AIBU to wonder if this is discriminatory by The Breastfeeding Network?

[MPharm]

Today a friend shared a Facebook post advertising a voluntary opportunity for pharmacists to work with The Breastfeeding Network to provide advice on medications during breastfeeding. This is a large part of my day job so I had a look out of interest. One of the essential criteria is 'experience of breastfeeding at least one baby for four months'. As a childless woman I therefore cannot apply. This role is not peer support, or help to establish breastfeeding. It is a pharmacist role advising on the passage of drugs into breastmilk. I can't see why lived experience is essential. AIBU to wonder if this is discrimination? AFAIK being childless is not a protected characteristic, but is infertility? Sex is, so it's surely at least discrimination against men.

In addition, someone has commented on their post expressing her sadness she cannot apply as she breastfed for less than 4 months. The reply says if she 'breast/chest fed at all' she may be considered. So their language can be inclusive of some groups, but not child-free women?

People who are asking for advice on any aspect of breastfeeding might have additional questions and will benefit from lived experience.

That was certainly my experience. I was prescribed a drug that I really needed and it was only when I got home that I realised the GP hasn't asked me if I was BFing and had prescribed a drug which said not to take.

I decided to ring the BFN before speaking to the GP who outlined it all for me and was able to relate her own experience and talk me through my others questions.

So yes, YABU.

Completely in agreement with this.

Also the focus is promoting and protecting breastfeeding within the NHS and uk breastfeeding campaigns. Someone who has breastfed is more likely to want to protect breastfeeding by working with mother's to support their medical needs than someone who has not.

This. I've used the BFN a lot for various reasons.

What is it with all the threads on MN about "lived experience" as prereqs for jobs?

The man advising on period dignity

The person with active MH issues seeking peer support role for MH issues

Now this thread.
Weird.

@WhereAreMyAirpods The breastfeeding counsellor or drugs in breastmilk person will be talking through the shades of grey : the dose, how long they are likely to be taking for, techniques for "pump and dump" while the drug clears the system, whether it would be possible to feed then immediately take the medication so it's clear of the system by the next feed, how important it is to the mother/child that the breastfeeding continues etc etc etc.

But this is exactly what a pharmacist does and would consider? Just because I haven't personally breastfed doesn't mean I don't have a professional understanding of all these things. As I said, this is a large part of my NHS day job. If the NHS consider me qualified, why don't TBN?

I accept the comments that someone who has breastfed may be more inclined to continue to encourage it, but again as a HCP I would also do that.

I agree with PP that if it was desirable I wouldn't have batted an eye, I understand why it would be. But essential? I just don't think it should be excluding so many potential applicants.

@lljkk Maybe there's just a lot in the news? I also recently read an article about a senior RAF recruitment officer who resigned due to pressure to meet E&D targets. Which is sort of the opposite, but still means recruitment is topical

And actually, given they've replied to someone who fed for a shorter time period saying they should apply, I suspect it is desirable and not essential anyway!

But OP you've said yourself that you wouldn't be interested in the position. Have you considered perhaps that's not because it's voluntary, but because you're just not that interested in BFing? There's nothing wrong with that, I wouldn't expect somebody who hasn't had children let alone BF to be that interested. I bet there are charities that you would give up your time for though. There's nothing wrong with them wanting somebody who they feel will be most committed to the service they provide, and that's arguably somebody who has BF themselves.

They are "excluding you" - from a voluntary position which you had no intention of applying for anyway - because they are a charity composed of women who have breastfed supporting other women who are currently breastfeeding.

Your pharmacy training is completely different to the training which a breastfeeding counsellor has.

I think they want to be able to tell women that they'll always get someone with direct experience of breastfeeding as well as a qualified pharmacist if they contact them. As you say, any pharmacist should know about the interaction of drugs with breastfeeding (they don't, in my experience, but they should) so if that was the sole skill what has anyone gained by contacting BfN rather than just going to their local pharmacy? The 'value added' here is that they get both. To be honest, the fact that you can't see the use of lived experience in this role seems to demonstrate perfectly why you wouldn't be well-suited to it.

I do think that the specific requirement for four months is odd - I'd understand a bit more if they'd specified experience of longer-term breastfeeding, but that would narrow their pool even further - and think that it probably should have been desirable and just specified personal experience of breastfeeding. In practice of course many charity volunteers have a personal connection to the work of the charity and most users would expect that.

So what if the BFN had breast fed but had had a baby that latched easily, no reflux, she'd never needed for much as a paracetamol for 4 months then she'd stopped because she thought it was a bit weird doing it past six months. How does her lived experience help her relate her own experience to a struggling Mom like yourself, someone who might need to pump etc?

Reading the JD the post holder needs to be able to give bf advice.

I think lived experience is pretty essential.

Much like period advice for young girls is better from a woman who has had periods than a man who has not.

Course they need to give breastfeeding advice. When I was a Bfc I would refer women to the Breastfeeding Network's drug line all of the time. Because I knew that the person who manned the phone lines (it was phone support at that time) was BOTH a fully trained pharmacist AND a fully trained breastfeeding counsellor.

