I've been trying for over an hour, while I read 36 posts, to find an
acceptable, "mature" way to appeal to others of my profession for solace.
There isn't one, so I'll just put it out there.

In the past three months I have had more than the usual number of clients
who have decided to stop breastfeeding, often when things have turned the
corner toward resolution. In my private practice work I often work with a
mom for a long time, little steps toward a desired goal.  But lately there
seems to be so little deep commitment.  Is it true that the moms are just
not committed to breastfeeding or is this blaming them for my own incompetence?

Of course, you don't know whether or not I am competent, whether or not I
used good judgement in dealing with a particular case.  There is no private
practice LC here that I could refer a mother to for another approach.  I
have a reputation for being capable of doing this work well, but I'm
doubting the validity of the assumption.

A mother recently contacted me before her baby was born because she wanted
to b'feed and I had worked with her friend.  We talked about preventive
measures and I worked with her in the hospital and after she went home.  The
baby nursed perfectly, all was well. Milk in in 36 hours, no engorgement.
Doctor cautioned about jaundice because of blood incompatibility and said
she would watch it.  All was fine in this regard when baby went home on day
two.  Then on day four baby, who had been feeding well every three hours,
slept 5 hours and even then was hard to wake. (This was New Years Day and
mom didn't call me until many hours after the problems began.) Feedings
became harder to initiate due to engorgement and baby lost her great
latch/suck skill. A.M of day five, blood work showed bili of 15--lights were
ordered, pumping and supplementing was ordered.  Mother rejected anything
but bottle feeding.  ("So, we can work with that.")  Then six hours later
mother called and said she is stopping breastfeeding. This was last night
and I began trying to write this at 4:45 this morning.

Was I insensitive to her level of frustration?  Should I have suggested the
pump for her engorgement that first day of difficulty?  This case shouldn't
have ended like this.  What went wrong?  I can think of causes, but I
suspect they may be excuses. I did the best I could, but this mother could
have stopped breastfeeding without the help of an LC.

In December I worked with a mother who had weaned at one week and who wanted
to relactate at 4 weeks.  Within a week,she brought in an adequate milk
supply, baby fed well, and after five days she quit because her
three-year-old was jealous when she held the baby so much and her husband
continued to make demands on her time.

I get to know these women well, working with them intimately for a
concentrated time, then when they give up on b'feeding  when they seemed so
determined, I am stunned. I believe that Chloe, or Kathy, or Jan, or Chele,
or Maureen, or......could have brought the case to positive relolution.  But
these mothers live in Milwaukee.

How do the rest of you resolve this?  Is this a maturity issue?  (I'm only
57.) Do you ever doubt your competence?  Do you wonder why you are trying to
do the impossible?  Are you able to say, "One baby at a time. And not all
babies."  Is my problem that I believe that every baby deserves to feed at
her mother's breast and that every mother deserves the experience of
breastfeeding.  Does the outcome of my work matter too much to me?

Pam said, "What happened to me, 13 years ago, (misinformation about
breastfeeding and a drug) shouldn't have happened. The choice effected the
rest of Jonathan's life and my family's lives! " Do you grieve when a mother
you are working with quits?  Does anger at abm companies and their partners,
the pediatricians, purge your grief? Do you look at percentages?  "I'm
batting 600 (60%)--pretty good."

Well, I guess you get my question.  And I have to work it out within myself,
of course, but if any of you have or have had similar struggles I'd
appreciate hearing how you deal with it.

Patricia Gima, IBCLC
Milwaukee