Your child has a badly injured leg.  As a parent, do you appreciate
improvements in the x-ray machine that more accurately visualizes the
injury?  Do you appreciate the improved use of inflatable devices to more
comfortably immobilize the limb, or value the massaging leggings that
prevent blood clots while your child is confined to bed.  When the time
comes, do you applaud the improved light-weight crutches that have been
engineered for the size and weight of a child?  Are you grateful for the
innovative physical therapy equipment that is designed for the specific
strengthening exercises your child needs, etc?  All who wish to return to
the good old days when they set bones without benefit of anything but half a
bottle of whiskey raise your hands.

Case study of a client of mine: a pediatric nurse.  Her baby was breech,
delivered emergency c-section.  Aspiration of meconium led to suctioning
that injured his vocal chords.  Several days in NICU with pneumo-thorax.
Baby aversively conditioned to deep oral penetration, hence very clenched.
Mother's  nipples bloody and infected, mastitis resulted.  Mom has hx of
eczema, which flares on the areola but is initially treated as thrush by
another nurse who thinks that yeast is inevitable after the antibiotics and
fails to query about the mom's hx.   Mom wanted to breastfeed, but is ready
to quit from pure despair and confusion.  I get her on day 15 when the milk
supply is in the toilet and the baby is below birth weight.  After several
weeks of daily follow-up phone calls and lots of equipment use (shields,
pumps, bottles, scale) we are coming out of the forest.  Baby is now nursing
without a shield, pumping has been mostly d/ced, the weight checks are down
to once every 5 days.  Baby is growing on exclusive milk feeds, mom is
healing, and while this has been really hard, it's going to be ok. Over and
over I reminded her that this isn't what normal bfg looks like.  This is
what a crisis looks like.  The goal of therapy is to get back to normal.

As in all technologies, one hopes that the practitioners using the equipment
are ethical and educated about the proper use of the machinery that is
available to help one's clients recover fully.  Breast pumps are tools.
Nipple shields are tools.  Sensitive scales are tools.  If I have to use a
tool to help a mother return her baby to normal feeding (i.e. exclusive
bfg), I want GOOD tools: tools that work, that are easy to clean, that take
into account size variations, that have pressure settings that can't hurt a
mother, etc. etc.

 In 22 yrs of practice I have helped thousands of mothers with dreadful
problems who have gone on to happily nurse babies for years at a time after
a brief period of sometimes very intense intervention that was supported
with equipment.  Many have successfully nursed subsequent children.  In a
number of cases, these clients have been physicians or nurses who have gone
on to more knowledgably care for other bfg women  because we had the
technology to sustain their own lactation in the face of complications.

I take the point of those who say that not every woman needs a pump.
However, I appreciate good technology for the options it gives me in terms
of helping mothers and babies.  Again I say, we have a romantic notion of
some version of the "good old days" with regard to bfg.  The babies in the
past (and in parts of the world even today) who can't immed. bfeed just die.
Or get formula.  I appreciate any tool that allows them to get milk until
they can get it for themselves.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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