In the case under discussion, we are told the mother of this infant decided not to breastfeed, without further elaboration. 

I don't think it is ever acceptable for mothers who decide not to breastfeed to be challenged, judged or told that they are not doing 'the right thing'....there are many reasons for not BF, some related to living in a patriarchal society, some related to a woman's past history, some related to a woman's personal sense of agency or autonomy, and it's not for us to assess which are/are not 'good' reasons. Sometimes, as we know, mothers don't always know *why* they don't want to breastfeed. Sometimes, they really don't know, or don't believe it would be true in their case, that the experience has  many positive outcomes. 

Ideally, women would be *enabled* to breastfeed, and on an individual level, this would include a respectful and non-judgmental dialogue with those who say they intend not to BF,  so any misunderstandings would be addressed, and knowledge of the impact on their baby's health and well-being would be shared. 

If the decision is still not to BF, that should be accepted and respected, while sharing further information on alternatives (expressing, use of donor milk if realistic, use of formula, its safe preparation and how to use bottles and promote maternal-infant attachment with responsive feeding, skin to skin.....etc etc). 

In this case, we have no idea if any of this was offered or accepted - clearly, from the POV of infant and maternal health, direct BF from the mother would have been preferable to the huge palaver of creating a milk supply in the father, and someone somehow should have brought that to the discussion. 

Maybe they did. But we don't know. 

The authors of the case study did not regard this aspect as important, relevant or interesting enough to share. 

Heather Welford Neil
UK



> On 28 Feb 2018, at 1:50 pm, Christine A Raasch <[log in to unmask]> wrote:
> 
> While I haven't read all of the threads re: transgender mother and breastfeeding, today's posts, LACTNET Digest - 26 Feb 2018 to 27 Feb 2018 (#2018-56), Tricia's comments and the ensuing replies were thought provoking. Ultimately, my question is, who is looking out for the infant? The mother has a choice, the infant does not. As a mother you make many difficult decisions for your child, doing the right thing is often the hardest.
> Christine, RN, IBCLC
> 
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