Re:  Ann Calandro's query about relact. in mom with fussy 5 mo old who is
taking combination bcps.  There are numerous factors here which impact
whether a relact could be done.  At least 3 are mechanical.  #1.  Will the
baby accept being put to breast?  If she won't (and 5 mo olds are pretty
distractable)  then there is less point in trying.  #2.Mom only nursed for
19 days.  Depending on how vigorously she establ. her original  supply
(turning on all those prolactin receptors, etc), she may not have much
chance of  re-establishing a full supply.  # 3. The estrogen in the
combination pill supresses lact.  Even the mini pill is not ususally
recommended until lactation has been fully established.

Psychological issues seem to abound in this case, also.  Husband has lots of
control issues.  Lots of "Yes, buts...." to everything you have suggested.
I urge you to take a detached attitude.  Offer the best advice you can, but
it may be that nothing you say satisfies this family.  I'd share printed
copies of stuff from med. lit (not parenting or LLL sources) on safety of
banked human milk.  I would do the same with info on oral contraceptives,
etc.  This keeps your role more neutral and doesn't pit your authority
against dad's.

Suggest starter SNS (it's cheap and wont get mom in "trouble" with dad) with
whatever formula they are now using to see if baby will accept.  You could
also suggest pumping for a while with breast used as pacifier to see if baby
will accept.  It may well be that all baby's fussing has other causes,
perhaps acondiditon such as reflux could be causing baby lots of pain during
feeds -- whether human milk or formula.   I hate to see people make
assumptions about allergies so casually.  Of course they occur, but usually
resolve with food elim. if that's the real problem.

 Breastfeeding doesn't require a rocket scientist to get it going if THERE
IS NOTHING WRONG. I agree that we don't want to medicalize it for normal
babies with no problems.  Peer counselors, lactation educators, LLLLs,
people with nursery or pp experience, midwives, etc. etc. do a fine job of
assisting with the range of normal questions and issues which arise.  These
are NOT the cases an LC typically sees (and I, too, think the name should be
protected.)  We see babies and mothers with underlying conditions, issues,
and problems which complicate the normal issues and problems.  We need
expert training and lots of experience and constant education to not screw
up and HURT these more vulnerable couplets.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx