Cheryl, I am not surprised to see the talk about abm supplementation. This talk varies tremendously as mother/baby situations vary -- from simple concern to slow weight gain to FTT cases of varying severity. That said, I proceed! Blame it on my mother-support background, I do not like to see a mother use abm as a crutch. My reliance on it will no doubt be seen as the ultimate strike against her own bountiful milk supply. Imagine calling your LC/LLLL/etc & being "told" by her you don't have enough milk! (That is what we're "saying" ... & sometimes it's true.) Sometimes a mother contacts me when her baby is primarily supported artificially. I am cautious in my language because it is important that she trust the team of health care providers helping her baby. I don't wish to be the first suspicious player she encounters! Sometimes I think the biggest gift I can give a woman is the pep talk I lace through our consult. Milk is an emotional secretion. I make sure the woman knows that I absolutely believe in her breasts, her power as a woman and a mother to make this thing happen. Many women report a change in 24 hrs! I love to hear followup reports of leaking milk at 3am & gulping babies. I do not mean to simplify the myriad problems women encounter with supply, weight gain, or sobering physical challenges to mom/baby. But if there is a mountain to climb, I want to hear the woman announce she is taking her own first step. The abm is tied to her ankles like so many weights. This is not to discount the fact that some mothers & babies present too late to cut the abm as quickly as I'd like, but cutting the abm is itself an act of defiance by the mother. When we discuss our action plan for future bf management I point out details in the baby's feeding history that relate to the new change. I give a short "why" for each step. Light bulbs are forever going off over mothers' heads. Frequently mothers interrupt me to finish explaining why we are doing this or that. That's when I know I have her! I get a lot of "So that's why ..." & "I kept thinking I should _____ but everyone said _____." I particularly enjoy it when a mother looks straight into the baby's eyes & explains the plan to the baby! Sometimes she apologizes to the baby for not trusting her own instincts -- or the baby's. Of course, you can't just be whistling Dixie when you say this stuff to a new mom! You've got to believe. Cheryl, I hope you've opened a new dialogue on the ramifications of abm use & our attitude toward abm. And Ellen, I suspect I've expanded on your well-taken comment re concern for Mom's confidence. If I'm off track or haven't gone far enough, please post! Diane W., is this perhaps another issue for your next edition of "Watch Your Language?" (That is, the LC's attitude toward abm.) I will post later on the never-ending issue of semantics. I find it a challenge to communicate through this format. There are endless details to a given case we cannot give, endless questions if we were all in a room w/ a mom, & when we generalize about a practice (as I have attempted here) we may all be thinking about a different interpretation of that practice. Hopefully, we keep an open mind about the format -- the limitations of on-line discussion and the highest intentions of those who attend this discussion. Susan Johnson MFA, IBCLC, LLLL __________________________________________________ Do You Yahoo!? Yahoo! Auctions - buy the things you want at great prices http://auctions.yahoo.com/ *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html