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ITALIAN ENGLISH FRENCH SPANISH GERMAN HOW NOT TO PRACTISE WHAT ONE PREACHES: I’d like to tell you an unbelievable, ludicrous story which amazed and embittered me and which unfortunately will create an uproar. I am a pharmacist of Bassano del Grappa and, since I have had my first child, I have realised how important breastfeeding and supporting mothers is. If I hadn’t been helped by a professional from La Leche League, I would have used formula myself and my life would have taken an entirely differentdirection, and now I wouldn’t be here, writing … I immediately joined in theFAAM Farmacia Amica Allattamento Materno (Breastfeeding-Friendly Pharmacies - Code Complient Pharmacy) project in support of breastfeeding http://progettofaam.org/ and over these years I have worked really hard to promote, support and protect breastfeeding: training, conferences, courses (http://www.zoes.it/it/content/blog/la-dottssa-chiara-pozzi-perteghella-intervistata-sulla-farmacia-amica-dellallattamento). To improve my skills, I decided I wanted to qualify as an IBCLC, a professional breastfeeding consultant (http://www.iblce-europe.org/Other/download_1_candidates.htm#English), so I started studying hard to sit the exam on July 26th, 2010 (editor’s note: the exam is very strictand takes place on the last Monday in July all over the world. In themeantime, I got pregnant with my third child …. In order to be admitted to take the exam, you have to fulfil the following requirements: at least 100 hours’ consultancy and 80 hours’ training, but I waited till the last minute before I enrolled for the exam, April 30th, 2010, because I had just given birth (Pieralberto was born on April 5th), so I wanted to see if and how I managed with three little kids. So I decided to send all my CV (I paid 535 euros as a registration fee) and pointed out that I would go and take the test with my baby because at three and half months oldyou have to breastfeed on tap. On May 18th, that is, just two months before the exam, I was informed by the national IBLCE manager that only examinees and examiners may get into the room, so I would have to let my baby out: I might go out and breastfeed him, but the time it took could not be made up for, or I could express my milk and have it fed to the baby by someone who looked after him outside the room. The reason for this procedure is that the baby might disturb the other examinees (editor’s note: the exam lasts two and a half hours in the morning and two and a half hours in the afternoon, with a lunch break, and consists of closed-answerquestions). I was flabbergasted at this news and decided to ask Dr Armeni, as the president of AICPAM, Associazione Italiana Consulenti Professionali in Allattamento Materno (Italian Association of professional breastfeeding consultants) http://www.aicpam.org/ for explanations. Again, I was given a chilly, unsympathetic answer: according to the international rules, a breastfeeding examinee cannot take her baby into the room and, if she has to breastfeed, she may, but she has to go out … so I went to the IBLCE Europe manager and asked her if I could sit the exam in a separate room with my baby and again I was given the same answer. Now, I’ll try to share some of my reflections with you: I AM AN EXAMINEE AND I AM BREASTFEEDING A BABY AGED THREE MONTHS AND A HALF AND, IN ORDER TO SIT THE EXAM AND QUALIFY AS A BREASTFEEDING CONSULTANT, I CANNOT BREASTFEED MY CHILD…. OR, IF I DO BREASTFEED HIM, THEN I’D WASTE TOO MUCH TIME FOR THE EXAM… The regulations did not state that, if you have a baby and you take him with you, he cannot get in and, if you get out to breastfeed him, the time it takes cannot be made up for. This is discrimination between me and the other examinees, because, as a matter of fact, a breastfeeding examinee has less time … I find the regulations discriminatory and even inconsistent. There’s no need to explain the care and diet that a child of three and a half months of age needs. There’s no need to explain that to the IBLCE International Board of Lactation Consultant Examiners http://www.iblce.org/: aged three and a half months, a baby sucks his mother’s breast lots of times, because he is hungry and because he is thirsty (and don’t forget that it’s extremely hot in Bolzano on July 26th) and even because he wants to be close to his mum. But what the regulations offer me is a babysitter and a bottle of expressed milk. And so I, who opted for the maternage approach whereby I live with my baby in a baby-sling to reconcile his needs with mine, should keep him away for two and half hours, while I answer such questions as: EXTERNAL PREGNANCY covers all these behaviours: the mother takes the baby around in a baby-sling or wrap for several hours a day; the mother frequently breastfeeds the baby; the mother takes the baby at work with her. HOW INCOSISTENT IS THAT? And, if I express milk and he won’t drink it, what should I do? Should I keep answering the questions or should I get out and breastfeed him, thus “wasting precious time”? Where’s the support to mothers in all this? The feeling you get as you read the reasons given by IBLCE and AICPAM is: mum, stay at home and don’t disturb. Want your baby close to you? Stay at home…. And think that there is so much work going on to involve mothers in society, not to exclude them, to enable them to breastfeed anywhere, to create a child-friendly society … Indeed, this year’s AICPAM meeting is called "Women and their breastfeeding choices: cultural changes and practical support systems", http://www.aicpam.org/giornata.asp When I read the title, I burst out laughing, not least because the meeting will take place in my town (Bassano del Grappa). So, I regret to say that I will not sit the exam, because I don’t think such discrimination and inconsistency should be tolerated and because I don’t like to be qualified as a breastfeeding expert by people who showed they know nothing about it. I ask the health workers who work in breastfeeding, to the mothers and all the people concerned to write to the IBLCE Europe manager, Ilse Bichler, IBCLC Regional Director, Steinfeldgasse 11, 2511 Pfaffstaetten (Austria) mail office@iblce-europe.org, to the IBLCE Italy examination superintendent, Laura Antinucci : italy@iblce-europe.org, to the president of AICPAM Dr Armeni Ersilia siliadoc@fastwebnet.it and to all of the AICPAM executives mariocirulli@libero.it and ask them to change the regulations sothat a mother can take the exam with her baby without being discriminated against. I conclude with two important details that I brought to the attention of the president of AICPAM but which have not been taken any notice of: 1. In 2002, a breastfeeding examinee took the exam with her baby in a baby-sling and nobody was disturbed. 