This is an interesting thread and obviously the circumstances in which we 
practice and the support (good, bad and ugly) offered to breastfeeding women 
postpartum would dictate how we would handle the situation.  The dilemma for 
me is: on the one hand I believe that women need as much information as 
possible re breastfeeding in order to filter out the myths and 
misinformation with which they are bombarded.  On the other hand, I feel 
that instilling confidence in women that their bodies were well-designed to 
nurture and nourish their babies is important, too.  It was Derrick 
Jelliffe, I think, who said that breastfeeding is a "confidence trick".  The 
vast majority of women I work with have had Caesarean births - as a result 
many feel their bodies have failed them.....

So, with breast reductions and induced lactation I share all possibilities - 
emphasising that it doesn't have to be an all-or-nothing situation.  In 
hospital it *will* be expected that women with reductions cannot breastfeed 
and mothers need to be prepared for this negativity and know where to get 
good support and evaluation of the breastfeeding.  For most other 
situations, I tend to assume that breastfeeding will work and make sure that 
mother knows how to recognise problems early on and where to get appropriate 
help.

Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask]

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