Jennifer says<<You are so right! I find it so disheartening to hear the 
constant "meet the mother where she is" argument,>>

Jennifer, I am curious as to why you would argue against meeting the 
mother where she is in the breastfeeding experience? How do you expect to 
help her to hopefully have a successful breastfeeding experience if you do 
NOT meet her where she is at that particular point in time? How can you 
say that as an LC you are not protecting the mother and baby when you are 
assisting the mother to provide her baby with superior nutrition (not to 
mention a wonderful emotional experience?

Meeting the mother where she is is about helping her, not covering up some 
perceived horrible error by the medical community.What happened to "do no 
harm" on your part?

<<When I did hospital labor support, I found I had to be very conscious 
of my own tendency to watch the EFM,>>
Your job as a doula is to support the mother and NOT watch any monitors at 
all. That is totally outside your scope of practice, nor is it appropriate 
for you to do so. Latching, hopefully, is a low tech skill, as you point 
out. Fetal monitoring and the interpretation of same, however, is not, 
whether it is continuous or intermittant. 

Necessary intervention can cause harm as well, but they are sometimes 
necessary. Take resuscitation for instance. If the baby isn't breasthing 
and has to have some bag/mask ventilation, it is better to do that and 
have a pink crying baby for Mom to nurse soon thereafter, then to not 
resuscitate adequately and then have that same baby have to be separated 
from Mom as she lies in an isolette full of oxygen.

<<I know with all of my heart that 
everything matters--how we gestate matters, how we birth matters and 
how we nurture matters.>>
Do you really think that medical people don't think that these things 
matter? Why do you think women are encouraged to make 12-15 prenatal 
visits for each pregnancy? We do twice weekly non-stress tests on higher 
risk women (gestational diabetics, those with an elevated AFP,those with 
twins, a history of previous stillbirth and a myriad of other reasons). Do 
you think women are encouraged to take classes (childbirth, breastfeeding, 
newborn care, prepared C/S) so that the medical community can undermine 
them? Come on. Give these people some credit. I daresay no one is 
discounting the importance of pregnancy and birth.

<<I believe witnessing the mother's 
wounds as she reveals them is very much our responsibility>> I don't think 
anyone would disagree with you. I feel that you make the assumption that 
medical people are not addressing people's huts and issues. But at some 
point, we have to move on. We need to asknowledge these problems and then 
work around them and with them. That is our job. Do you think an 
infertility specialist doesn't acknowledge the clients past difficulties?

<<In the long run, I think if we are committed to public health, we need 
to know what that really means. Artificial feeding is destructive, in 
any amount.>>
We can be committed to public health but we also have to be realistic at 
the same time. There is always going to be artificial feeding (to use your 
specific example), Jennifer. That will always be a fact of life. It has 
always been such. We don't have to like it or agree with it, but we have 
to work with it. The only way we as LC's can "do no harm" is to educate, 
encourage people to make informed choices, and encourage as much 
breastfeeding as possible. I would rather help mothers feel good about 
what they do as opposed to feeing guilty about what they did not do. If a 
mother chooses to exclusively breastfeed for only 3 months (let's say) and 
then they combine breast and formula (in whatever amounts) for the next 9 
months while she goes back to work, then let's applaud the fact that she 
is breastfeeding and support her in any way that she desires. I feel it is 
far better for her to feel proud about what she is giving her baby than to 
feel guilty because she is no longer exclusively breastfeeding.

As I still maintain, any amount of breastmilk is better than none at all. 
I am just realistic enough to know that in our society as it is now, we 
are not going to have a lot of mothers who have the commitment to or the 
ability to provide exclusive breastmilk.

Some of us are luckier than others. With my second, he was exclusively 
breastfed for 2 years and I had a wonderful daycare that used my milk and 
never overfed him. But I was also lucky enough to be able to work in the 
hospital, where I had access to the hospital grade breastpumps, my 
schedule was flexible and I was in (and am still in) a breastfeeding 
friendly environment. Just because I did that (and it as because I wanted 
to as well)I know that others cannot or arenot able to have the benefit I 
had. But I also know that my goals were not everyone's.

If we do not take women where they are then we are, indeed, doing that 
harm that so many here keep mentioning.

Are we actually doing harm if we do not support our breastfeeding mothers 
choices?

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