About exclusive pumpers, Marie Davis writes:

<< One sad side effect I have seen is the dramatic increase in exclusive
pumping
 (no feeding directly at the breast). <snip> You need to know that this is an
epidemic. These
 are the clients that we LC's don't know about because they are doing it
 without us.<snip>
 In the past, I only saw about 1 or 2 moms a year who exclusively pumped
 either for sexual abuse issues or infant facial deformities or suckling
 disorders and plain cussedness at not wanting to give the baby formula. Those
 moms didn't pump for very long. However since the AAP statement the moms that
 EP are trying to hang in there for at least a year. <snip>
 The profile of the Eper is rapidly changing. I see a definite trend -- a
 domino effect -- and I don't like what I am seeing.>>

Marie, although these cases certainly are sad, to me they seem on balance
like a positive rather than a negative trend, since these are generally
babies that in the past would still not have breastfed -- but they wouldn't
have had their mothers' milk, either.

 <<Doctors get blamed, nurses get blamed and sometimes the mother strongly
 blames the hospital LC (most don't know if the LC person was qualified or
 not) for their circumstances. >>

For a while I've been meaning to post about this.  I sometimes see these
mothers, as a non-threatening lay bf resource, and nearly always they have
seen an LC, gotten "helpful" advice about using a bottle to make sure the
little one was nourished during their initial difficulties -- and then had
zero follow-up.    No doubt sometimes the LC expected the mom to follow up.
But in all these cases the mother has told me, "She just told me to do this
-- she didn't tell me there was any plan to get the baby back to the breast
afterward."

What I want to urge is, when you are dealing with moms in crisis and you feel
that you just need --for whatever reason -- to get them bottling short term,
please *tell them* what the plan is for going back to the breast.   Not every
detail, necessarily, don't make them nuts about it.   But give them some
sense of the trajectory for fixing the problem, of which today's bottle is
just one part.

Otherwise, why should they call for follow up?    And by the time they
realize that this has been an only partially successful solution, the baby
may have been exclusively bottlefed for weeks -- not so easy to get back to
breast any more, by then.

FWIW.

Elisheva
spending time with the mothers who don't call back

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