To all,

Not be beat a dead horse, but I guess I will anyways.  I guess the phrase
about "not enabling bad choices" gave me something to think about.  My
question would be, who decides that it is a bad choice and what is the
criteria?  Some of this really goes to the heart of what we spend a lot
of time doing. as LCs or LLLLs.  Many new or aspiring LCs are worried
about amasssing a solid base of knowledge about breastfeeding.  But they
also need to fugure out how they are going to impart that information to
the women they are trying to help and use it to help these women make
very important decisions in their lives at a time when they are very
vulnerable and unsure of themselves.

When I teach my prenatal breastfeeding class, I spend a lot of time, in
different ways, trying to get them to think about priorities and the
choices out there and the consequences choices can have.  As far as
comparing breastmilk and formula, I don't really pull any punches and I
don't worry about making someone feel "guilty" about their decisions..
About things like co-sleeping, nursing older children, etc., I let people
know that it is an time-honored method of child-rearing that has research
to back up its safety/advantages so that if they go in that direction
they know they are doing something very normal and healthy.

When it comes to working with a mom who is searching for solutions to the
problems she is having with breastfeeding, I continue to give valid
information.  But I usually offer several choices to her as to how she
might want to proceed, outlining what I feel are the pros and cons of
each plan and the possible consequences.  At that point, it is up to her
to make a choice as to what is best for her and her baby and it is my
responsibility, I feel, to support her decision as best I can.  Now in my
heart, I have an opinion as to what I think the best plan would be which
would be most likely to ensure that breastfeeding will continue.  And
maybe some of you think that that is the only plan that should be
offered.  But the funny thing is, that over the years I have been
surprised to find out that the plan I liked the least sometimes turned
out to be the most successful for that mother/baby dyad.  Sometimes new
research shows that my choice really wasn't the best after all.  Even in
some cases where the mom chose to go with formula with one child, the
next time around she kept on with breastfeeding and was comfortable going
to me for help because I had respected her decisions the first time
around.

It is not easy sometimes.  And I am most aggressive about putting forth
some really strong points when I feel that a mother is opting out due to
"frivolous" reasons, a judgement call on my part, I'll admit.  But my job
is to help a mom make a fully informed choice - bad or good? - only time
will tell.  Which is why we should never feel badly about the choices
that moms make - we don't really know for sure what the result will be
down the road.

This would definitely be a great topic to kick around at a conference -
there is not a lot of  right or wrong here, but many  grey areas that
even us old-timers continue to struggle with.  And now I need to
acknowledge some well deserved guilt for using the computer as an excuse
for not sitting down and doing taxes while I am at home recuperating.
Hopefully, you will not see my name on any more posts for the next few
days.

Warmly,
Sharon Knorr, BSMT, LLLL, IBCLC in Newark, New York (near Rochester)
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