low-ranked journal in the field simply asserting this terminology as a rule, but that has not caught on in the field. Top journals like this one still use the term. Per WP:DUE, we should be following what they do. Crossroads ^-talk- 07:19, 3 December 2021 (UTC)

The terms "breast milk" and "human milk" have both been widely used for decades. Breast milk is simply the more common term in English. The vast majority of the people who use the term "human milk" are not even thinking of gender spectrum inclusivity. Using the term "breast milk" is not transphobic.

You're taking a course in LGBT reproductive health. I imagine that course teaches you about ways to make breastfeeding-related healthcare more inclusive, other than language policing. Is there something else you've learned in the course that you can bring to Wikipedia? I think we'd all welcome substantive high-quality information on LGBT health issues, but I for one am pretty tired of language policing to be honest. Clayoquot (talk | contribs) 16:59, 3 December 2021 (UTC)

All humans have breasts. The idea that men have only "chests" and women have only "breasts" is factually incorrect (the chest is everything from the collarbone to the diaphragm, most notably the lungs; the breasts are mammary glands that happen to be located on the chest in humans). I've previously only encountered a resistance to the word breast applying to men in sexist contexts (e.g., people telling men with breast cancer to say that they have "chest cancer", because the people issuing these language decrees are uncomfortable with the idea that men have breasts).

This discomfort was not a problem before the 20th century. Phrases like "his breast" appear in Shakespeare, Coleridge, Dickens and other authors before the 20th century. Some 19th-century medical texts instruct early forms of CPR by telling people they can revive an unconscious person if they "put both hands on his breasts and push them lightly". I wonder if it is primarily US problem. WhatamIdoing (talk) 06:50, 7 December 2021 (UTC)

Language is a critical piece to address here. It's highly assumptive to conclude that just because 'breast milk' is still used in some medical journals and sources, that using the term breast is all-inclusive or preferred by any means. Many studies have concluded that trans men and gender-non-conforming persons are more comfortable referring to their 'chest' as 'breast' is usually associated with women. My proposal was to merely to use the term 'human milk' at least once in the beginning of this section to address gender diversity.

Rberkow (talk) 16:15, 9 December 2021 (UTC)rnberkow

I've no wish to ban the term human milk from the article.

I'm curious about your claim that the term breast milk is used in only "some" sources. Have you seen any medical journals exclude the more common term? WhatamIdoing (talk) 06:49, 31 December 2021 (UTC)

Breastfeeding

Explain breastfeeding 223.239.24.168 (talk) 10:47, 14 January 2022 (UTC)

Could you please be more specific about what needs to be explained better? Clayoquot (talk | contribs) 15:38, 14 January 2022 (UTC)

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SAFETY OF SUCKLING

is it healhy for a baby to drink breastmilk of their mother who is suffering from diabetes ? — Preceding unsigned comment added by R.PRAKASH BABU (talk • contribs) 17:44, 26 January 2022 (UTC)

@R.PRAKASH BABU, if you are asking on behalf of a specific mother, then she should talk to a licensed healthcare practitioner. WhatamIdoing (talk) 01:21, 27 January 2022 (UTC)

New content on insufficient milk supply

I just removed this addition from Lehafken from the lead;

It is unknown what percentage of women are physically able to provide enough milk to meet all of their infants’ nutritional needs for 6 months; current estimates suggest that 10–15% of women may experience chronic lactation insufficiency for biological reasons, and 5–8% may not experience milk coming in (lactogenesis II) at all.

Re: It is unknown what percentage of women, this kind of wording doesn't provide information and creates an inappropriately frightening tone. I don't object to including estimates on the percentage of women who experience chronic lactation insufficiency, however the source does not support 10-15%... for biological reasons. What I've seen in the reliable secondary literature is that one study found that 15% of healthy first-time mothers had low milk supply 2–3 weeks after birth, with secondary causes accounting for at least two-thirds of those cases. In other words, this study found that low milk supply for biological reasons was around 5%. The claim that 5–8% may not experience milk coming in (lactogenesis II) at all. is not supported by its reference at all as far as I can tell. Clayoquot (talk | contribs) 06:18, 12 March 2022 (UTC)

New content on colostrum

I removed another addition by Lehafken:

The volume of colostrum produced during each feeding is estimated to be 2-10 ml on Day 1 of life, 5-15 ml on Day 2, and 15-30 ml on Day 3. This is considered sufficient, calorically, for feeding a newborn during the first few days of life, though the infant is in a semi-fasting state until full milk production begins due to expending more energy than taking in. The caloric content of colostrum is slightly lower than that of mature milk.

