> I think many peds do see bf babies as more trouble for them than bottle-fed babies and that they are thus inclined to support weaning when difficulties arise.

For five years, I did all the lactation work for a home birth practice here in the Chicago area (family practice MDs).  One of the doctors had a stock response when parents told him that breastfeeding was "too much work."

I'm not sure I agree with his numbers, but what he said was:  "In the first five weeks, breastfeeding is more work than bottle-feeding.  This is the adjustment period."  He would then draw a graph that showed breastfeeding higher at the beginning in terms of the work load and artificial feeding lower. (One axis of the graph was "amount of work" and the other axis of the graph was "time in weeks")   "What happens, though," he would say, "is that at about five weeks, theses lines cross, and breastfeeding begins to be less work than bottle-feeding."  He would
then extend the lines and mark the place where the breastfeeding and bottle-feeding crossed with a 5.  Then he would continue to show the breastfeeding line fall so that while bottle-feeding stayed the same amount of work, breastfeeding continued to drop.  His conclusion was, "Over the long-term, breastfeeding is far less work."

I had mixed feelings at first about his approach.  I hated to admit that breastfeeding might actually be more work than bottle-feeding at any time.  But I saw that it had the desired effect on the parents.  I also noticed that in my teaching I talked about the first six weeks or so as the time when special care needed to be given to latch-on and positioning and talked about how the baby is "less coordinated" during this time and how many mother need to learn how to help her baby effectively attach

I'm still not 100% sure this approach is helpful (I guess no approach is going to be right for everyone), but I have used it with good result on occasion.  When mothers talk about switching to formula or going to pumping and bottle-feeding, they seem to respond well to the idea that while these may seem like a "quick fix," they may not be in their long-term best interests if continuing to breastfeed is an option.

Food for thought.

Nancy Mohrbacher, IBCLC
Chicago suburbs, Illinois USA

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