Karlee-
 
Thank you for your thoughts on my post.  I have to say that it doesn't feel great to be aligned with a formula company with respect to the language I've used.  "Viable" and "alternative" are actually in the dictionary and are not "owned" by ABM companies.  
 
That aside, though, I think that you need to understand that the situations I was referring to were rare and were big judgment calls on my part.  It turned out that they were good judgment calls, according to the clients to whom I made the recommendations.  You state that for women who are really hesitant to have a baby at the breast, that it is even more important for that mother/baby dyad to experience breastfeeding (I'm assuming because of the bonding that happens). This is exactly the dangerous reasoning that can, IMO, ostracize women.  Of course, a mother that is hesitant can have many, many reasons for feeling that way, some of which we are not qualified to tackle.  If *we* as LC's polarize breastfeeding (i.e., give the impression that it must be breast particularly, as you suggested, for the hesitant mother), we may win the battle (i.e., the one feeding we observe), but lose the war.  I spend my days helping women breastfeed; that I threw out for discussion that there is a small sub-set of women for whom breastmilk-feeding may be more appropriate does not merit your suggestion that I run around "recommending" this to mothers.  I don't mean to sound so harsh, but it's this sort of inability to look outside the box that sometimes frustrates me with this profession.  Whether we like it or not, the confluence of westernization, technology and breastfeeding just don't always make for the perfect breastfeeding situation.  We do a disservice to babies and to women by running around like a bunch of ideologues. Some women---who, 15 years ago, would have been formula-feeders---are just not going to have a baby at their breast and opt to exclusively pump and bottle-feed.  Should we not address them?  Should we not discuss that these babies are incredibly well-off for being fed breastmilk?  Should we not, in fact, praise these mothers for doing an incredible amount of work?  Should we not, if our judgment dictates, actually recommend this course of action if the woman is clearly going to give up?
 
One last example:  I saw a client last week.  She said that there was a latch-on problem, but when I saw her, there really wasn't much of one--it was more that her technique was not great.  We fixed that, the baby had a pretty good feeding, etc.  She still needed to pump and supplement for a bit, though.  She called me two days later in tears, said that she had just been to her doctor to be put on Zoloft because with all the work she's doing (bf, pumping, supplementing), she is experiencing high anxiety and depression.  She was about to go away for one week to visit her family.  I told her to forget putting the baby to the breast and to pump and bottle-feed for a week (which is basically what she had been doing the last day anyhow).  I was very concrete, and very clear.  I told her that I can get the baby back on, but that I need a really full supply when I do.  She started crying again and told me that if I hadn't said that, that she was going to quit and formula feed.  She had been very anxious about nipple confusion, about taking the breast out of the picture, about sabotaging the entire process, but she also knew that she couldn't keep up this schedule.  I'll let everyone know what happens, but I think that that was the right thing to tell her to do.  She was already basically doing that, but with tremendous guilt about it.  I switched the lens through which she saw the whole situation, and she felt empowered instead of like a failure.  I don't know how many of you would have chosen this advice for this mother.  But I just sensed that if I had kept the breast in the picture at all costs, that it would have been too demoralizing for her to "breastfeed," and then watch the baby take several ounces in a bottle.  Her supply is very good, and I actually think she is going to ultimately breastfeed with no problem (I've had several clients for whom I took this course of action--a very different course than what I described in my original post, as this is temporary but before I was referring to times when we might recommend pumping and bottle-feeding as a permanent modus operandi).
 
I welcome discussion on this...
 
Heather in NYC, a huge breastfeeding advocate but also a breastmilk-feeding supporter :-)
 
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