"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."

I hear you Heather and I do see the point. However..... the moms I work
with are pretty smart and they do read "our literature." I did not see
the article in Leaven that Sara referred to earlier until one of my
clients showed it to me a said she felt it was "unfair."

I agree with Jean Cotterman: The only fair distinction to make is to say
that breastfeeding is either direct or indirect. If we are not careful
we risk alienating many of the women we wish to support.

And finally, why do we need to distinguish between those who pump and
feed out of "necessity" and those who do so for "convenience?"  We can
never really know what goes on inside the woman who decides to
indirectly feed her milk. Rates of sexual abuse in this culture are high
and often involve the breast. Sometimes when a mom is adamant that she
won't put babe to breast for, what seems to me a flimsy reason, I step
back and ask "what has happened in her past?"

Susan Keith-Hergert RNC, MS, IBCLC
Holistic Natal Care
Cincinnati

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