Marsha writes:
I have one question about that.  I have added this to my teaching
repertoire with new moms recently, telling
moms that they need to nurse (or pump for NICU moms) often in those
first few days for this reason.
However, I have to wonder, if this is strictly true, why is it many
Hispanic and Asian
moms can bottle feed the first couple of days until their milk comes in,
then breastfeed without problem?

I have wondered about this also.  We have a fair percentage of Hispanic
moms most of whom insist on giving bottles at first ("no milk" no matter
how much we can express and show them it's there) but report they have
nursed their previous for a year or more.  Of course, we don't know how
exclusive that is, but from the ones where I have been able to chat for
longer (with the interpreter, I can't spend as much time as she is
usually also needed elsewhere) it appears they do primarily, if not
exclusively breastfeed after those first days.
I suspect that confidence is a big factor.  Because they believe it will
work, it does.  I'm not talking about half-hearted belief.  I'm talking
about it being as confident a belief as believing that the sun will rise
tomorrow.  When a mom gives bottles because she lacks confidence, not
just because she believes that's the way it works, she will continue to
doubt her body's ability to produce enough.  She will continue to see
every nuance in baby's behavior as a reason to question her nursing.
Another frustration with these moms is that when asked on admission
whether they will be breast or bottle feeding, some say "bottle" meaning
that's what they will do while in the hospital.  The admitting nurse
then checks "bottle" and we don't plan to see her.  Then, just as she is
getting ready to go home, she may mention that she will be breastfeeding
at home.  We have to hurridly summon the interpreter and cover our info
with her.  I am trying to get the L&D nurses to inquire further to be
sure what her long range plans are.  Unfortunately, you know the
objection many give-"We don't want to appear to be pressuring her to
breastfeed."  Can't "make" her feel guilty you know.  That's so much
more important than being sure we meet the needs of the moms who do plan
both.  ARRGGGHHH again.  I've learned to ask the postpartum nurse of any
mom with a Hispanic sounding name to ask mom about her eventual feeding
plans before we eliminate her from our list of moms to see.

Winnie

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