I agree with Lisa.  I have each mom I see fill out a questionnaire of health
related questions as well as pregnancy, childbirth and breastfeeding history.
 One of the questions list about twenty illnesses or disorders asking "have
you ever had any of the following, please circle?"  Sexual abuse is listed.
Several moms have circled this and for most that circle it, they seem to be
OK and breastfeeding is taking a normal course.  But, I have also had moms
that this was a barrier they had to work hard to overcome.

I don't bring up talking about it if they have the husband or another family
member with them unless I have an opportunity to do so alone with them.  Or,
I may call the following day to check on them.  If all is going well, I don't
bring it up.  But, if she is having problems, I simply ask "have you had
counseling for your sexual abuse and have those issues been resolved?"  Many
sexual abuse victims are stuck in the denial stage and have never resolved
these issues.  Helping the mom to realize that she needs to deal with and
resolve these issues by seeing a counselor is not only important to
breastfeeding, but also to mothering as it often effects all relationships in
some way.

Warm regards,
Pat Lindsey,IBCLC - Lactation Services
Pediatrics Plus Staff LC & Private Practice
Orlando, FL

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