Karen writes:
"As a community LC I can't force someone who contacts me to fully
BF, which research indicates is associated with longer duration. "

Yes, we can't force someone to breastfeed in the way we feel (and
research shows) would be best for her and for baby.  In some cases,
if I can help her decide to "wait a while" I feel something has been
accomplished.  I usually approach it as;
 "If at all possible, we strongly encourage nothing but your breast
in baby's mouth for the first month.  There are many differences
between feel and action of an artificial nipple and your breast.
While some babies seem to be able to go back and forth with no
problem, others get mixed up very quickly as to which behavior goes
with which container.  Until we can come up with a way of telling by
looking at a baby which ones can "handle it" and which ones can't,
it's best to avoid the potential problem.  If you plan to introduce
a bottle, waiting a month seems to work out better than starting
earlier.  Whether or not you use a bottle will be your choice.  If
you will be working outside the home and baby can't go to work with
you, he will have to learn that food can come in other containers.
If you aren't working outside the home, remember that baby doesn't
"have to" learn to use a bottle.  While some moms want baby to be
able to use a bottle from time to time, others never use a bottle.
They totally feed at breast until baby learns to use a cup."

I know there are those that no matter how much strong evidence we
give them for exclusive, direct breastfeeding, they are going to "do
their own thing"  I agree with Karen's approach that we need to help
these moms keep at least partially breastfeeding.  I have known a
few that report later than when the baby reached a month old, they
were so "attached" to breastfeeding that mom wasn't as eager to
start a bottle.  So sometimes, by leaving the door open rather than
being too rigid, we may actually help the mom move toward the more
"ideal" when she wouldn't have with an "all or nothing" approach.

Winnie

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