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breastfeeding, and FBT

Posted Aug 15 2012 10:09am
Many of the arguments about Family-Based Maudsley Treatment feel familiar.

I was probably well-trained for FBT advocacy from years in the breastfeeding gauntlet. I've heard the "well, I could never have done that!" and the "well, it isn't for everyone," and "Well, your success at that makes me feel guilty for not doing it."

Not "succeeding" at breastfeeding isn't a mark of poor parenting and not "making a success" at FBT/Maudsley isn't an indictment of anything.

You cannot make someone successfully breastfeed, or homeschool, or bake fresh bread, or love fresh apples. None of these choices work if they are NOT choices, consciously and thoughtfully volunteered. This is also true of FBT/Maudsley. It is less likely to work for those who have it forced on their family  without options. None of these lovely things ARE right for every situation and anyone who says they are is a mindless zealot (I actually haven't met any).

I don't want everyone to have to engage in FBT; I want everyone to have the opportunity.

The point of offering parents a choice isn't about browbeating people it is about opportunity and judgement. If we believe in a certain idea the best way to promote it is to truly believe that people will choose it in the right situations and then to respect them when they do NOT make the same decision you did.

P.S. In case you're about to comment on this (people always do) with "but aren't you telling people they have to do FBT/Maudsley because you say it is "the only evidence-based approach for anorexia and has the highest rates of success for adolescents ill for under 3 years" but I'm not.  Just as "penicillin has the highest rates of success on certain infections" isn't saying that all infections should be treated with penicillin or that no other antibiotics can be used. Citing the actual success rate is important information in making choices, not telling them what to do. Insurers, national health systems, and parents who think higher rates of success equals no other choices need to sit in the naughty corner and reconsider.
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