Debbie - forgive me if this is late - just catching up on Lactnets.  I feel
some of your frustration because this kind of thing (in various forms)
happens to me too.  I have come to the sad realization that just sometimes,
when the mother *says* one thing, and *does* another, and breastfeeding
slowly fails, that she  may be what I would call "marginally motivated" to
breastfeed.

It always takes me quite a time to tumble to it, mainly because these
mothers always vehemently protest that they "*really* want to breastfeed".
There's always a lot of internal dialogue that I have with myself, perhaps I
should have said this? perhaps I should have made that clearer? - but in the
end actions speak louder than words.  Eventually you may have to accept that
this mother either doesn't really believe that breastfeeding is that
*important*, or that she really doesn't want to do it.  I try and leave the
mother with *written* guidelines, so that we can both be clear on what
actions are likely to facilitate breastfeeding, and what omissions (e g lack
of drainage) are likely to cause lactation failure over time.

I'm starting to see quite a few former clients like this with their second
or third babies, and - amazingly - I find that history often repeats itself
as these mothers manage their lactation/breastfeeding in exactly the same
way all over again - even with anticipatory guidelines.  I frequently get
the feeling that they have their own agenda. They are often just a little
evasive and it's hard to get at the facts. I often wonder if they are trying
very hard to satisfy society's expectations (breast is best!) but because
they would actually prefer *not* to breastfeed (for whatever reason, and I
feel quite sure some of the reasons are deep and dark and evil) they create
conditions whereby it is bound to fail.  The LC can feel like a pawn in the
game (I often do!) as the mother demonstrates to friends, relations, doctors
that she "tried everything" up to and including *you*, but still "couldn't"
breastfeed.  *Very* bad for your ego, and your reputation!

What more can you do?  Continue to be lovely with her, she may well call you
again when she has her next baby!  And hang in there! It sounds like you've
done everything you could.  Be quite clear in your own mind that you have
given her all the information she needs (you are not responsible for her
choices), document everything, and keep remembering all the mothers you
*have* helped to breastfeed!

Pamela, Zimbabwe