Another Lactnetter brings up the idea of advocating for patients who opt for
bottle feeding.  I want to make clear that my position is unequivically that
breast is best, followed by human milk in another container. I suspect that
the issue of nipple confusion is more complex than we think, and that these
complexities may influence many women to bottle feed who could successfully
breastfeed if only a skilled assessment of their infants were to take place.
These women deserve more than mere support for their choice to wean.  They
need better lactation management!

 When I talk about accepting patients/clients where they are, this is what
seems to me to be a spiritual acceptance.  In other words, I acknowledge
that no one comes to full wisdom of choice (esp. in parenting) all at once.
I have no right to shame another.  I also must honor the circumstances of
each family, and not judge.  However, I've never had a client who mistook my
convictions about breastfeeding being good for her and her baby.  I have
learned over the years to state facts (as best I understand them)
dispassionately, lovingly and then to detatch from the client's decision.
That allows me to accept her where she is, guide her to make her choices
work for her, and gives me a chance to educate her in ways that may
influence future choices.  That is what "informed choice" means, and I take
that obligation very seriously as an ethical dictate.  No one should mistake
my efforts to salvage partial breastfeeding as a retreat from my committment
to this as a health issue.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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