Abstract
In my editor position, I see thousands of words every day. Admittedly, my point of view is skewed because of the abundance of written words in my daily life, but I would like to share it with you. As writers, readers, scholars, and clinicians, we use precise language as an essential tool of our trade. It enhances communication in ways too numerable to mention, which I am sure you understand. My purpose in writing this editorial is to shed some light on recurring language usage issues that all the JHL editors encounter daily in the submissions to our journal, with the hope that so doing will assist authors and readers in understanding distinctions between words we commonly use and misuse. In this editorial, I am sharing with you several JHL policies about language usage and the common misuse of words we see in submitted manuscripts.
At JHL, we have made some policy decisions about word usage, reflecting the need for clarity and parsimony in what we publish. As of the beginning of last year, we no longer use the commonly spoken and written term breast milk; instead, we use only the terms human milk or mother’s own milk, which are more accurate in indicating the type and origin of the milk. After all, cows do not make “udder” milk. It is difficult to know why the term breast milk came to be used so frequently. Many of our submissions still use this terminology; authors are required to change it before publication.
Although this is not an issue of JHL policy, another circumstance in which using words as they are commonly used in conversation causes a problem when writing scholarly work is the distinction between the words breastfeeding and lactation as well as pumping and expressing milk. Our preferred usage is expressing milk, as it is more descriptively accurate in reflecting the physiologic process used. We avoid the use of pumping, as it makes assumptions about how milk is being removed from the breast. The words breastfeeding and lactation are too often used interchangeably and they are not interchangeable. Breastfeeding is the act of transferring human milk to an infant at the breast. Lactation is the physiologic process of producing that milk. They are the yin and yang of our profession—deeply interdependent but discrete entities. Both of these instances of misuse foster lack of clarity. A profession needs to have clearly defined language understood by all in the profession.
Our colleagues, who speak and write the Queen’s English, have raised some concerns about JHL’s policy requiring American English. Although JHL will accept manuscripts using British spelling and send them out for review, our journal publishes only American English spelling. It is common practice in publishing to use one or the other of these English language styles, not both. This may not be very culturally sensitive, but little can be done to change it given the need for publishers to choose one typeset for economy of both time and money.
A more recent policy about word usage concerns how we, as a profession, talk about ourselves. Distinctions in the level of lactation care are currently a “hot” topic in our profession, which will take time to sort out. However, we cannot be vague about the level of care being provided when it comes to research interventions, policy discussions, or any article that gets published in JHL. Language usage for providers of specialized lactation care (International Board Certified Lactation Consultants [IBCLCs]) and many different types of lactation support and education service providers (e.g., CLE, CLC, LE, etc.) becomes muddy when the term lactation consultant is used. We no longer publish this term; it just is not precise enough. Authors must use the term IBCLC when referring to lactation specialists holding that credential. When referring to a licensed person (e.g., MD, MBBS, RN, RD) who specializes in the care of breastfeeding families but does not hold the IBCLC credential, a description that includes this information must be provided. If the author is referring to lactation support/education providers, it is appropriate to specifically identify their credentials or to describe their level of lactation-specific education and area of practice. It is time that we, as a specialty profession, reexamine some of our common usage of language and discard what is old and no longer serves us well. Described above are two examples of old language that no longer is useful in moving our profession forward. I am sure there are other similar terms that need a closer look, and with your help, we will do so. Additional language usage requirements are published in the “JHL Author Directions” (2018).
Another hot topic in lactation and other circles, reflecting changing socio-cultural contexts, is the use of gendered language. For millennia, feeding infants human milk has been the role of females (heteronormative); thus, using gender-specific language when referring to infant feeding (cisnormativity) has been the norm. Today’s world is different, particularly in the developed world; feeding infants human milk is no longer just the domain of cisnormative individuals. The complexity of how this different world affects lactation practice, education, and writing was addressed by Alice Farrow (2015) at the ILCA 2017 international conference, having been published in JHL.
Although it has been said that JHL continues to use cisnormative language, despite the changing face of breastfeeding families, the JHL editors welcome this diversity and embrace inclusiveness. We do not have a policy about using or not using cisnormative language. Our use of cisnormative terminology is not intended to be exclusionary; rather, it reflects the heteronormative locations and samples that our researchers study. Were we to receive submissions of research about LGBTQI families, the language used would not be cisnormative. I wish there were more research about breastfeeding in the LGBTQI community; we would all benefit from it. JHL welcomes these submissions, along with discussions about the issues that LGBTQI individuals experience for our Insights Into Practice and policy-informing manuscripts as nonresearch submissions to our Insights Into Policy. The truth is that we do not get these submissions. Are we not getting these submissions because they are not being written or because we are continuing to use cisnormative language based upon the submissions we do receive? I do not know; however, I do know that the change desired by the LGBTQI community (Farrow, 2015) will not take place if the research and discussions are not able to reach the broader research and clinician community, which JHL serves.