Kirsten Berggren wrote:

<<I think it's important in these statistics to emphasize that we're talking
about a percent of women who may not ever achieve a *full* milk supply. This
is very different language than saying "not medically able to breastfeed". I
would think there are only .0001% of women who are not medically able to
breastfeed *at all*. But saying that "5% may require some supplementation",
or "5% will not be able to be fully breastfed" leaves open the possibility
of MOSTLY breastfeeding, with a little help from some supplements. I really
push to get away from the "all or nothing" mentality.>>

Kirsten, I agree. I think the "not medically able to breastfeed" language is
driven by a narrow perception of breastfeeding as FEEDING only. If we can
encourage people to think of skin-to-skin at mother's breast as the best
environment for a baby to spend time in (à la Nils Bergman) or to promote
the concept of "mothering at the breast" (à la La Leche League), then it
makes sense to encourage breastfeeding for all mothers, even though up to 5%
of mothers may have to use some supplementation when there are supply
issues. 

I see three jobs (at least) for LCs arund this issue:
A) to help the mom maximize her production, so that minimal supplementation
is needed;
B) to hold the line on inappropriate supplementation; 
C) to advocate for increased availability of frozen donor milk (from
non-profit milk banks), which would avoid the risks of formula
supplementation, and which would make medically necessary supplementation
more acceptable to many women.

The first rule is still "Feed the baby."

Chris

Chris Mulford, RN, IBCLC
LLL Leader Reserve
working for WIC in South Jersey (Eastern USA)
Co-coordinator, Women & Work Task Force, WABA
 
 

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