There can be advantages to not having access to e-mail for a while..  By
reading a thread over several days, one can better sort out ones own
feelings on a subject.
The dilemma of how to define the mom who BY HER CHOICE ALONE is pumping
and giving EBM by bottle (or whatever container) is increasingly coming
into play as we all seem to be noting that we see this more and more as
women accept the value of human milk, but still have issues with the
delivery system that they can't (or won't) overcome.  We see it also in
those moms so convinced of the value of breastfeeding that they will do
whatever it takes to get their milk to baby even if they have run into
barriers that prevent feeding AT the breast

In our unit, when nurses fill in the delivery record and must choose
"breast" or "bottle" to describe how mom intends to feed, some will
indicate these moms and "breast" while others describe them as
"bottle".  Because pumps and even hand expression are not the same as
baby, mom are not always able to provide their colostrum to baby the
first day.  Therefore, more of these baby's tend to get formula at
first.  (That's a whole other issue I'm not getting into with this
post.)   A more specific definition will help in communication between
staff members in these situations.

I had been using Jean's definitions, but not applying them to this
situation.  When I talk about a mom returning to work outside the home
who pumps and leaves that milk for baby the next day, I say that baby
continues to be breastfed-directly when mom is home and indirectly when
she's away.  I hadn't thought about using the same definition for moms
exclusively feeding with EBM.  I think it carries less emotional
distinction especially for the mom who is in this situation NOT OF HER
OWN CHOSING - the baby with a cleft, oroboobular disproportion, etc.

I agree that in talking with the moms in this position, we probably
don't need to break down the definitions, but there are times in
communicating with each other (that includes all those who work with the
mom) when it is important to differentiate.  I think the terms "direct"
and "indirect" breastfeeding do it best.

Winnie

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