Louise,
I think a lot of women use ABM first due to a lack of self confidence rather
than trouble with breastfeeding.  The problem, we all know, is that it can
become a self-fulfilling prophecy, with the bottles squeezing out the
breastfeedings over time.
        I am careful to see why a mom wants to use ABM, then give her
information on the disadvantages of any artificial milk over exclusive breast
feeding, and support any decision she makes, because it is then an informed
one.  Some mothers would not continue to breastfeed without an occasional
bottle of ABM.  Is this a perfect world? No, but we have to respect a mom's
individual choice.  I think you are right that we need to be aware of a
mother's feelings as we educate her, especially in the sensitive immediate
postpartum.  Moms need to feel that they are doing the best they can for their
babies.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]