Barbara A., I have scratched my head & wrung my heart
over this question for years.
When I think of the logistics of supplying human milk,
feeding the baby in a way that preserves bf, and
ensuring lactation support for the mother I can think
of many creative ways to simply.
Out here in my neck of the woods, folks say they do
what they do because it is "easier." I have learned
that easy is a euphemism for "I have a cultural
barrier to the new way of thinking." Frankly the only
thing that make the status quo "easier" is that that's
what you're already doing. Mothers in my area bottle
feed ebm in public because it's "easier." Mothers
tell mds & mothers-in-law they've weaned when they
haven't because it's "easier." If hospital protocol
included human milk for every baby (support practices
in place) & someone suggested we begin giving abm &
set up a training program to train staff in the
intricacies of bottle feeding as soon as the baby
could take something by mouth, develop consent forms
for parents to allow both the abm & artificial
nipples, court staff support for trials... Everyone
involved would say, oh no, it's easier to continue ng
feedings of ebm until baby can try the breast, it's
easier, why complicate the practice in place, why
stress staff & parents & babies (let's not forget the
babies) with distracting practices which will then
require retraining so that baby can breastfeed by
discharge...
Attitude is often the biggest obstacle to change.
Certainly we have enough research by now to suggest a
different protocol for feeding NICU babies. So what's
the problem?
I'm not naive. Part of the complication here is that
parents bring their own cultural biases to the unit as
well. After all, most of us grew up seeing artificial
feeding as the norm. For those of you following the
NYT piece on "extended" nursing, you may recall a post
calling breastfeeding a "new age" practice. We have a
long way to go.
Whenever I think of abm use in a hospital setting
without parental consent, I hear that voice in the
back of my head saying, "First, do not harm."
Susan Johnson MFA, IBCLC
(in a city where a few Breastfeeding Angels -- can't
call them Nipple N--'s any more! -- are making great
progress, in & out of NICU, one baby at a time)
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