Anne:  I'm so glad to see your post about devices.  I posted a few
weeks/months back a few times about this.  We--that's the collective, not
you LNers--are so heavily dependent on technology that we forget things
like patience.  [Yes, I know I could use some of this before I post some
things, but I'm much better at it with babies.]  The difference in
philosophies is in that many hcps think of birth as pathological and that
lactation is just one continuation of a pathologic event (and weaning
brings the mom and baby back to "health" or normalcy).  Fortunately, I
don't think that means most on this list view it this way, but our society
leans in that direction.  Instead, pregnancy and lactation might be viewed
as an enhancement in health--a better than normal state, if you will.
[Can't you just see men running for hormone shots?]   Anyway, for every
intervention, no matter how innocuous, has a reaction and ripple effect.
You've all heard how putting a laboring woman on her back compresses the
vena cava and can cause fetal distress, but how many realize that putting a
hospital gown on not only depersonalizes and strips identity but it also
changes the smell of the mother and her breasts.  Olfactory cues are very
important to newborns.  So, at the risk of saying hospital gowns are
technology, they are a deviation from the "normal state of mammals" that
has an impact.  Now, take that a step further and add any number of
lactation devices.  This poor mom has had her self-esteem ripped away by
the message of "you simply can't do this without technology."  In the first
days after birth, before any shields, SNSs or cups, let's all vow to
support mom with self-esteem building words like "You're doing a great
job;" "Oh, he's looking at you and bonding." or "He's licking the breast
and getting to know you/your scent/the taste of colostrum."  I explain
these statements a bit by using the analogy of crawling being an important
developmental step.  Not all babies do it, but for some it is
indispensible.  Mom's hang on to those positive statements.  Then, teach
them what to look for: #s of wet diapers, skin turgor, fontanelles, etc. so
that we don't get a baby that is 17% below bw and dangerously dehydrated.
I think we've become victims of those few bad outcome cases that were
publicized by the Wall Street J. a few years back and are afraid to wait
through those first few days (not a week or weeks).  Paraphrasing Dr. Jack
Newmans...the big problem isn't lactation failure, but lactation management
failure (which puts the blame on the lactation-training deficient medical
personnel and process instead of the woman and baby).  Remember, there are
still many hospitals with NO LCs on the floor (a few of ours, for example).
Sorry for the lenght...I just was inspired by your post. ; )

: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC  email: [log in to unmask]   : )
: )HSR & Health Educational Consultant        voice/fax: 541 753 7340    : )
: )LLLLLLLLLLLLL**CHANGE THE WORLD, NURTURE A CHILD!**LLLLLLLLLLLLLLLLLL : )