Without the "fully trained breastfeeding counsellor" bit, the mum is just as well going to Boots. Pharmacists might have a bit of training about drugs in breastmilk but pharmacist training does not include the myriad of other issues mothers deal with like getting the latch right, cluster feeding, crises of confidence, worries about not having enough milk, breastfeeding twins or tandem feeding an older child, dealing with a blocked duct, suggesting alternative feeding positions etc etc etc.

And I'm sure that loads of mothers who have breastfed can totally identify with the "I'm the expert" and "I know it all even though I have no direct experience or specialist training" attitude which is common to many GPs and related medical professionals.

I'm torn. Back at the start of breastfeeding, the advice from certain midwives who had no children was worse than useless, it was quite wrong. Family who had never breastfed were equally useless. The health visitor, a couple of neighbours, other mums and randoms around my life at that time who had breastfed was exactly what I needed. Back when I was breastfeeding, medical professionals on several occasions told me to take drugs unsuitable for breastfeeding or not take drugs that are fine, and have been told "you can just stop breastfeeding". I would just search The Breastfeeding Network for the drug and show the doctor/ dentist the info to discuss whether a drug was appropriate or not.

For balance, I only knew to look drugs up on The Breastfeeding Network because my old male pharmacist saw the baby, asked if I was breastfeeding and told me to check before accepting doctor prescriptions. He also saw my medication and told me not to touch fenugreek as it's contraindicated but frequently advised by midwives (including mine!) to increase supply. My health visitor also commented, the GP and consultant didn't. I wouldn't have asked him about breast pain etc, so I don't know how he would have got on with that.

So my real experience is that it would be better in most cases for the person to have breastfed, and the plethora of advice from those who don't isn't always useful. Perhaps a compromise could be that professionals declare if they have personal breastfeeding experience or not as part of providing advice to limit the conversation to drugs and supplements, then signpost other support. In fact, it's useful for anyone giving advice to suggest local breastfeeding groups for added support.

I've DMd you Osp

UKDILAS is the place to go for proper evidence-based advice on medicines and breastfeeding.

But not a place for breastfeeding support or advice on issues other than drugs.

It's not a competition. The BfN is providing a DIFFERENT service for mothers, by mothers.

What evidence would they want to prove this criteria? It's not like you get a certificate. Just apply and say "yeah, I've done that, no problem".

@WhereAreMyAirpods
In my experience, some of the evidence used by the BFN re drug safety in breastfeeding is dubious. UKDILAS reviews the evidence in a systematic way whereas in my opinion, the BFN approach has often been 'it will be fine'. And yes, it's not a competition and the BFN also offers support. But they do frame themselves as a place to go re drug safety advice

The organisation is the Breastfeeding Network. Experience of breastfeeding seems a reasonable requirement.

@WhereAreMyAirpods

Most pharmacists, breastfeeding counsellors, and indeed doctors are very wary about giving advice re drugs and breastfeeding. It's a very specialist field.

Surely it would be better if all breast feeding counsellors, HVs, GPs, midwives and other HCPs were required to provide links to, and publications from, the official sources of pharmacological advice that already exist. Duplicating (and in my experience often diluting or misquoting ) existing information isn't an efficient use of resources.

Indeed it is. Which is why it is VITAL that people volunteering with the BfN or similar to advise breastfeeding mothers on drugs and breastfeeding can wear both hats with medical and breastfeeding expertise. OP only fulfils 50% of the criteria. She might know her drugs inside out and back to front, but has zero direct experience of breastfeeding. So she's not qualified.

(even if she wanted to volunteer in the first place, which she doesn't)

That's not what mums need in most cases though. A mum who has been told by her GP - for example - that she needs to start on a SSRI for depression and stop breastfeeding wants to speak to someone who can both advise on the medication, and talk through her feelings about breastfeeding and whether she can combine both with alternative medication regimes.

The "official publications" like formularies are facts, dose figures, yes/no answers, licensed/not licensed. No shades of grey. That's not what they're intended for at all.

You're right of course, but I guess I just wonder whether X months of breastfeeding is the best measure of breastfeeding knowledge. As I mentioned in an earlier post, the woman who saved breastfeeding for me was an amazing lactation consultant who'd never had a child or breastfed. OTOH, my mother breastfed for years, and whilst she was a great emotional support, she didn't know much at all about breastfeeding issues as her experience was relatively easy. She ended up learning a lot from me, tbh!

I suppose what I'm trying to say is that as someone who needed breastfeeding support, I couldn't care less how long someone has breastfed, I care how good their knowledge is. I think that the BFN would be better of requiring applicants to have good breastfeeding knowledge, rather than an arbitrary requirement of a certain amount of months breastfeeding. Perhaps an applicants in-depth knowledge did come from breastfeeding for three months, and that's fine. But I just think equally good knowledge could come from elsewhere.