This is a general article that is supposed to cover every major aspect of breastfeeding for the entire world, so details such as volumes of colostrum per day are excessive. More importantly, I am concerned about biased wording such as This is considered sufficient, calorically, which implies that a) it might not actually be sufficient, just "considered" sufficient, and b) that for purposes other than providing calories there is credible doubt as to whether it's sufficient. The claim about semi-fasting state is not supported by the source as far as I can see. Clayoquot (talk | contribs) 06:30, 12 March 2022 (UTC)

References

More statements not supported by the sources

Hi everyone. I've been up for over an hour reviewing the edits by Lehafken. Lehafken, I really hate doing mass reverts of contributions by new users, but in this case I'm seeing just too many mistakes in addition to the issues I mentioned above. For instance:

• This cited study concluded, "This data reinforces evidence for breastfeeding recommendations in mothers after vaccination and helps inform milk bank policies concerning donations from vaccinated women, because milk-delivered antibodies could offer human milk-fed children protection against SARS-CoV-2 infection." but you summarized it as it is unknown whether this provides benefits to the babies., which is essentially opposite to what the study concluded. Additionally, please review WP:MEDRS; we generally use secondary sources, not reports of single studies.
• This review concludes "Although the majority of breastfeeding studies are observational, and definitions and comparisons vary widely, breastfeeding appears to have numerous short- and long-term health benefits for the infant and the mother... Furthermore, longer duration of breastfeeding appears to be associated with greater maternal benefits. As such, breastfeeding represents a modifiable protective factor for various maternal health conditions." Your summary of this is extremely one-sided: It is unknown whether this is due to healthier women being more likely to succeed at breastfeeding and less likely to develop those conditions, or whether breastfeeding causes the reduced incidence.

I'm making the difficult decision to revert your changes and promise I will try to check if I reverted anything that should be included, and re-add it soon. Some of the sources you brought are useful; they just need to be summarized more accurately. Best wishes, Clayoquot (talk | contribs) 07:13, 12 March 2022 (UTC)

Agreed! I am looking at some of the edits from Lehafken, and am frankly disappointed. Many of these edits are not medically accurate, and were things that I personally took time to correct as a part of WikiProject Medicine. I know that we are supposed to keep things data-based and as unbiased as possible, so I will go through and correct some of these new additions with additional citations as needed. Again, I'm a CLC and a soon-to-be MD going into OBGYN. Please let me know if you or anyone else has questions!! Best, Kporter0918 (talk) 15:38, 21 March 2022 (UTC)

Why do my edits on breastfeeding jaundice keep being deleted? In everything I read in the literature about neonatal jaundice and feeding method, and even on UptoDate it is acknowledged that exclusive breastfeeding is a risk factor (if I remember correctly). As an IBCLC of 17 years, it seems to me that parents need to know this information—even if it will affect their feeding choices. Some will want to supplement proactively, which can avoid the inherent mother–baby separation for phototherapy and potentially longer hospitalization or readmission. (Responding to a question about nursing a baby while wrapped in the phototherapy blanket, I know this can be done, but in many hospitals, including mine, they do not provide that as an option.) I know informing parents of this risk factor is not what is recommended by breastfeeding authorities like the ABM, but it’s an issue of informed consent and parental choice. The ABM’s protocol on jaundice also acknowledges it is more likely in breastfed babies https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/22-jaundice-protocol-english.pdf. Also, parents need to know that if they do choose to supplement, they will need to initiate pumping as well. Lehafken (talk) 16:15, 27 March 2022 (UTC)

Hi Lehafken. I've been hoping others would comment in response to your question. Since nobody has yet, I'll offer some thoughts.

Wikipedia policy is to talk about all significant risk factors and not hide anything from the reader, as Wikipedia is not censored. However, it is appropriate to describe risk factors with the nuance and contextualization that are given by reliable secondary sources. In this case, the ABM's jaundice protocol says that breastfeeding, especially exclusive breastfeeding, is associated with higher rates of newborn jaundice, but that low intake rather than breastfeeding per se is the issue. The current version of the article seems to address the risk issue fairly well. Is there something in particular you think it should say differently? There have been a lot of edits lately so it's quite possible that someone deleted something valuable that you added.