2. In Rome, last year, on the day of the examination, there was one examiner’s small dog in the room. Given the sweltering heat of late July, it needed to be close to his mistress who took it out from time to time to relieve itself. Once again, none of the examinees was disturbed by the little guest… Aware that this outburst will fatten up the formula manufacturers and all those who do not work so that they can breastfeed… One last thing: I am not doing all this for myself! I will not take that exam! I believe it is a fair battle for all those mothers who will want to take it in the future. Dr Chiara Pozzi Perteghella
Please find below an email sent by Dr Armeni to the Board of AICPAM where my address has been included by mistake. I have enclosed it because I think the tone of this email is not only unsympathetic but even offensive to me and to those pharmacists who support breastfeeding. My reply to the doctor can be found below. I personally think is not the ‘done’ thing.
For the following reasons: If it is a matter of principle, thenthe principle must be shared with the management. This is not a confrontation
between the examinee and Aicpam, this is something different... From a practical point of view,there must be a different room and one or two proctors (if there is more than one examinee, one must stay in the room and one will escort her to the bathroom). The system has been arranged in time and with quite a lot of work (requirements are very strict). In addition, I do not agree on Aicpam having to bear the costs. The less said about the fact that such request was made in an arrogant, patronising tone (you are talking to me about oxytocin, WHO, etc???) as well as in a personal tone (I don’t embody Aicpam or IBLCE), an elaborate request that throws challenges that make us reflect and which may lead to improvements for everyone and for good – not the occasional measure, in the Italian style –, that is what I would expect of a reasonable, sensible person. Judging from her words (ah, having a handwritten letter!) and apart from what she did (breastfeeding-friendly pharmacies, those really don’t make much sense to me – well, I don’t know), this person puzzles me. To make a long story short, I propose: 1) to take a vote on sending a proposal to IBLCE about this matter; 2) if the proposal is voted on by the majority, then someone will write and translate it; 3) as soon as I have everything ready, I will take care of contacting the right person in IBLCE and I will send it. Of course, any consequence will become visible next year. All this has a name: democracy. Looking forward to receiving your replies, I wish you all a very nice day, Silia My reply: Dearest Dr Armeni, Firstly, I would like to point out that my surname is "Pozzi Perteghella"; secondly, I thank you for giving me your mobile phone number, but I am unable to accept the invitation to call you because your email, as you may well imagine, quite surprised me. It surprised me for the things it says and the tone it uses, which is far different from the tone of the emails you used to send me. I think I can say that both the tone and contents are fairly disrespectful of my profession, of myself and, if I may, of my child. I realise that in your opinion a mother should not be allowed to have her child with her during the exam; this is very surprising, coming from a person in your position, but I acknowledge that. You are the president of AICPAM, Associazione Italiana Consulenti Professionali Allattamento Materno, the Italian Association of Professional Breastfeeding Consultants, and, instead of being happy that this matter will be tackled by quite a lot of professionals, you couldn’t find anything better than disparaging the Farmacie Amiche dell'Allattamento Materno or Breastfeeding-Friendly Pharmacies project, which “don’t really make much sense to you". I hope you have had a chance to visit one, at least. You accuse me of speaking in an “arrogant, patronising tone”, but your words below speak volumes about who feels so self-important that they think they have nothing to learn from anyone. Saying that, I ask you: is your position representative of the IBCLC world or is it something that doesn’t quite add up? If the answer is yes, then you can rest assured I have no intention to get into that world, as I believe that just another piece of paper would not possibly certify my professional and personal experience as a mother. But the problem, I insist, is not myself nor my child: the real problem is the principle – which in my opinion is sacred – that a breastfeeding mother is entitled to have access to any normal everyday activity: this is no intensive therapy, this is normality, and an exam, no matter how difficult, is a normal activity. I was apparently wrong when I claimed that being an IBCLC, as well as improving my unfailingly ongoing training (!), would have made me a member of a network of professional breastfeeding supporters. I can live without that exam, but obviously I will take great pains to inform my fellow pharmacists of the position of your association, which I think doesn’t look too well. Dr Chiara Pozzi Perteghella
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