I agree with Kika that sometimes our job is to give a mom permission to
stop.  
Case in point: 
Nearly 10 years ago, just before I started working in the hospital, they
called me to come in to help a mom who was "hysterical".  She had good
reason to be hysterical. It was day 6, and she had a 4+k screaming baby,
engorged and edematous breasts from which nothing came out, and super
sensitive nipples to boot.  It was impossible to put this baby to
breast, as it would be like attaching him to a wall.  At the time, the
breast pumps in the hospital were old and not working, and the only pump
available in Israel was the mini, which was hard to get.  IN short, we
came to the understanding that this baby was not breastfeeding, and in
fact was very hungry, and that given her situation,  we both concluded
that we had to FEED THE BABY!!  She was so relieved.  I got yelled at
from the head nurse, of course.  I was supposed to help her breastfeed,
not help her stop!!
Fast forward 7 years: I am asked to do a series on breastfeeding for a
parents channel on cable TV.  Who is my co-host? This mom, who I forgot
to mention is a journalist.  I did not remember her, but she remembered
me and thanked me profusely over and over for what I did for her. She
did an amazing job in the program, and was totally pro-breastfeeding.  
  Some parts of the program brought tears to her eyes, but I promised
her that for her next baby, I would be there for her from the beginning.
( She was trying desperately to get pregnant).  
 Fast forward to last November: I walk into the breastfeeding room and
there is one mom sitting there alone, without a baby.  I look again and
it is this mom!!  When I  came over to hug her and congratulate her, she
started to cry.  She had delivered a 28 week preemie a little over 1 K
and had tried to pump once ( this was day 4) and nothing came out.
Well, you can ask my kids, if I promise someone something, I will go to
the ends of the world to keep my promise, and this became my project.  I
wanted to teach her to hand express the colostrum into a small sterile
container, which is what I do with preemie mothers.  Psychologically
when those few drops of colostrum are in a small container, they look
like a lot more than when they barely wet the bottom of the bottle.
After massaging, and squeezing, and great effort, there was one drop
hanging on the end of her nipple, and I was willing it to drip into the
little container, while I was telling her that by Sunday ( this was
Friday) she would be squirting milk across the room. Now she tells me
that she thought I might be a candidate for psychiatric evaluation for
delusions, but she wrote down all my instructions about pumping and did
it all.  
Sure enough, on Sunday morning, she comes in with nicely full breasts,
and proudly showed me the 30cc of milk that she had pumped!!  
Well, it was a long way, lots of pumping, charts, kangarooing, thrush,
tears, laughter ( she is really funny), lactoengineering, power pumping,
you name it and her baby got only breast milk. The two times they tried
to give him HMF, he started showing signs of NEC and gastro-distress (
duhhh) so she signed all the forms of refusal of anything except her
milk.  
In short, now he is 6 1/2 months old, growing beautifully, fully
breastfed straight from the source, developing as if he was in utero to
the end, and both mom and baby are so happy.  
She often thanks me for both experiences....knowing when to quit, and
getting things going against all odds.  
I agree with Kika that part of our job is to sense when the mom needs to
stop.  It is not often, but it does happen.  My rule is that when the
breastfeeding interferes with mother-baby bonding for any reason, and
sometimes it does, you have to weigh the situation and help the mom let
go if need be. 
 
 
Esther Grunis, IBCLC, waiting for the barrage of rotton tomatoes
Lis Maternity Hospital
Tel Aviv, Israel
 

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