I agree with Lisa Marasco.

As much as I agree that over the years, *too much emphasis* has been put on
the potential problems (which are most of the time not even there) in
lactation, I have seen my share of heartbreaking instances of mothers who,
even with the best support and breastfeeding management, don't lactate
successfully.  There is nothing worse for these mothers than to hear things
like "maybe you didn't nurse often enough" or "you should have gotten help
with your latch" and suggestions like that.  The fact that prenatal
healthcare providers don't even look at breasts and offer insight before the
baby is even born is, to me, a double-edged sword -- on one hand, do we want
mothers being told "your breast tissue looks a little sketchy...you might
not bring in enough milk" and on the other, it's just a devastating surprise
to mothers who fully expect to breastfeed and learn, 2 weeks postpartum,
that they don't have normal breast anatomy.  I know two mothers for whom
getting pregnant was of little issue (slight luteal phase things but no
progesterone needed to get/stay pregnant) but are not able to bring in full
milk supplies due to hypoplasia and PCOS and research has yet to tell me
what else.

I think it's a fine line to walk, especially with first-time mothers,
because we are constantly exposed to direct and indirect messages in society
that tell us breastfeeding is extraordinary and "not for everyone" -- but
for that rare (but, I'm afraid, growing) segment of the population that
gestates, but does not lactate without incident, even with the best support
there is, it can be incredibly isolating and upsetting to encounter such an
all-or-nothing attitude.

It's easier to work with mothers who've had a poor lactation experience in
the past; they are expecting a struggle, they tend to be super-committed to
perfect breastfeeding management in the early days and weeks, and their odds
of success are better simply from having experienced more than one pregnancy
and attempt at lactation -- but still, for these mothers, the attitude that
they failed at lactation because of some mistake they made can be
devastating, especially when the problem was completely beyond their
control.

I'm sorry if this post seems a bit emotionally charged, two of my very
dearest friends, vehemently committed to breastfeeding, are currently
nursing infants...both have hypoplasia and both accomplish all feedings at
the breast with a supplementer, but each makes only about half of what her
baby needs.  One is on an incredibly expensive herbal regimen, the other is
breaking the bank with domperidone...both have proven to me that
breastfeeding is about much more than just the milk, and for that, I am
thankful -- and vigilant about how I approach a mother who is looking for
support.

Respectfully,
Diana in NY

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