Hi, All:  I vividly remember a statement made by Kittie Franz 20 years ago 
as she lectured to our UCLA Lactation Training Programs class that has 
stuck with me all these years and has become my practice mantra:

What do I need to be doing to put this baby to the breast?

If we all lived by these words, many of the problems and attitudes that we 
see in breastfeeding management would be greatly lessened or not even rear 
their ugly heads.  So...in terms of relactation, the easiest way to 
accomplish this is to PUT THE BABY TO THE BREAST.  If the baby will 
willingly suckle at the breast, ALL the feedings can be done at the breast, 
allowing for frequent practice.  Some sort of feeding tube device will be 
needed for a time, possibly the entire time the mother nurses this baby.  
The preference is EBM, but if her life circumstances make pumping too much 
of a stressor for her, I would rather see her expend her time/energies in 
putting her baby to the breast instead of at a pump, and use formula in the 
FTD.  I have also used a combination nipple shield/feeding tube at the 
breast to "fake out" a baby who is totally into bottle feedings. Whatever 
it takes to PUT THE BABY TO THE BREAST, and whatever the mother is willing 
to try is the method we use.  I usually end up with a happy mother and 
thriving baby and many of these couplets go on to exclusive nursing.  Even 
if mom ends up with a partial milk supply, she is still NURSING her baby.  
And isn't it what this is all about - the TOTAL breastfeeding experience, 
rather than getting stuck in the nutritional component of breastfeeding and 
ignoring the emotional/bonding component. I would rather see a mom 
partially breastFEED and nurse her baby long-term, than struggle to fully 
breastFEED and end up nursing her baby for less time than she would have 
liked due to the obstacles and barriers put in her way (breastfeeding 
technology - the term coined in the new Breastfeeding Handbook for 
Physicians - pumps, FTDs, galactogogues, etc.).

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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