Nikki writes:
  "This discussion about mothers that choose to pump leads me to wonder 
if
 it is mothering that we are fighting for, more than breastfeeding."

  I think this is such an important issue. Breastfeeding is an innate 
aspect of mothering, but is not an innate aspect of childcare. I think 
that we as LCs are partially responsible--in our eagerness to jump on 
the "breast is best" bandwagon, we have become pawns in a very 
competent marketing strategy to make human milk a commodity, a product 
of lactation, just as the fetus is a product of gestation. So many of 
the issues discussed recently play into this. Exclusive pumping is 
indeed becoming more common and has been for at least ten years. 
Whenever the bar gets pushed like this, we are all quick to think of 
the moms who would never have been able to bf or provide milk to their 
babies w/o this alternative. We are so humbled by adoptive moms, moms 
of sick babies, moms who have mechanical problems with feeding at the 
breast and so on who have toughed out a grueling pumping schedule b/c 
they love their babies so very much. Most of us have friends--women we 
love who have had to do so (I have a good friend who is a doc who 
exclusively pumped for a preemie after trying very hard to feed at 
breast).

  Yet, whenever we see these trends, we need to be careful not to circle 
too much around these examples and remember the bigger picture. We are 
quick to be politically-correct and understand the difficult 
situations. But, most of the moms I work with who consider exclusive 
pumping are able to bf, but are quick to throw in the towel, seeing 
pumping as a viable alternative to feeding at the breast, NOT to AIM. 
Women have so many conflicting feelings when bf is a struggle and 
pumping often allows them to push these feeling aside. The further 
tragedy is that most will wean from the pump within days or weeks and 
bf will end altogether.

  While I do believe that we have numerous cultural barriers to 
successful bf'ing, I think we also have to be careful here. I worked 
for 4 years with the poorest women in one of the poorest cities in the 
US. At the time, our claim to fame was the highest incidence of teen 
pregnancy in the US. In spite of barriers beyond belief, we achieved 
very high bf rates among our moms. I think that our attitudes about 
what we value has more to do with bf rates than cultural barriers do. 
When a woman's sense of self is deeply rooted in mothering, she will 
make different choices than when it is not. Having other women around 
her who value her as a mother has a huge impact on her, whereas having 
others value her more in other roles will also have an impact.

  As Nils Bergman reminds us, babies breastfeed, not mothers--we simply 
have to provide our presence and I would also suggest our willingness. 
I firmly believe mothers are far more willing and able when they birth 
normally and when their instincts are intact. When I teach prenatal 
bf--it's always about meeting the physiologic needs of the infant. 
Proper latch, etc is irrelevent by comparison. So, back to the original 
concept--it's about mothering, IMO. When responsive mothering happens, 
bf'ing is likely to happen, too.

 Jennifer Tow, IBCLC, CT, USA
 Intuitive Parenting Network LLC

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