My thoughts on the issue of whether or not to say a mother is breastfeeding
when she feeds human milk via a bottle or other container is : who are you
speaking to and how specific do you need to be at that time? Technically
feeding at the breast is specifically breastfeeding and any other would be
breastmilk feeding, but I believe women become hurt when we don't say they
are breastfeeding because bottle feeding and formula feeding have become
synonomous and if we say the breastmilk feeding mother is bottle feeding it
puts her in the formula feeding category. And she has worked mighty hard to
not be in that category. I believe when we are speaking to "lay persons" we
should categorize all women who give breastmilk as in the breastfeeding
category, but when we are speaking among "professionals" we should have more
categories: ie bottle feeding formula, bottle feeding EBM, cup-feeding EBM,
tube-feeding EBM, etc. etc.
Cheryl Muller, RNC, IBCLC
To: Recipients of LACTNET digests
Subject: LACTNET Digest - 8 Sep 2001 to 9 Sep 2001 - Special issue
(#2001-778)
Topics in this special issue:
______ 2. Breastmilk feeding
----------------------------------------------------------------------
v
------------------------------
Date: Sat, 8 Sep 2001 23:18:50 -0500
From: "Sara D. Furr" <[log in to unmask]>
Subject: Breastmilk feeding
Cynthia wrote about the Leaven article entitled "Supporting the
Human-Milk-Feeding Mother." It can be found at
http://www.lalecheleague.org/llleaderweb/LV/LVFebMar01p3.html .
This is a thoughtful article but I had the same reaction reading it as I
have had to several of the posts here. Like Valerie, I really don't want to
tell mothers who have struggled to get the baby to the breast, pumping and
feeding their milk all the while, that they are not breastfeeding. I
discussed the Leaven article with a mother who was in this situation. She
is a LLL Leader and was distressed by the article in Leaven. As I have read
the posts here, part of me has had hurt feelings, on behalf of this
determined woman. She has had several children who had the classic
"oroboobular disproportion" which has been discussed here on Lactnet. She
never gave up! We corresponded by e-mail, she corresponded with Dr. Jack
and she was also seen by several LCs at the breastfeeding resource center
here in Lincoln.
I received an e-mail from her yesterday saying her now 5-month old son had
his first day ever where he took all of his milk at the breast. She is also
tandem nursing her 2 year old who was not able to fully latch on until age 6
months. For both of these children, and one other, she pumped her milk,
finger fed and sometimes bottle fed human milk until their mouths "grew
into" her breast. I cannot even imagine the determination this required.
She refused to accept that these children would not breastfeed. So her
perseverance has paid off and she is finally ready to get rid of the pump.
What a thrill it is to hear this news. So would I want to put her in a
category different from me? No, because I know that her babies were getting
skin-to-skin contact regardless of how she was feeding them. In fact, I
would venture to guess that there are more than a few breastfeeding mothers
who had less eye contact and less social interaction during feeding than
this woman did with her children.
I have also had contact with women who had difficulties breastfeeding and,
not wanting to miss out on the well-known benefits of breastfeeding, have
chosen to pump exclusively. Sometimes the problems preceding these choices
are minor and are perhaps more excuses than problems. And there are women
who, all along, plan to exclusively pump. I think the women who make a
choice to feed human milk, not at the breast, in a situation where
breastfeeding *is* an option need our support. But like Gonneke, I find
myself judging them, wondering if they know what they are missing. I would
not give up the intimacy of breastfeeding for anything. It is such a big
part of my mothering. I can't imagine mothering without breastfeeding when
breastfeeding is an option.
I agree that labels can provide information about a situation, but it seems
there are two types of human-milk-feeding mothers: those who do so by
choice and those who do so by necessity. It is the second group that I
grieve with. But I hope the story I related about the mom whose baby is
getting all his nutrition at the breast now at 5 months will help us to
remember that anything is possible when you are working with a determined
mother!
Sara Dodder Furr, breastfeeding advocate and volunteer
Lincoln, Nebraska, USA
------------------------------
--
possibility, leukemia is another...
