Natural Family Planning International

I have reviewed the breastfeeding information in the new CCL manual, The Art of Natural Family Planning: Student Guide, and it is disappointing.  There are two statements that are seriously incomplete and therefore possibly misleading.
 1) “Some studies show that 97% of mothers who exclusively breastfeed can be assured of postpartum infertility for at least six months” (page 161).
 2)  “Exclusive breastfeeding: Generally, highly infertile during the first six months postpartum” (Reference guide, page 254; italics in the original).
      For “exclusive breastfeeding” to be considered a time of infertility, it is essential that the mother still be in amenorrhea, at least after 56 days postpartum.  Bleeds up to 56 days postpartum are not to be counted as menses.  This “exclusive breastfeeding” rule is often called the Lactational Amenorrhea Method (LAM).  Amenorrhea means the absence of menstruation.  To repeat, the absence of menstruation is crucial for this method to be highly effective.  Mothers who count on natural infertility for six months may become pregnant while relying on the CCL statement if their menstruation returns before six months while exclusively breastfeeding. 
      On November 7, I wrote CCL for the studies mentioned in the first statement above.  Executive Director Andy Alderson did me the courtesy of a reply on November 14, as follows:  “Sorry for the delayed response.  While I understand your request, I’ve read your ongoing blogs against CCL.  I don’t think it is productive for the League to get into communications with you at this time.”
      I find it regrettable that Mr. Alderson regards our blog exposure of what CCL is doing and saying as being “against CCL.”  Our hope has been that CCL teachers, promoters, and other interested parties will recognize that CCL’s changes are not in the best interests of CCL.  We still hope they will be able to lead CCL’s current management back to its previous and successful path that was helpful to so many. 
      What our blogs are showing is what CCL is doing.  Is what CCL does  going “against CCL?”  Eventually others would have learned what we have exposed and may have blogged on the new changes.  CCL is welcome to present their viewpoint at each blog of ours if they choose to do so.  Of those who have told us they wrote to CCL about their concerns, none have received a reply.

CCL’s definition for exclusive breastfeeding in their new manual is not clear.   Here is the CCL definition: 
“Exclusive breastfeeding is defined by the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) as the standard of care for babies during their first six months of life.  It is characterized by breastfeeding whenever the baby indicates a desire (day and night) with each feeding fully emptying the breast of milk.  Initially, a minimum of 8-12 feedings per day is required to establish the breastfeeding, with baby kept in close proximity to the mother” (page 154).
      Could a mother believe she is following the requirement for breastfeeding infertility if she nurses according to the definition of exclusive breastfeeding given above?  I certainly think so, so I will call it a “rule.”
      Do you see anywhere in that definition that the baby is to receive only breast milk for its nutrition during the first six months of life?  Could a mother read that definition, believe she is completely nursing and yet think it’s okay to give solids to her baby when her baby is three to five months old?  It looks that way to me.
      Also, nothing is said about the absence of pacifiers or sleeping with the baby or specific behaviors that would help the mother maintain breastfeeding amenorrhea during those first six months postpartum.
      During the mid-60s, as a La Leche League member and later as a LLL leader, I learned that many exclusively breastfeeding mothers have an early return of menstruation or become unexpectedly pregnant during the first six months after childbirth.  I learned that more than just “exclusive breastfeeding” is required to maintain amenorrhea.  If mothers want to have the 97% effectiveness rate (98% by most studies that include amenorrhea in their definition) during the first six months postpartum, they must not have any menstrual bleeding after the 56th day postpartum.  Exclusively breastfeeding mothers can become pregnant during the first six months postpartum if they are having menstrual cycles.
      The point is this.  If a mother does exclusive breastfeeding and hopes that this will give her natural infertility for at least six months, she needs to do more than just not give her baby other liquids or foods.  She needs to follow the Seven Standards of Ecological Breastfeeding.

Changes by CCL’s new management
We think it is unfortunate that the new CCL management has chosen to delete the major charisms that John and I brought to the League: ecological breastfeeding with its Seven Standards, the covenant theology of human sexuality, and a form of systematic NFP that offered different rules for different situations.  Another change is the dropping of ecological breastfeeding as a baby spacer.  On page 100 of the Student Guide the spacing of children is mentioned three times, but this is attributed to abstinence during the fertile time of the cycle.  In the new CCL manual, the natural spacing of births is not associated with breastfeeding except in the incomplete and misleading statements quoted above.

