Valerie wrote so cogently:

<While I believe absolutely that there is a physical difference between
the
mother and baby who are breastfeeding and the mother and baby who gets
that
milk in a bottle, I  am not willing to say to that mother that she is not
a
breastfeeding mother.  Which means that I hold two somewhat opposing
concepts
within my mind in regard to this discussion.

I cannot say to the mom of a neurologically-impaired infant that despite
her
pumping her milk for a year and all her continued efforts over the months
that she is not a breastfeeding mother.  I cannot say that to a mother of
baby who had cleft lip and palate that never went to the breast.  I
cannot
see their tears of grief over the loss of the breastfeeding relationship
and
say to them you aren't or weren't a breastfeeding mother. I think
language is
important. Our language is important to mothers.>

Your comment is so much to the point, and so sensitive. This subject has
been on my mind all day for the very reasons you articulated, and for
many "closet" reasons seldom discussed.

Since my own early disappointing breastfeeding experiences, I have said
"Too often, *mothers* are left feeling inadequate, when it is really our
*system* which is inadequate." Perhaps that includes the language in our
system as being part of what's inadequate.

I believe that what we need for professional discussion and individual
parent education is *not* a label for the mother, but agreed-upon,
contrasting labels for the *processes*. I propose "direct" and
"indirect", which are terms actually only defining those processes that
are commonly practiced now.

Until someone comes up with something better, in my situation, I believe
I shall start to use the term "Indirect breastfeeding" to refer to:

The process whereby a mother collects her milk for her baby to receive by
teaspoon, cup, dropper, tube or bottle when required by the medical
condition of baby and/or mother, separation for work or school, or when
the individual mother deems it appropriate for her situation.

After all, this is what
    * mothers of prematures and handicapped babies
      are being encouraged to do.

    * mothers who return to work and/or school, or
      have an occasional "night out"  are encouraged
      to do in preference to formula.

    * Stay-at-home mothers often choose to use
      for short separations due to errands, etc.

    * mothers who personally feel uncomfortable
      directly breastfeeding in public use as a
      solution when out in public.

    * would then also apply to mothers who make a
      personal decision to manage the first part or the
      entire breastfeeding experience this way, for
      whatever personal reason the individual mother
      decides: (severe nipple problems, family
      opposition, history of inappropriate touching,
      abuse, etc. in childhood or adolescence, etc.)

This would allow us to agree that Rule #1 "Feed the baby",  (with
mother's own wonderful breastmilk) and Rule #2 "Support the milk-making
process" are being done in both direct and indirect breastfeeding.

Meanwhile, we can explain that when and IF the time becomes right for
each individual mother-baby dyad, (sometimes days, weeks or months
later),  Rule # 3 "Fix the breastfeeding" will add the distinct
additional benefits derived only through the process of direct
breastfeeding. (We can all probably come up with a long list at a
moment's notice.)

I see this as a cultural compromise that can ultimately lead to a higher
and higher breastfeeding rate, direct or indirect.

Jean
***************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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