You know, this discussion has gone on and on about how bad this 
intervention is and how bad that one is and how different home birth is 
and we have talked about the validity of literature as well. We are 
beating a dead horse here, colleagues.....................We are also 
preaching to the choir!

We all come from different institutional environments,different walks of 
life, some here from countries other than the US, and we all bring our own 
family backgrounds and experiences as well.Like us, our clients all come 
from these dissimilar backgrounds. Cultural practices can also make a huge 
difference. Talk to some of the LC's on this board from South Florida, for 
instance. I have learned a terrific amount about how different cultural 
practices are even there. 

We are never going to have the perfect breastfeeding world. We are all 
going to have sitautions that bother us. We are always going to think it 
was Dr.X or hospital X that screwed up the baby's breastfeeding. It 
probably was Dr. X and the hospital, but there is absolutlely nothing we 
can do after the fact. I could go on and on. So, let's pick up the pieces 
and help the mother to start from NOW.

We are never going to be able to change the climate of OB care completely.. 
We are never going to be able to fight the formula companines and be 
totally successful. I think we all know that. This to me is a good example 
of the expression "...you can't fight City Hall." There are always going 
to be situations that are beyond our control to a certain extent. As I 
said once before (and as I tell all my mothers in breastfeeding class and 
at the bedside as well), babies do NOT always read the guide books.

As LC's,we have a terrific amount of power, really, to start each baby and 
mother off with as much success as we can. We just need to take that 
couplet where they are now, right now, forget yesterday,forget the 
interventions and put aside what didn't go right and concentrate on the 
now.  So they had a low sugar and had to have formula.....let's put that 
behind us and work with getting that baby to breast now, so he will do 
well and maybe he will breastfeed for a year or two. We cannot change what 
a neonatologist said to a parent, but it is now, and Mom wants 
breastfeeding to go well and so let's concentrate our efforts on something 
that we CAN control.

I have just closed a VNA case (yesterday) with one of our own babies who 
was readmitted to us 2 days after D/C with a high bili. Not only did I 
have a mom and baby with the potential for an ABO set up, but the baby 
didn't breastfeed well from the get-go. The infant had a significant 
weight loss. It was one of those things. So, who's to blame here: her 
c/section, her small breasts that made latching difficult, her blood type, 
her baby's blood type, the fact that she had a pretty flat affect and 
needed to be more assertive, the need for phototherapy, the pediatricians
(who are really pretty breastfeeding friendly) or what? What or who shall 
I blame here? All of those factors are water under the bridge right NOW. I 
needed to take this baby and mother where they were: whether it was when I 
was still working with them during her initial admission or at the time of 
re-admission. It didn't matter what happened before, because I needed to 
deal with NOW.

Long story short, regardless of what interventions the baby had to have 
during both admissions, the baby finally went to both breasts effectively 
and is now being exclusively breastfed. This is at day 16. This happened 
in spite of the doctors, nurses, phototherapy, small amounts of formula 
the baby had before Mom's milk supply caught up, and any of the other 
myriad of interventions that may have had to happen.I don't know because I 
wasn't there 24/7 and lots can happen.

The point is I probably could have sat around and bemoaned all the 
problems this baby had had and what might have caused them. But the 
parents are already stressed enough and don't need me telling them what 
should not have happened. I took this baby where it was at the time. We 
put away what happened last week, yesterday, an hour ago, and concentrated 
on the now and the mother's desire to breastfeed exclusively.

I guess I am also feeling that I think due to our collective efforts or 
not, many babies go on to breastfeed exclusively despite what heppens to 
them in the early days. Let's concentrate on helping the mothers to be 
successful. It will be because of consumer breastfeeding success and 
consumer demand that changes will maybe come and force OB's, pediatricians 
and the formula companies to back off a bit.

We are never going to get to everyone and we have to accept the fact that 
some mothers just do NOT want to breastfeed and really don't care about 
the nutritional benefits of breastmilk. There will be others who 
exclusively breastfeed for only a few weeks or months. Who cares as long 
as the baby has had some benefits of human milk. They are still better off 
that those babies who didn;t receive breastmilk. All we can do is  spread 
our knowledge and expertise to as many mothers as we can through classes, 
WIC, articles, you name it.

Think how many children would be at even higher risk if it weren't for 
LC's all over the world........................

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