History Repeats Itself
CCL has previously had these problems with incorrect or inadequate instruction.  I know because in my last three years with CCL, I blew the whistle on mistakes in teacher training and instructional materials, and I received the typical whistleblower treatment.  CCL should have learned from their past mistakes.  Some of CCL’s previous mistakes involved the Lactational Amenorrhea Method.                                                                                                 I regret that I have to bring up this mistake again, but I feel obligated to point this out publicly in the hopes that the word will get out to CCL teachers.  CCL should include a corrections sheet with each manual. 
      All of us in the NFP movement need to be accurate and clear, no matter what rules or method we teach.  I really do wish CCL well, but it needs to get substantive things right the first time when teaching others.

Sheila Kippley
NFP International
www.NFPandMore.org
Author: Breastfeeding and Catholic Motherhood and Natural Family Planning: The Question-Answer Book (e-book at this website)

Is it physically possible for a breastfeeding mother to “use” her baby? Yes. Is it morally right or wrong for a mother to “use” her baby? That depends upon what is meant by “using” another person. There is a good sense and a bad sense to that word. An employer uses other people to accomplish a task. If he pays them fairly, provides a safe working environment, and treats them with the dignity due them as human persons, we say he is using them as members of his extended family in the good sense of the term. On the other hand, if the employer pays the least possible amount, fails to provide a safe working environment and in general uses them not in accord with their dignity as human persons, we say that he is using them in the pejorative or bad sense of that term.
      If a breastfeeding mother is engorged and puts her baby to breast for relief, she is clearly using her baby, but is that wrong? My answer comes later. Again, what if she knows that ecological breastfeeding normally delays the return of fertility for over a year. What if she likes that idea and decides to do ecological breastfeeding for that reason? Is she doing something wrong? Is she “using” her baby in the pejorative sense?
      You may think these are silly or purely speculative questions or even cruel ones since they could lead to scrupulosity among sensitive mothers. But the question of “using” one’s breastfeeding baby has been raised in recent months so it calls for a response.

The Question
Would a mother who chose to breastfeed solely for its baby-spacing effects be “using” her baby in the pejorative sense? The short and simple answer is “Absolutely not,” but something more might be helpful.
      We need to start by recognizing that this is a purely hypothetical question. In real life, it would be impossible, practically speaking, for a woman to have or at least to retain such a narrow reason for breastfeeding. For one thing, breastfeeding has too many advantages or blessings to keep focused on one single benefit. Second, to obtain any significant spacing, the mother would have to do ecological breastfeeding, and it can be demanding.
      Still, one person with a theological background was given this question and replied that “If a woman were breastfeeding with the SOLE or even PRIMARY intent of preventing ovulation, then, yes, she could be using her baby as a means to an end.” That sounds like a pejorative sense of “using.”
      Further, a friend has informed us that in its new teacher training program, the Couple to Couple League has written as follows: “As a matter of fact, if the only goal of breastfeeding is the infertility at the expense of the mother, the baby and/or the family, that could be a ‘use’ of the mother, baby and/or family. And as pointed out in ‘The Human Body,’ we should love people, and use things… not the other way around.” (“The Human Body” is a CCL publication.) The inclusion of “at the expense of the mother, the baby and/or the family” is not helpful for our basic question, but the whole sentence gives the impression that our hypothetical single-focus mother would be “using” in the pejorative sense.
      Let’s look at this in terms of a standard analysis of a human act as we did last week.
There are three factors that constitute the morality of a human act.
1) the thing done,
2) the circumstances, and
3) the intention of the person who acts.

      1) Let us focus on ecological breastfeeding in particular because that’s the only kind that offers extended infertility. In this case, the thing done is a basic human good. It is the form of baby care that gives the baby the best nutrition and nurturing.
      2) The circumstances are such that they do not affect the morality of the action. The mother is able to nurse, and the baby is able to suckle.
      Here we need to address CCL’s inclusion of extraneous circumstances, “at the expense of the mother, the baby and/or the family.” Adding extraneous circumstances completely confuses the issue, whatever it might be. Is it good for a mother to worship at Mass on Sunday for the sole purpose of pleasing God? Of course it is, even if there are also other very good reasons that she might not have in mind on any given Sunday. But now add “if it is done at the expense of a child who is so sick that he needs the full-time presence of his mother.” Clearly, the mother has a primary obligation to care for a desperately sick child, and for her to leave her child under those circumstances would be child abandonment and the wrong thing to do. So when we address the morality of breastfeeding for a single intention, we have to eliminate extraneous circumstances.
      3) The intention is the key issue here. Let’s state the question again and then rephrase it.
      Would a mother who chose to breastfeed solely for its baby-spacing effects be “using” her baby in the pejorative sense?
      In other words, would a mother who chose to breastfeed for the sole purpose of seeking the natural effect that God himself built into the nursing mother-baby ecology be “using” her baby in the pejorative sense? Not at all. She desires a God-given good, and the only way to achieve that good is to let her baby nurse frequently. How can anyone say the she would be “using” her baby in a pejorative sense of the word?

