If I might offer my POV. It seems to me that you are mixing up
supporting breastfeeding with supporting mothering. As an IBCLC, it is
my job to help mothers attain their breastfeeding goals and to share
evidence-based information and my experience as an IBCLC with mothers
so that they can make informed decisions. It is not my job to to judge
their mothering skills. While it is true that I have advised mothers
to supplement with formula when necessary, it would not be
professional for me to state or even to insinuate that there is no
appreciable difference between breastfeeding and formula feeding. That
is simply not true. Breastfeeding is the biological norm for human
beings - eating species-specific milk is the biological norm for all
mammals. Are there mothers that desperately want to breastfeed but
cannot? Yes, and part of my job is to present them with all of the
alternatives/possibilities so that they can make choices that make the
best of a bad situation. Are there mothers that are not interested in
breastfeeding at all? Yes, and they do not need my services. Is there
a place for an IBCLC in an infant feeding clinic? Yes. Would it be
appropriate for an IBCLC to advise exclusively formula-feeding mothers
on how to feed their babies? Not really (unless they were feeding at
the breast with a supplementer) - that is not within our scope of
practice.

Feeling guilty is part of being a parent. It is part of being a human
being. Trying to make a mother feel guilty about her choices is not
okay. Sharing information with a mother which leads her to feel guilty
or sad or whatever later is not my problem. If it were, I could not do
my job. If you are looking for a way to help mothers without ever
having them feel bad, you are going to be disappointed. Not unless you
are willing to put aside all science and research and simply tell moms
that anything they do is fine, which is ok if you are an advice
columnist perhaps, but not ok if you are a professional, be it an
IBCLC or a nutritionist or an RN.

I completely understand where you are coming from. It is hard to see a
mom suffering and second-guessing her choices.  The best way to avoid
that is to be honest and empathetic from the start and give her the
most current information available. Help her to sift through her
choices and support her. But if she decides to formula-feed and you
are acting as an IBCLC, then you should walk away and devote your
valuable time to helping another mother who may be able to succeed at
breastfeeding with your help.

In conclusion, I am sorry to hear that you had a negative exchange
with a La Leche League Leader. I would like to believe that it was a
case of misunderstanding. Leaders are supposed to accept mothers where
they are and offer support for their breastfeeding goals. However, it
is not their job to provide continuing support to mothers who have
decided to bottle-feed formula, even if they really like that
particular mom - they have limited time to volunteer their services
and must concentrate on those that need breastfeeding assistance. They
are not trained to provide support for artificial feeding away from
the breast. However, there are a number of mothers that continue to
attend meetings for the mothering support, apart from feeding choices
or after their babies have weaned from the breast.

Good luck in your future endeavors. Please let us know how it goes.

Sharon Knorr, IBCLC, NY, USA

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