Dear Cynthia,

I agree with your comment on how little moms in the USA usually know about
normal babies before they give birth.  I think this ignorance is the cause of
much of the fall-off we have in the first two weeks of breastfeeding.  Here's
something I wrote to a WIC colleague just this morning:

Yesterday I talked with a young couple at WIC--Hispanic but both speaking
great English, so I bet they're second-generation.  5 day old baby.  First
baby.  Mom said milk had "just" "come in" on day 3.  Mom was engorged but
said the baby was latching on well now--we didn't put the baby on the breast
during her visit because she was asleep, and when I suggested it Mom said,
"Oh, I brought my milk in a bottle for her," implying that she had done a
good job of preparing for her visit to WIC.  Mom had been given checks for a
half package of formula because she's using some formula when the baby won't
settle down after breastfeeding.

I explained about CCK.  I explained about cluster feeding.  I explained about
babies wanting to be held.  I explained about new babies being more active at
night, and got her to laugh by making her remember that the baby was more
active at night BEFORE birth also.  They seemed to "get" all these points.
The dad was very supportive, and had changed enough diapers to notice the
difference between formula poop and breastmilk poop.  She said her goal was
100% breastfeeding. But STILL, she had that half package of formula, and she
wasn't going to change.

So at WIC typically the situation is that we have a new mom; this may be her
first outing with the baby.  She's postpartum--sleep deprived--still
sore--her breasts are acting like strangers and giving her a new surprise
every day, and the goal she set when she heard the prenatal lesson about "the
benefits of bf" probably seems unrealistic to her at this point.  She sees
formula as buying her a little sleep time, and a little time to feel more
like "normal."  She doesn't view it with the same disgust that we do. She
doesn't think about foreign proteins in her baby's gut or setting her kid up
for ear infections later on; she thinks about how Daddy can settle the baby
with a bottle of formula after she has sat up from 2 AM to 5 AM trying to
nurse the baby into the kind of deep sleep the baby had all day.

Somehow we have to get across to her that things are still going to change.
Nursing can still be easy, but she has to give it a chance.  She will have to
make some changes in her expectations of life with a baby.  Probably she will
have to change herself MORE if she wants to be an exclusively bf mom, than if
she uses some formula.  So we're talking about LLL's good old concept of
"growth in mothering."  This is a tall order for a WIC mom...for any mom--but
surely it is what we have to foster if we want to improve breastfeeding.

Remember the concept of "bottle-feeding like a breastfeeder" for moms who
give up breastfeeding but still want the closeness?  I think what we're
trying to change is the notion that you can "breastfeed like a bottle-feeder."

Yours in the struggle,
Chris Mulford
RN & IBCLC in Eastern PA, USA



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