When someone says they feel "icky" about breastfeeding, it gives you a 
perfect opportunity to explore this with them. Empathy is the best first 
response. "Yes, some women feel breastfeeding is icky, because it seems 
like breasts are for sex in our culture". That will open the door for 
her to talk more, and then you can give correct information. But if you 
give information without the empathy, there is usually resistance.

As for the spina bifida, breastfeeding is likely something the baby can 
do. It's important for children with disabilities to develop a sense of 
mastery and control. Breastfeeding can be a first step toward this. Some 
infants with spina bifida have to be positioned only on their bellies, 
to avoid pressure on avulsed nerve tissue. Mom can recline or lay down 
and lay baby on his belly for feedings. It would be a lot more difficult 
to bottle feed a prone baby (though I've used semi-prone positions with 
the Haberman feeder for babies with Pierre Robin Sequence.)

Catherine Watson Genna, IBCLC  NYC

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