For the sake of argument, one might say that the hypothetical mother with her narrow focus has acted with less than the best intention. To that I would offer two responses. First, let’s assume that’s correct. We are required to act for a good intention, but there is no moral teaching of which I am aware that obliges us to act out of the best intention. That’s a concept that a person might discuss with his or her own spiritual advisor. I have heard of some saints who took a promise always to do the best thing, which I imagine would include or might include always acting for the highest intention, but I believe it would be rash for anyone to do so without good spiritual direction. It would be a recipe for scrupulosity and could tie a sensitive person into knots. Second, in the case at hand, the mother’s intention is to achieve a God-planned effect, not an unnatural effect. What can be wrong with that?

This issue should never be raised in the context of general instruction about breastfeeding because of 1) the risk of causing a scrupulous conscience and 2) the total unreality of the question in real life. In real life, the question would only apply to a mother who did ecological breastfeeding, for that’s the only kind that offers extended natural infertility. And in real life, a mother who started with only that limited intention would either soon stop ecological breastfeeding because of the demands of this form of baby care, or she would expand her horizons as she learned both from her own experience and from others the many other benefits of ecological breastfeeding.

To return to the question of intention, our hypothetical mother who chooses to do ecological breastfeeding only for its baby-spacing effects is not doing anything wrong or sinful. She has chosen to do what is best for her baby by all available measurements. She is simply focusing on one God-given effect instead of the big picture. Her limited intention is a good intention. She is not engaged in any form of contraceptive behavior. She allows her baby to nurse whenever he wants, but she cannot force her baby to nurse. Using a standard moral analysis, I cannot find anything wrong or sinful in the choice to do ecological breastfeeding solely for its baby-spacing effect, hypothetical as such a decision might be.

As far as I am concerned, the only thing wrong in this picture is the suggestion that such a mother may be acting wrongly, “using” her baby in a pejorative sense. That plants the seeds for a scrupulous conscience. In my opinion it is wrong to put into NFP instruction and teacher training such concepts that may lead sensitive moms to wonder, every time they pick up their babies, if they are “using” their babies in some sort of wrongful way.

To return to our opening question, what if a mom is feeling engorged, and she nurses solely, at that moment, for personal comfort? Is she using her baby? Of course she is. Is there anything the least bit wrong with that? Absolutely not. Does she love her baby any less because at that moment she is hoping that he will relieve her engorgement? Of course not. Let us be done with negative talk about “using” a breastfeeding baby.

John F. Kippley
Sex and the Marriage Covenant: A Basis for Morality (Ignatius)
Natural Family Planning: The Question-Answer Book, a short, free, and readable e-book available at
www.NFPandmore.org.

“In my 30 years in Brazil, I saw many promising apostolates rise and then fall as they abandoned the charisms of their founders.”—Bishop Karl Jozef Romer, Pontifical Council for the Family, 2002 CCL Convention.
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Need for a news release by CCL on the breastfeeding
Some might wonder why I have blogged about eco-breastfeeding and the possibility that CCL will drop this teaching. The purpose of this blog is to illustrate how important the teaching of eco-breastfeeding has been over the years with CCL. If CCL is dropping this teaching, then I believe CCL should issue a news release about this major change. CCL had two news releases about incorporating the Theology of the Body throughout their teaching, and one of their news releases dealt with the changes in the teaching of the sympto-thermal method. Certainly the changes that seem to be occurring with eco-breastfeeding require a news release by CCL.

The teaching of the Seven Standards or ecological breastfeeding has been a major part of the teaching in the regular series of CCL classes since 1971. To drop this teaching or to replace it with something else is newsworthy. Catholics and former CCL attendees should know that the CCL teaching in this area is now different. The teaching we brought to CCL has changed with respect to the “triple strand,” and the most drastic change appears to be the elimination of the teaching of the Seven Standards of eco-breastfeeding during the regular series of CCL classes.

