I take both points to be valid and extremely important! To sum it up very simply, Kathy says "I work for the mother" and Pamela says "I work for the baby" but I bet as LC's they are both striking a balance between advocating for the baby's health and needs, and meeting the mother where she is
and at what she can handle.

I work in a culture and environment where formula feeding is the cultural norm, where most moms return to work at 6 weeks, and in a hospital where patient satisfaction (mother's) is paramount.  Over the years, I have had to move to the "I work for the mother" camp. I would have never made it in this profession if not. I would either burn out (that feeling comes and goes often) or getting fired from a job.

I think we can certainly advocate at a social and public health level - for breastfeeding - and I see that as  mainly focusing on the needs of the baby (although we know the mother is impacted by not breastfeeding as well).   But working with individual clients, I don't think I can be effective, or even heard by the mother, or respected by the doctors, if I don't "work for the mother." It will take years to get physicians to really advocate for breastfeeding, and it may be  too late for pediatrician to affect the mother's choices. Obstetric and midwifery care providers, and just generally getting the public health messages to teens, men, and elders will be important. It will take cultural and legal shifts and more to get the mothers to be motivated and the infrastructures to remove the barriers to breastfeeding.

I am finding that if I sort of go along with the mother, suggest expressing when she changes her mind about breastfeeding, help her with partial breastfeeding -- then she is more likely to continue breastfeeding, help her friends with breastfeeding, and refer them to me instead of seeing me as not respecting or "getting" her.  This has been a hard transition for me and I am still working on it after 35 years.

Great, respectful discussion.

Laurie Wheeler RN MN IBCLC



Laurie Wheeler | RN | Nursing | BMH-UNION COUNTY
Phone: (662) 538-2395 | [log in to unmask]
Opinions expressed above are not necessarily those of Baptist.



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