I think this discussion (about meeting the mother where she is,
baby's right to be breastfed, working with the mother and advocating,
or not, for the baby) is revealing essential differences in practice
between those of us who are, primarily and maybe exclusively,
mother-to-mother breastfeeding workers, and those who may have some
clinical responsibility to the mother and baby beyond this.
I am a volunteer breastfeeding counsellor, and in the tradition of
formal and organised mother-to-mother support (started, lets not
forget, by LLL, but taken up in various ways by other volunteer
organisations) I do indeed have her, and her needs, at the centre of
any encounter.
I explore with her what these needs might be - if I am doing my job
properly, she may well not see her needs the same way at the end of
the encounter. She will have had the chance to discuss other options,
and their consequences, and she will still feel valued by me and not
judged, whatever her decision.
I never have to speak to anyone who says 'I don't want to breastfeed.
Please teach me how I can formula feed my baby' - they don't often
call a breastfeeding counsellor to ask that, but if they do, I am not
trained or experienced in this and I am obliged to refer the mother
to her midwife or health visitor (who *do* have clinical
responsibility for both her and her baby).
I am often contacted to discuss using formula alongside
breastfeeding, or weaning from the breast after a period (soometimes,
a long period, at least a long period in our culture).
*Of course* I share with the mother what we know about the
physiological and emotional needs of her child, and the research
underlying it. I recommend books and internet sites if she wants to
know more about this. If I am doing my job right, she won't feel
criticised. I certainly do not talk about the 'right' of her child to
breastfeed for as long as the biological norm - as a mother-to-mother
volunteer this would be entirely inappropriate, but I certainly can
and do explain the health impact of the use of formula/weaning, and
we explore how far that might balance against her other concerns.
Some mothers actually hate breastfeeding, but they have a right to
know the full story, too, and they may also decide to continue
breastfeeding *even though they don't like it* - because there are
lots of things we do for our kids that we don't like doing! I don't
think 'happy mother' needs to be at the top of any notional list - or
that someone 'ought' to start formula feeding if she doesn't like
breastfeeding. Eeek! What a thought.
In my work as a volunteer, mother-to-mother counsellor (despite my
25+ years experience and the 3 years training and annual updating
etc etc I have to do) I am not doing any healthcare of the mother or
her baby, and so the mother's autonomy in these choices is my concern.
It may well be different for people working with different parameters.
Heather Welford Neil
NCT bfc, tutor, UK
--
http://www.heatherwelford.co.uk
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