The teaching of ecological breastfeeding in 1971 was similar to what it is today. We did research prior to 1971 (the beginning year of CCL) on the standards listed below, and this study resulted in a 1972 publication in a scientific journal. As you will see below, the criteria for this research on ecological breastfeeding or natural mothering were quite similar to what we teach today at the NFP International website. The criteria listed in the 1972 published research were these:
No pacifiers used
No bottles used
No solids or liquids for 5 months
No feeding schedules other than baby’s
Presence of night-feedings
Presence of lying-down nursing (naps, night-feedings)

To see how ecological breastfeeding (EBF) and the “triple strand” are important parts of CCL, I went to the CCL website on April 28-29, 2007 and looked for these two concepts. The message at the website is certainly different from the messages I have been hearing from others and have reported in my recent blogs. As you will see, CCL needs to update its website.

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What follows is what I found at the CCL website on April 28-29, 2007. I have added the boldface emphasis.

“NFP…can also refer to the spacing of pregnancies through Ecological Breastfeeding.”

“Regarding the effectiveness of ecological breastfeeding, it provides an average of 14 to 15 months of postpartum infertility for those women who follow its guidelines.” [more info on EBF followed]

“CCL teaches two basic forms of Natural Family Planning (NFP) — Sympto-Thermal Method and Ecological Breastfeeding. …Ecological breastfeeding is actually the world’s oldest form of NFP.” [more on EBF followed]

“Ecological Breastfeeding is a type of nursing that respects and follows the natural order…It is actually the world’s oldest form of family planning because by providing her baby nourishment and nurturing according to the standards of Ecological Breastfeeding, a mother will almost always experience an extended time of infertility following childbirth.”

“Over the years at CCL we have found that teaching about Ecological Breastfeeding has been the most appreciated aspect of our classes. Many women tell us that they find Ecological Breastfeeding to be truly life-enhancing.”

“The League also teaches the world’s oldest form of natural child spacing — ecological breastfeeding. This is a form of breastfeeding that typically provides over a year of natural infertility after childbirth.”

“A Lesson Learned” expresses one mom’s gratitude for learning about ecological breastfeeding and child-centered mothering.

The following are excerpts from CCL’s official CCL documents, Bylaws and Constitution, both dated July 10, 2005 (not quite two years old).

BYLAWS

“The mission of the Couple to Couple League and the Foundation for the Family is…to teach ecological breastfeeding and encourage its use.”

“Permanent employees of CCLI, both full-time and part-time, shall be fully able and willing to publicly uphold and promote all aspects of the fundamentals of CCLI including its religious and moral teachings, the science and the practice of the sympto-thermal method of NFP, ecological breastfeeding, and the CCL Statement of Principles.”

“All CCL courses will introduce ecological breastfeeding..”

“Promoters who make public presentations and Teachers must fully approve the triple strand of the CCL approach to NFP education. This triple strand includes the STM, ecological breastfeeding and morality education.”

“Teachers, Public Promoters, and CCL staff counselors who have yet to experience childbirth and ecological breastfeeding or are beyond the childbearing years must fully approve of and promote the triple strand of the CCL approach to NFP education.”

“As such, a Teacher or Public Promoter who is a mother will normally breastfeed her baby during the first six months of life by providing 100% nourishment from her breasts, day and night, according to the demands of her baby. Once the baby begins solids, mothers normally continue to let the baby nurse as often as baby wants until baby-led weaning occurs.”

“The magazine, in-house publications and brochures published by CCLI shall focus primarily on the subjects of CCL’s triple-strand approach to NFP.”

CONSTITUTION

“Clarifying the League’s principle on ecological breastfeeding. (Appendix 1)”

“To teach the techniques of ecological breastfeeding and encourage its use.”

“To train couples to teach the CCL triple-strand program of instruction. (See Article XI)”

“To carry on an active program of teaching and counseling married and engaged couples in fertility awareness, its virtuous application within marriage and the techniques of ecological breastfeeding.”

“CCL…teaches the techniques of ecological breastfeeding and encourages its use.”

“Teachers and promoters must support and promote the concepts of mother-baby togetherness and ecological breastfeeding. Teachers are expected to practice ecological breastfeeding unless there is a serious reason that makes this impossible.”

“Permanent employees of CCLI, both full-time and part-time, shall be fully able and willing to publicly uphold and promote all aspects of the fundamentals of CCLI including its religious and moral teachings, the science and the practice of the sympto-thermal of NFP, ecological breastfeeding, and the CCL Statement of Principles.”

“Therefore it has adopted the Triple Strand approach to teaching natural family planning.”

“In its Triple Strand program of NFP education, the CCLI shall teach ecological breastfeeding,[etc.].”

