Many of us in this list are SOLD on the idea that breastfeeding will prevent
many ills - including psychological problems.  Even though breastfeeding is
not 100% protective of abuse and neglect, I believe that IF breastfeeding is
going well, the risk could be reduced. At the same time, we need to be on
the look-out for signs of physical and psychological neglect and abuse EVEN
among breastfeeding mothers.

It seems the CDC report was identifying the problems we are having with
drugs - and let me tell you, this is a SERIOUS issue - and we really don't
have the resources to address it.  Like the HIV crisis in the early years,
we are not catching the first symptoms partly because if we do, we would
have to admit that we have not developed the appropriate treatment and
resources to deal with them!

As I work in Public Health, I have daily reminders about the need to deal
with serious drug, alcohol AND psychological problems.

HOWEVER - I truly believe that IF we had the appropriate follow-up for new
mothers - evaluation on day 3 (per AAP Guidelines) followed by regular
visits and contact during those first crucial 2 months, we WOULD be able to
recognize and address many more issues BEFORE they become overwhelming for
the mother and family and thus help protect babies.

By follow-up I do NOT mean IBCLCs making home visits daily, but rather a
team of people available - from peer counselors, lay home visitors, regular
telephone contacts AND Public Health Nurses, IBCLCs, Social Workers, etc.
when needed...as well as good programs to refer women for help, both those
dealing with drug abuse and those dealing with psychological pain (many
believe the drug use is a way of self-medicating and dealing with
psychological pain).  

In my last 10 years here in California, I also have learned that mothers who
would normally not let us make home visits to "see how things are going"
(which she interprets as evaluating HER) will let us make home visits to
"help with the breastfeeding"...  Once we have developed a relationship, we
are more likely to accept our help in addressing other issues.  

This is one way in which breastfeeding advocates could be PART of the
solution... making sure we are knowledgeable about resources, advocating for
their development (especially ones that do not separate mothers and
children) and joining the network that is 'there' for the infant, the mother
and the family and the community...


Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

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