< Carol Bryant( 1992. A strategy for promoting breastfgeeding among
economically disadvantaged women and adolescents.NAACOG's Clinical Issues
in Perinatal and Women's Health Issues: Breastfeeding 3(4):723-30.) in her
focus group research found that women knew that bf was better for their
baby, but they didn't bf because of perceived "barriers". We should be
spending more time on listening to mothers and helping them overcome their
barriers than on teaching A's and D's. >

Carol L'Esperance, RN,MSN, IBCLC

Carol(s) both are totally right.  I have spent the last two days with
low-income women who had problems such as engorgement and nipple confusion
due to early bottles introduced at hospitals and staff who were too busy to
help moms.  These moms were identified during pregnancy and contacted by
the Public Health Nurse and visited early - when the problems were bigger
than the nurse could handle, I was called in.  

It doesn't matter if moms know that breastfeeding has many advantages - or
that bottlefeeding has many problems - if we can't get the correct help to
them on a timely manner, breastfeeding will be sabotaged.  When babies are
hungry and moms can't solve the problem for whatever reason - she will give
him food.  That this food is not the one she hoped to give or the one she
planned to give does not matter at 2:00 am when she's totally overwhelmed.

Early and frequent contact with postpartum mothers is the only way that I
have seen that works. - Soooo - do we ask for home visitors (trained and
supervised - and with backup specialists) as an adjunct to our health care
system?  

Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA  
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