Tuesday, March 15, 2011

When Experts Speak

I haven’t yet written about my current work with the hospital, but part of it involves looking pamphlets and brochures and explaining why this or that phrase will not resonate with the intended audience.

For example, my most recent work involves a flyer on breastmilk. The NICU hosts two different kinds of Moms: the Moms who envisioned nursing their newborns every two hours while a choir of angels sang in the background, and the Moms who think, “Euuuuuuuuuuewwwwwwww.” One group pumps diligently, the other group needs a little prompting.

Breastmilk is better than formula for all babies, but for healthy babies, the difference between babies who are nursed and babies who are fed formula is negligible. Repeat: negligible. You may have to read that sentence twice, because the La Leche League would have you believe that formula is poison, but formula is nutrition. But if you want a baby that healthy, strong, and smart, it’s better to be rich than to be nursed. So if you’re stressed out because you have to go back to work and pumping is making you so crazy that you’re losing hair in patches, pull out the powder instead; your baby will be no worse off because of it. Really.

If, on the other hand, your baby is a NICU baby, suck it up and pump, Mom. Your baby needs you. Breastmilk has amazing properties that modern medicine can barely identify, let alone replicate. The best it can do is to invent ways to get the milk out more efficiently in the event that your baby cannot.

Spending forty-five minutes tethered to a hospital grade pump is a real drag, especially if you have to do it eight times a day. I know. I bribed myself with candy bars to make myself wake up in the middle of the night to pump. I took a prescription drug that made me depressed, panicked, and exhausted (I sleepwalked through six weeks of last year’s winter) just to improve milk supply. It sucked. But sick babies need breastmilk and Moms are the only ones who make it. Breastmilk improves digestion and decreases risk of terrible diseases such as NEC. (Diseases to which preemies are susceptible. Healthy babies need never even know that these things exist.)

The NICU staff’s hands are tied, in a way, because the last thing they want to do is pressure a stressed-out NICU mom into pumping breastmilk for her baby and at the same time, they need that breastmilk more than anything. (They can use banked breast milk. Our boys were on breastmilk when my supply was inadequate, but it’s not the same. In fact, the constitution of a mother’s milk changes as her baby grows. The milk of a mom whose babies are twenty-five weeks’ gestation is different from her milk when her babies are twenty-eight weeks’ gestation.)

In an effort to gently get all Moms pumping, the NICU staff put together this flyer informing parents about the benefits of breastmilk.

And that’s where I come in. I look at the flyer and tell them why it doesn’t say what they think it says.

The breastmilk flyer that outlines 10 major benefits to providing breastmilk to babies ranging from decreased risks and increased benefits for the baby to decreased risks and increased benefits for the mom. (They can’t say “breastfeed” because in most cases, these babies are unable to nurse yet).

The trouble is, the flyer’s list of risks and benefits list multisyllabic medical terms that make even my eyes glaze over—and I know to what these terms refer. I can’t imagine an uneducated mom (the target audience) hanging in there past the second sentence.

The flyer makes a number of fatal assumptions, but one that stands out is that the flyer assumes that 1) mothers know that breastmilk is powerful and 2) mothers know that they are the only ones who can provide the breastmilk. To this end, one of the changes we made to the flyer is to call breastmilk “medicine.” Comparing breastmilk to medicine introduces an aspect of the liquid that these moms might not be familiar with. Now it doesn’t matter if she doesn’t know what necrotizing enterocolititis is. She understands that it’s a medical condition that can be treated through the medicine of breastmilk.
The gist of the recent breastmilk brochure is the recurring problem of education and communication. If you believed what I have to say to you, I wouldn’t have to say it. Given that you don’t believe it, then I have to say it a different way. In other words, those moms who already pump milk morning, noon, and night (along with early morning, late morning, early afternoon, late afternoon, late night and wee hours) know that the constitution of milk has special properties that can treat specific conditions. Skipping over that fact and listing just risks and benefits doesn’t the moms who may just think of milk as milk.

I know that information is only understood within contexts and that to change minds, you have to find the right context.

So I was very surprised to find myself resisting the advice of the speech therapist who told us that we must bombard our language-delayed babies with words and gestures. I looked at her, nodded at her dutifully, and decided that I know better.

Me—who has had one semester of Language Acquisition. What do I know that she doesn’t?

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