“Ecological breastfeeding can be an appropriate exercise of responsible parenthood; it is not just a child-spacing technique.”

CCL PRESS RELEASES

March 10, 2005: “CCL Teaching Couple Richard and Vicki Braun explained the Sympto-Thermal Method as taught by CCL, the moral aspects of NFP, and the role of ecological breastfeeding in family spacing.”

March 31, 2005: “CCLI remains committed to its “triple strand” educational approach, which combines the Sympto-Thermal Method of NFP, moral theology as it applies to marital intimacy, and the importance of ecological breastfeeding and its effect on the natural spacing of children.” [The main purpose of the release was to announce the incorporation of the Theology of the Body “throughout all of CCLI’s teaching materials and the organization’s affairs.”]

October 17, 2005: [announcement again on CCL’s teaching reflecting “the theological thought of Pope John Paul II” plus the new retooled version of the STM. Nothing was said about breastfeeding in this news release. If CCL can have a news release in March and October 2005 on the changes in two parts of the “Triple Strand,” why not a news release on the changes in the third part of the “Triple Strand?”]

Also found at the CCL website was my “Summary of Ecological Breastfeeding and Natural Child Spacing Program.” A similar summary is found in the original mimeograph first edition of The Art of Natural Family Planning. The brochure “Breastfeeding: Does It Really Space Babies” which John wrote for CCL is still at the CCL website. Both items have much to say about ecological breastfeeding.

As of May 28, 2007, in its website capital campaign promotion, CCL continues to promise several times the promotion of ecological breastfeeding.
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From Sheila:
Eco-breastfeeding has been a major teaching in the CCL’s “triple strand” approach to NFP. Is CCL going to promote this teaching in their new main NFP program? From what I hear, it’s not likely.

If CCL plans to drop the teaching of ecological breastfeeding, I would ask the members of the CCL Board to reconsider their decision on this. If, however, CCL does not teach the Seven Standards of eco-breastfeeding in its regular series of classes, then I recommend the following: 1) CCL should make the necessary changes at their website; 2) CCL should produce a news release to inform people of the breastfeeding changes. And 3) CCL should explain why it continues to promote ecological breastfeeding in its capital campaign drive and at their website, especially the by-laws and constitution, if, in fact, that’s not the case. For example, what happened since July 2005 (date of the CCL by-laws and constitution and since early 2006 (date that the promotional capital campaign brochure was sent) to the present day in 2007 that caused CCL to change its teaching?

The Sin of Onan
My husband’s article on that subject was published in the May 2007 issue of Homiletic & Pastoral Review. It is now available at our website. The unnamed priest in the article is Fr. Richard Hogan, a member of the CCL Board of Directors.

New Blogger: You will soon be hearing from John in these blogs. I plan to return during World Breastfeeding Week, August 1-7, for daily blogging on the merits of breastfeeding, including the theme for this year: the importance of breastfeeding during the first hour after birth.

An appeal for donations: This is our 9th week of blogging without a “commercial.” We have helped many couples and are now asking for help in our current mission. The mission of NFP International is to promote and teach Natural Family Planning here in the United States as well as in other countries. We teach ecological breastfeeding, systematic NFP, marital chastity, and the call to generosity in having children and raising them in the ways of the Lord. A secondary mission is to uphold traditional Christian teaching about love, marriage and sexuality and to provide materials that people can use to improve their spiritual lives. We also support the NFP apostolate over in Slovakia and in Georgia. Interestingly, the folks in Georgia were trained in the CCL method and later a bishop had the CCL teachers trained in the Roetzer method. The CCl teachers in Georgia, however, prefer the CCL method and want Jozef Predac of Slovakia and David Prentis of Czech Republic to give assistance in teacher training so they can train others in the “old” CCL method.

CCL has assisted other countries for years but in 2005 CCL decided to help only those who were teaching their program in English or Spanish. Thus funding was cut to Slovakia. Jozef and his wife have five young children and Jozef desires to remain in the NFP apostolate. NFP International provides his salary from donations. David Prentis is living off his retirement pensions and works as a volunteer, but Jozef needs a salary to support his family. Jozef sends NFPI a quarterly report of his activites. Some of his work is listed at International Mission at the NFPI website. If you can, please send a donation to:

NFPI at P.O. Box 11216; Cincinnati OH 45211.

We will greatly appreciate your help.

Sheila Kippley
NFP International
www.nfpandmore.org
Author: Breastfeeding and Catholic Motherhood (Sophia, 2005)
Natural Family Planning: Question-Answer Book (e-book
at this website, 2005)