As the professional liaison for an email group of pumping moms for the past 2
years I have seen an incredible number of women who are exclusively pumping
(EPing) often beginning in the first week or two and continuing to EP for a
year or more.

Their stories are all pretty much the same: the baby got numerous bottles in
the hospital, jaundice, sore nipples that wouldn't heal, separation of mother
and baby and sadly aggressive LCs who shoved or held a screaming baby to the
breast. Whether the LC really did or not is irrelevant it is the mother's
perception of forcing the baby to the breast that is paramount.

We've clearly gotten the message across that breastmilk is best for babies.
We have done a great disservice to them as well. How we teach and the
messages we are sending out drastically need reviewing. By being so dogmatic
against the use of artificial nipples mothers now believe that once the baby
has bottles the baby won't ever feed at the breast and they give up trying.
By placing so much emphasis on the first feedings and imprinting moms believe
if it's bad at the start the situation is hopeless or the opportunity to
breastfeed is lost forever. So they give up trying to get the baby latched
on. Sometimes as early as the first week or two. EPing moms are going to
great lengths to keep their milk supplies going. Often with small hand pumps.
And often without any outside support.

Not all of them remain EPers though. EPing list moms encourage each other to
keep trying to achieve latch on.  Moms actively work at getting the baby to
latch on using different types of bottles, tube systems and/or nipple shields
always maintaining a good supply. Those who have the most success are the
ones who *gentle* the baby back to the breast as Rapahel called it. They
offer the breast but don't insist, use nursing strike and rebirthing
techniques, lots of skin to skin contact, co-bathing, sleeping with the baby,
and attempting latch whenever the baby shows any interest. Persevering and
above all remaining patient, letting the baby take the lead. Never stressing
the baby at the breast. The information in the Breastfeeding Answer Book
(vol. 2) for the baby who refuses to nurse is very helpful in these cases.

Many of these moms report that the LC's they see insist on getting the baby
latched on and it didn't work. One or two LC visits and the mom gives up
because she perceives her baby is in distress at the breast. We never see
them again. They disappear into an entire subculture providing milk for their
babies mechanically.
We all know that breastfeeding is more then just the delivery method but when
things go wrong EPing isn't offered as an option.

Is there ever a time when it's too late to get the baby to the breast? I
don't believe so. The oldest baby I ever helped to the breast was 6 months
old. I reported on one difficult case that took 6 weeks before latch on to
Lactnet early in 1999. Dr Newman reports a nearly 2 year old going to the
breast for the first time in his book. As long as the milk is there the
possibility of latching on is there. I don't get their hopes up or mislead
them. I always let them know that the baby may never latch on. As long as mom
knows that feeding the baby at the breast is still possible she will continue
to try.

Having a good milk supply is critical to getting a baby to accept the breast.
Continuing to offer in a calm, relaxed manner is another.

Marie Davis, RN, IBCLC

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