Debbie:

When I was a hospital LC, we had a wonderful group of four neonatologists
(all female, by the way) who all supported breastfeeding and human milk
feeding.  Their standard counseling for every mother of a premie or sick baby
included an invitation to pump so the mom's milk could be fed to the baby.
 Many women who had never planned to breastfeed did pump their milk while
their babies were fragile; I don't remember any who did go on to breastfeed,
but we were very proud of them all for making the effort and valuing what
they could do for their babies.  I sometimes would forget that they were not
planning to put the baby to breast and launch into my normal spiel, then I
usually pulled up short when I remembered the mother's history.
Of course, I'd like to be able to tell you that pumping turned them all into
wonderful, warm breastfeeding mothers, but it just didn't work out that way.
 I mean, why WOULD spending hours a day hitched to a machine necessarily have
a beneficial emotional outcome?

I think there must be some powerful emotional force that has made these women
so wounded that they can't imagine holding their own baby to their breasts.
 Whatever it is, it was more than I could counteract in my brief encounters
with them as I taught them to pump and encouraged them to keep it up.

One approach that might work is to encourage all moms with NICU babies to do
kangaroo care.  I mean...if K-care is so beneficial for breastfeeding babies,
why don't we tell everyone to do it!!  Why should the babies who miss out on
mom's milk have to miss out on skin-to-skin with mom and dad on top of that?
 Mothers who are pumping should be told that K-care may help with their milk
ejection reflex, too.

If I ran the hospital, I'd have every baby held skin to skin--full term,
stable pre-term, breastfeeding, not breastfeeding.  Then I'd just wait and
see what happened next...

Chris