I have had quite a few moms in the last year who are EPing.  Out of all of them, only one actively chose to do so.  All the rest of them *settled* for EPing and were sad about it.  (I realize that moms who would hire a PP-LC probably have a different set of breastfeeding goals than those who are EPing and don't seek out professional assistance.)  In many of these cases, the breastfeeding relationship was disrupted in the first 48 hours while mom was still in the hospital through no fault of mom's other than ignorance of what can cause problems.  It is just my opinion, but I believe that the American birth culture is a significant causitive factor in the number of moms who are EPing.  The other thing I have seen is moms who are EPing because their baby has a tongue tie that is preventing effective latch but the pediatrician has told them that it is not worth clipping.  Of course, I'd rather see all babies at the breast but I have great admiration for moms who are willing to take on the extra work it takes to EP when they could just throw in the towel and feed ABM.  

Brenda Carroll, MA, IBCLC, RLC, LLLL
www.lactationsolutions.com

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