W.r.t. proactive supplementation, this is an issue on which people, including health care professionals such as yourself, have a range of valid, reasonable opinions. Wikipedia includes a wide range of opinions on many issues, but when it comes to biomeedical protocols we generally restrict ourselves to summarizing the opinions of professional bodies such as the ABM and the WHO (this is in the WP:MEDRS guidelines). As a website written by anonymous and largely non-expert volunteers, we're just not set up to try to improve on protocols based on editors' own experiences. The ABM's protocol for supplementation is basically "Do not supplement infants with anything other than mother’s own expressed milk in the absence of a specific clinical indication". If another major professional body says something different, we could include that point of view as well. Again, is there something in particular you think we should say differently?

(BTW the literature is intended to guide hospital policy in addition to the decisions of individual families. If mothers are supplementing because their hospital is not sufficiently breastfeeding-friendly, it's the hospital that should change, not the guidelines.) Clayoquot (talk | contribs) 05:17, 30 March 2022 (UTC)

No Clear Mention of Controversy

I'll disclaim that I am a layperson and do not have experience editing on Wikipedia. Despite that, I think my concern has some merit. I've spent a decent amount of time doing individual research on the benefits of breast feeding compared to formula, and to put it simply it seems clear that there's a large amount of controversy around the issue. Several reliable-seeming sources promote breastfeeding and connect it to a host of benefits, and other reliable-seeming sources call some of those benefits into question and argue that the value of breastfeeding has been significantly overstated. Without seeing the controversy explicitly described in the article, I'm left quite confused.

The controversy has been addressed in popular publications like FiveThirtyEight, Time Magazine, The Guardian, The Atlantic, CNN, etc., and also in scientific publications, though I feel less qualified to say which of those are reputable. At any rate, it occupies enough space in the cultural consciousness around breastfeeding (at least in the developed world) that not addressing it seems strange to me. — Preceding unsigned comment added by 71.205.224.197 (talk) 18:10, 2 April 2022 (UTC)

LGBTQ breastfeeding

Hi, I'm not a regular editor but I did notice the section I added to this article on LGBTQ nursing was removed by an anonymous editor without discussion or justification. Prior to adding the section in the first place, I did solicit input on the talk page and heard no objections. I would like to add it back. Dharmabum (talk) 20:58, 26 April 2022 (UTC)

Hi Dharmabum. I looked into this - it looks like you added the section in 2016 and it was deleted in 2017 in this edit. The person who removed it said in her edit summary that the issue wasn't discussed on Talk, but it clearly was discussed.[2] Her other justification for the removal was that it didn't meet WP:MEDRS - well, I can see some stuff in there that should have WP:MEDRS sourcing, but that's not a good reason to delete an entire section. The person who removed the section was subsequently banned from editing a range of topics including breastfeeding. I've restored the section as it should never have been deleted. If you could help improve the sourcing that would be great, as standards have risen since 2016. Thanks for speaking up! Clayoquot (talk | contribs) 23:10, 26 April 2022 (UTC)

I removed it again. Watchers at the time didn't restore it and it stayed out for years. That it's "a whole section" isn't as important to me since getting a section is often due to length, and we actually have material on this already now, partly using the one good source from the old material. If Dharmabum wishes to improve on the existing material with WP:MEDRS sources, that is good, but citing so many medical claims to non-medical sources as well as a claim about terminology preferences to human interest pieces is not great. It would be better to use existing material as a foundation and start fresh with better sources. Crossroads ^-talk- 00:23, 28 April 2022 (UTC)

"Watchers at the time didn't restore it and it stayed out for years" is just as weak an excuse as someone saying "Watchers at the time didn't remove it and it stayed in for years", which is the kind of behavior that leads to Wikipedia:List of hoaxes on Wikipedia. Once these discussions exist, edits made years ago are unimportant.

Of course, well-sourced information is much better than weakly sourced or unsourced information. I think the only open question is whether it makes more sense to have a separate section, or to have the trans-related information spread throughout the article. I can see advantages to both approaches. WhatamIdoing (talk) 17:28, 27 May 2022 (UTC)

Removed a sentence about "language"

I've removed unsourced content that I regard as trivia and unimportant for this kind of article (a source might be found at mama and papa but even with a source, I think it's unimportant here). This was the sentence: "In languages around the world, the word for "mother" is something like "mama". The linguist Roman Jakobson hypothesized that the nasal sound in "mama" comes from the nasal murmur that babies produce when breastfeeding." EMsmile (talk) 08:17, 18 January 2023 (UTC)