Linda J. Smith wrote:
>Coach Smith here.
>Breastfeeding is a biologic process involving two people. We don't discuss
>the "advantages" of a mother delivering her placenta after birth. Mothers
>don't have a choice whether or not to lactate after giving birth - their
>breasts are going to make milk.
I _love_ the analogy with the placenta! That's going in my 'keep and use'
box!
Also, there is a serious point that can be taken up here, and used with
vigour. When laying the foundations of post birth care for both baby and
mother - whether the audience be professionals - family, supporters etc - we
can clearly detail the lactation process as being a natural result of birth,
thus emphasising its normal nature. Again, referring to my earlier point -
not by using the words 'normal' or 'natural', but by how we position the
information in our planning and discussion.
However, we can then, in a seperate set aside space, genuinely give
information and support about the mother who has chosen to 'switch off' the
lactation process, and her extra needs for care and support. Masitis is no
fun, and signalling that the mother who has chosen to formula feed, needs to
have her needs met by everyone, can only reiterate the point that lactation
is going to happen to every mother: it cannot be prevented, it can only be
closed down.
I'm highlighting this, as it's my personal ante-natal experience, this was
never discussed at all. Even in the classes dedicated to 'the feeding
choice', my midwife never 'matched' aftercare of the lactating breast to the
'which way you will feed discussion'. And in fact, I've never heard it ever
done so - but my experience is limited. Thinking about it now, it's
patently obvious it has to be said up front:
"For mothers who decide that they do not wish to continue lactating, [as
they had chosen other feeding methods] we need to be looking at problems
arising from.... and can offer these treatments.... to keep the mother
comfortable whilst her body closes down the lactation process. Infection
rates are.... "
It's worth saying that whilst I can see how such strategies would be helpful
in our overall construcion of our 'cause', I'm seeing that as a beneficial
side effect. Mothers do _need_ this support genuinely, and deserve to have
their information up front, and the treament/remedies on hand.
(I'm still furious that in my own ante-natal classes, no one ever mentioned
that formula carried risks. I don't care about how people might not want to
make others feel 'guilty' - I care that there was genuine and reliable
scientific research that was not routinely made available to me as a
pregnant woman. I'm appalled that 'keeping me in the dark' is/was seen as
appropriate by a Health Service there to guide me through giving birth. Had
I chosen to close down my lactation, and _then_ found I had mastitis and
everyone knew it was risk... I'd be livid!!!!!!!)
Perhaps.... perhaps we need to not discuss mothers who 'chose other feeding
methods'.....? Perhaps we need to discuss... choosing to close down
lactation...? or at least add it to the 'keep and use' box? After all, we
mediate how we discuss these issues to the audience in front of us. I'll
happily discuss the 'dangers of formula' with other like minded people but
it's not something I'd ever say to a mother in front of me using formula
with her child! Even how I give this information to pregnant friends is
difficult enough! (Thank the System Overlords for....
http://www.theecologist.org/archive_detail.asp?content_id=586 which can be
so easily printed off and added into the pregnancy books when I hand them
out.)
I wonder if this might be seen as a contentious point- using the language of
"choosing to close down lactation?" ? If we build this into our planning
and discussion, are we 'encouraging' mothers to stop the lactation process?
Indeed, do we never mention the care issues beforehand, as we're 'hoping'
everyone will give it a go, and then mopping up the problems on an
individual basis afterwards....? If you've got 8 woman in a room in the
ante-natal class all saying "We'll give it a go.... " will you 'wreck'
something by then going on to discuss in sequence the issues around closing
that lactation down? Even if you know that only one of them will get to 6
weeks - as that's the standard rate in your area?
Equally, how many are then totally unprepared for the problems as they
struggle on at home.. could you argue that _formula supplementaion _ is one
reason so many women succesfully cease lactation, as the using both for a
few days allows the breasts to cease lactating with less side effects? So,
once again, soemthing being given to 'help' is responsible for there being
no real awarenss or discussion of the problems of closing down lactation ...
therefore once again 'hiding' that lactating is what happens as a normal
result of birth....
Also, of course... the mother who has decided to close down lactation
_immediately_ is probably quite a small proportion of the total who try once
or twice...
What an interesting set of 'unknowns' this discussion has highlighted! How
many mothers state upfront: no, I'm formula feeding? How many mothers are
even given advice of closing down lactation prior to birth? How many woman
get infections from closing down lactation? How many of these infections
are recorded back at the delivery service, versus the GP?
I've only ever heard of 'problems' with nipples and breasts in relation to
the mothers breastfeeding... never heard it discussed in terms of those who
choose never to do so!
Morgan Gallagher
Online Lactaneer
Nursing her 28 month old darling boy (as I type!)
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