I have had experience now with some moms who have done this 
for long periods of time.  I think we need to be careful not 
to give the impression to moms that it is impossible just 
because we so dearly want them to breastfeed.  We often say 
to moms that pumping means they will be unable to feed their 
babies completely with breast milk because a pump is not as 
good as a baby and therefore only with baby at the breast can 
moms gain and maintain an adequate milk supply.  

Some moms have proved this totally wrong to me, and in doing 
so have also opened my eyes to other options than the 
traditional one I learned as a League Mother and La Leche 
League Leader.  

Of course we want moms to have a breastfeeding relationship 
as close to natural as possible - we know it is easier, it is 
better for baby for many, many reasons from mouth stimulation 
to physical contact, etc.  However, as Nikki Lee stated in 
her letter in the JHL.  As professionals our job is to 
educate and inform - and let the mom choose what she can 
handle now.  

If we state that only what WE think is breastfeeding is 
correct, we may prevent many babies from benefitting from 
their mother's milk - in whatever way mom feels she can 
deliver it.   After all, we all want Natural Childbirth, 
but sometimes Cesareans are necessary.  Giving birth to 
the healthy baby is the important part - the process, 
although wonderful when it works, is NOT the only way to 
deliver a baby.  Breastfeeding is NOT the only way to deliver 
breast milk to the baby either.

Moms with NICU babies who upon discharge  are still very 
sick and need measured amounts of food and frequent 
hospitalizations may choose to breastmilk feed - one of 
the moms here turned in her Lactina pump only after her 
child was over one year old.

Moms with Cleft Palate babies may be unable to cope with 
the special attentions required of SNS feeders and palate 
obturators are not easily available - one of our moms is 
still breastmilk feeding her son at 8 months - and the 
physician is amazed at the fact this child has had NO ear 
infections despite the problems he has.

Moms who were abused, moms who are just unable to cope with 
breastfeeding at night, moms who...  We  come across these 
weekly - and now I tell them that yes, their babies would 
greatly benefit from breastmilk-feeding even when they can't 
put the baby to the breast.  Of course, I continue to offer 
support in getting the baby to the breast - but I NEVER tell 
a mom she won't be able to maintain a milk supply just with 
pumping as I used to - moms have taught me a lot!

Just the other day a mom came to me to "confess" that she is 
giving her baby only one ounce of breast milk a day - by cup.  
She bottle feeds formula.  When she started formula at one 
month, she found her baby got sick - with ear infections and 
colds.  So she started hand expressing milk until she got an 
ounce, then would give this to her baby daily.  since then, 
he has had no illnesses and she feels she is doing the best 
she can for her baby - who am I to disparage her efforts or 
disbelieve her statement?

I praised her to high heaven and asked her to PLEASE keep me 
informed of her experiences - and to give me a picture of her 
baby (I have lots of pictures of breastfed babies all over 
the office) when she had one to spare.  She was so proud of 
herself.  Who knows what will happen with this baby - or with 
subsequent ones?

Jeanette Panchula, BSW, RN, IBCLC
Puerto Rico
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