A call for ethical breastfeeding medicine education based on best available science (without ideological exclusions)
Non-profits are not necessarily operationally pure and pull commercial levers to ensure their own survival
Lactation non-profits leverage goodwill from the belief that the non-profit is a pure or superior form of governance structure for supporting breastfeeding women, compared to a business or social enterprise structure.
This belief in the governance purity of the non-profit fails to take into account the growing critiques of charity and non-profit operations, their vulnerability to poor governance, and their difficulty responding in an agile or timely way to emergent challenges. Because non-profits and charities, too, need to survive commercially, they can quite easily take on unconsciously predatory business practices. Others may be tightly controlled by families or founders, in order to secure founders’ incomes, though this may not be transparently declared as a conflict of interest. Still others use levers to exclude or silence perceived competitors under the guise of non-profit purity of intent. This naivity concerning the governance structure of lactation non-profits (which I shared myself prior to founding a charity) does not, in the end, serve the best interests of lactating women and their babies.
Lactation medicine needs to be embedded in a 21st understanding of complex systems
Each of these beliefs – that the disruptive outsider who disrupts group purity requires stigmatising punishment, that the lactation non-profit mission is pure, that there is a purity of knowledge and authority in lactation education - these beliefs are simplistic distillations of very complex realities. For instance, the disruptor does cause discomfort and inconvenience, even though she needs to be invited into the group, for the sake of the health of the group and ultimately for the sake of the families they serve.
21st century knowledge of complex systems teaches us that if we start to behave according to simplistic or reductionist paradigms, we risk unintended and sometimes dangerous outcomes in a world and in families which operate as complex systems. This is the crucible in which lactation medicine finds itself today, even as it gains traction as a standalone special interest or field within medicine.
Recommended resources
Possums Breastfeeding & Lactation articles which address lactation non-profits, ideology, and harm