As  i understand it, the theory of change management is not about being warm and fuzzy, it's about what works. It's a theory often used in business and in industry. The bottom line for any business is not the psychological state of its employees or customers. However change management theory states if that is ignored, change will not be effected.

So if the mother feels psychologically unsafe change will not be effected, and breastfeeding promotion will be unsuccessful. I bet there is a theory of change somewhere that says for every unsuccesful attempt at change, the status quo refreezes further.
James Akre said it takes a village to raise a child, a view which I think was controversial here. Take a look at what our fellow inhabitants of the village are saying her:
http://www.examiner.com/article/pediatrics-journal-says-to-stop-calling-breastfeeding-natural
Barmy, bizarre, ridiculous. Normative standard indeed.

The mother is and the lactation consultant are only two elements of the change process. Jane Heining, in the 2006 paper, "Barriers to compliance with infant-feeding recommendations among low-income women" cites health professional advice to give formula. How can we expect mothers to pay attention to ...us.. when her day to day health professionals are saying something different. There is a long road ahead of us. We need to get the village on board, starting with our professional colleagues. As long as there are GPs who prescribe the wrong antibiotic for mastits, public health nurses who suggest formula at the first concern, breastfeeding will continue to be disconfirmed. 

Pamela asked "How come the research is put aside in order to promote maternal choice not to breastfeed?" I can only speak for myself, but I most certainly have always promoted breastfeeding. I have never, never, never supported not breastfeeding, so it is not true to say maternal choice not breastfeed is being set aside. 

My attitude stems from pragmatism to a large extent. I once read something in JHL which I've since been unable to locate despite numerous searches. In essence it said that mothers listened to those who were nice to them. They almost always listened to their mothers, while their physician's advice was followed if the physician took on board the mother's concerns first.

Jane Heinig said "Mothers, believing that providers felt compelled to reject infant-feeding recommendations, would not ask for assistance if they faced feeding difficulties." The reason I've put in that point is it  underlines for me how fear of judgement can leave women more accepting of advice from strangers in the supermarket than from 'expert' professionals. (That was in the study too). The old phrase "I don't care how much you know until I know how much you care" is a pretty good summary.

And the reason the discussion is about the mother's perspective is that she is the one who makes the decisions. She makes the decisions about feeding, about whether to use a car seat or not, about how long to leave the baby in the car seat. It is not downplaying the importance of breastfeeding for the infant. For me it is recognising the limits of what we can achieve and working within those limits.

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