Karyn-grace Clarke wrote:

"Frankly, I think that offering every single child-bearing woman her 
own IBCLC for lactation management in the same way she is offered 
proper medical care for pregnancy will naturally INCREASE attendance at 
LLL meetings. My plan is not to render LLL and it's Leaders as 
redundant, but to work more closely with them in lactation management 
for EVERY SINGLE CHILD BEARING WOMAN."

There is so much that concerns me about this idea. If every single 
woman had the "proper medical care for pregnancy", she would have no 
medical care whatsoever. "Medical care" is the underlying problem, and 
more of it is not the solution. A mother who has appropriate care  has 
access to a community midwife who protects the norm of uninterrupted 
birth. The midwifery model of care includes assurance of successful 
breastfeeding as a role of the midwife. The medicalization of birth has 
done serious damage to babies, who are--contrary to conclusions one 
might draw based upon current Western obstetric parctices--sentient 
beings, fully competent and aware of their experiences. As a result, 
their families and society as a whole are deeply wounded, not to 
mention the damage done to women during the tender hours and days pp 
when they are internalizing their beliefs about their relationships 
with their babies and about themselves as mothers. To build upon this 
deeply flawed model will not improve outcomes as so many babies are 
completely incapable of feeding, organizing neurologically or even 
making appropriate ellicitations of their mothers.

"The very mothers who are most at risk for weaning early (or not 
eveinitiating breastfeeding) are the very ones who likely will *never* 
set
foot in a La Leche League meeting, regardless of whether or not they 
have been informed.  I'm thinking ethnic, low-income, and teen mothers, 
for example. Are those mothers to be denied regular, maintenance 
'flossing' just because they don't wish to sit in a room with a bunch 
of others discussing how and when to feed baby, nurse in public, or how 
to be intimate with your partner during lactation etc.?  It is not 
enough."

No, it isn't, But Heather is correct--peer counseling is. Women need 
peer support, not more intervention. After all, LLL is just peer 
support that tends to support a fairly homogeneous population.

"We live in a medical-model culture, not a role-model culture.  The 
majority of women receive information and health care counselling from 
professionals who work within the medical-model, and it does not appear 
to me that this will change anytime soon.  LLL and the like are not 
enough."

Well, I dread the thought that IBCLCs are to be those professionals who 
"work within the the medical model". I have no desire to do so and I 
hope I am not the lone voice who remembers that human feeding is normal 
behavior and normal behaviours need to function outside of the medical 
model, where they can be protected.

" The health care community will never treat LLLL's on an equal 
footingbecause they are *volunteers* (please, ladies...I mean no 
offense - this is just a fact and one that I understand well:  "Are you 
an LC?"  was a common refrain from the PHN's and doctors I come in 
contact with)...and without being taken seriously by a women's health 
care providers, there can be no sharing of information and no respect 
when different opinions occur. (Though I am wearing my flame-retardant 
suit, I would appreciate it if y'all could refrain from throwing fire 
darts my way!)  I am not saying that LLL hasn't made tremendous headway 
- please...they are the reason behind it ALL- and that some communities 
don't have great relationships with the local Leaders...I know that 
they do...but...It is not enough Frankly, I think that offering every 
single child-bearing woman her own IBCLC for lactation management in 
the same way she is offered proper medical care for pregnancy will 
naturally INCREASE attendance at LLL meetings. My plan is not to render 
LLL and it's Leaders as redundant, but to work
more closely with them in lactation management for EVERY SINGLE CHILD 
BEARING WOMAN."

Karyn-grace,
I understand your perspective. The current system sure isn't working 
and you are looking for solutions. We should all be looking for new 
answers. But, I don't want every single child-bearing woman to have her 
lactation managed. I don't want her birth managed either. We have made 
a mess of birth and feeding and infant care. We have done this through 
management and intervention and lack of trust. We have done this by 
ignoring the nature of the infant. David Camberlain, in the current 
APPPAH Journal writes about the "real baby", not the ones taught about 
in medical school or pshycology programs--the sentient, feeling, fully 
conscious babies who remember their intra-uterine lives, remember their 
births, remember--and are shaped by--their early experiences. Managing 
these babies further is not the solution to honoring who they are or 
meeting their needs.

If we want babies to breastfeed, they need to be born normally.

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC



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