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
------------------------------
> I cannot say to the mom of a neurologically-impaired infant that despite
her
> pumping her milk for a year and all her continued efforts over the months
> that she is not a breastfeeding mother.
I don't know for the others ofcourse, but I was definitely referring not to
mothers of impaired babies or other challenges, but to mothers who for their
personal reasons, not being medical reasons, voluntairily chose to not feed
their baby at the breast while very well having the opportunity of chosing
to
fully breastfeed.
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gonneke van Veldhuizen, IBCLC
MOM, LLLL, primary schoolteacher
Hiilensberg, Germany
------------------------------
------------------------------
Date: Sun, 9 Sep 2001 09:45:13 +0100
From: Magda Sachs <[log in to unmask]>
Subject: language / 'breastfeeding' / human milk feeding, etc.
I think in this discussion we should be orienting ourselves to the
international definitions which have been accepted for use by the WHO and by
the IGAB. I don't necessarily believe these are the best definitions there
couuld be, but thehave been used in recent research, e.g. Coutsoudis on HIV
transmission, Aarts on how exclusive is exclusive breastfeeding and Hornell
on bf styles. If we don't mesh what we understand with the research we will
never know what the heck we are talking about in terms of outcomes and so
on.
WHO for exclusive breastfeeding includes breast milk, including expressed
milk or milk from a wet nurse. Also drops, syrups. This will be adequate
for some studies, but for, say hiv transmission research, is obviously
problematic (early reports in the literature talked about transmission form
a wet nurse). The IGAB definitions differentiate breastfeeding from
breast-milk feeding.
In her brilliant short resume on this in Feb 2000 Breastfeeding Abstracts
(LLLI) 'What is the definition of breastfeeding?' says that "it becomes our
duty, each one of us, whether researcher of lactation consultant, program
planner or health care provider, mother or supporter, to be cognizant of the
variety of definitions used by writers and researchers." I think if we all
start using what we like and feel comfortable with [and I will say, yes I am
guilty of this] then we are probably undermining the protection, promotion
and suppport of breastfeeding.
Labbok says that the JHL advises authors to use the IGAB definitions, but I
thought they used WHO??? Does anyone have a sense of which are used in
practice? My feeling is that JHL authors arenlt that scrupulous about this,
but don't flame me if I am wrong. (I just think this is not emphasised or
even very clear in articles I have read, rather than they are willfully
subverting these definitions).
I personally would like to see us all using the WHO definitions and possibly
reforming them from within if we find we need more categories or explicitly
oriently the terms we do use to these terms (e.g. "my definition of
exclusive breastfeeding, or breastfeeding itself, differs from the WHO usage
in the following ways...").
When I heard the term 'human milk harvesting', I did not connect it to the
breast-milk feeding mother, but to the harvesting by researchers, and
especailly commercial enterprises and so on. I could spend an interesting
afternoon debating whether I see milk banks in that category. I find the
term powerful and justified for some who seek human milk, but certainly full
of implications that I would not be willing to lay at the door of women who
feed their own children their own milk without putting the baby to the
breast
Magda Sachs
Breastfeeding Supporter, BfN, UK
------------------------------
Date: Sun, 9 Sep 2001 10:46:07 +0100
From: heather <[log in to unmask]>
Subject: Re: Breastmilk feeding and Breastfeeding.... technicalities.
We don't necessarily say to mothers everything we say to each other
here - of course we wouldn't say to someone feeding her baby EBM (for
whatever reason) 'you are not breastfeeding'....I can't imagine an
appropriate reason for us giving any definition to her, except to
echo one she used herself... apart from Jean's excellent idea of
'direct' and 'indirect' bf, or my own term, 'feeding your own
expressed breastmilk', none of which sound to me judgmental.
But we need to know among ourselves, in our written work, too, what
we are talking about, and to have some consistency. That's the only
way we can maintain clarity....heavens, there's enough potential for
misunderstanding, even among those of us whose first language is
English, without adding to it ; )
Feeding EBM is not the physiological or psychological norm for the species.
And that's a fact : )
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
------------------------------
End of LACTNET Digest - 8 Sep 2001 to 9 Sep 2001 - Special issue (#2001-778)
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