In a message dated 12/30/2003 10:52:27 AM Eastern Standard Time,
[log in to unmask] writes:
Do we get so hung up on the mechanics of all of this that we
are giving mothers the impression that breastfeeding is so difficult that
they will not succeed unless the lactation consultant is there?
Dear Friends:
    I agree with Pam on this. In my area, lactation has become very
medicalized with all sorts of rules about when and how to breastfeed that take a
mother's attention away from the messages she needs to get from her baby.
    A typical client for my private practice is one where mother is waking
baby up to feed on a schedule (usually every two hours), pushing baby's head
onto the breast (thus bending the head forward and preventing baby from opening
wide enough), and/or chasing the baby with the breast so that every time baby
looks like it is 'fumbling', mother shifts position. Breastfeeding has become a
battle; mother can be injured, baby is upset or withdrawn............and all
from a poor beginning and unhelpful teaching.
    Imagine if the catcher in a baseball game kept moving the glove; it would
drive the pitcher crazy. Constant moving of the nipple 'to help', makes some
babies very angry. It also doesn't work.
    It would be easy if mother and baby were left alone together to figure it
out. I have seen lots of 'incorrect' latch at home visits, where  baby is
thriving and mom is comfortable.  Breastfeeding is not a visual art, it is a
feeling activity.
    In one hospital where I work, the nurses are  uncomfortable with hand
expressing onto a spoon and giving this to baby. (So many babies there unable to
feed secondary to birth injury, maternal-infant separation, and routine
supplementation with formula). Another LC there adds 10cc of water to the colustrum
and this satisfies the nurses who have some belief about volume. But what does
it teach the mother?
    Mothers are taught to look everywhere but the baby for breastfeeding
information. However, the baby is the only one with the answers, as long as baby
is respected and close to mom and heard.
    Reminding mothers ofthis can help them to deal with the confusion when so
many different people are giving breastfeeding guidance; instead of
remembering what the LC said or the nurse said or the MD, just look at the baby!
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
Maternal-Child Adjunct Faculty Union Institute and University
Film Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative

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