*sigh* I have to be honest in reading this case. 

As many IBCLCs, I've seen more cases like this than I would like to. PPD or 
not, it appears this mother does NOT want to breastfeed. (Plenty of women 
who do have PPD manage to breastfeed successfully. I've personally been 
there, depressed, and still struggled through, and succeeded, in the days 
when your only salvation was a kind LLL leader, in the days before IBCLCs.)  

The suggestion to ask her why she personally wants to breastfeed is a great 
one, but she may still give you canned answers, and still put forth no effort 
once you leave her side.

I know we have all seen cases where Dad wants the baby breastfed more than 
Mom does. Had a Dad sit next to me in tears, saying "I'd do it if I could." But, 
his wife had no interest, and within a few days of his returning to work (he 
was home for a few weeks, doing all the 'charting,' reminding, bringing her the 
baby, contacting me ect) she simply stopped nursing the baby. In this case, 
as per usual, her story changed over the ensuing days week and months. From 
a completely normal supply (and few minor workable problems, which were 
resolved with the first visit) the situation was then told to others as "I didn't 
have enough milk." "My breasts weren't right for breastfeeding." "My doctor 
said formula was best for the baby, as my milk was too weak." (doc said no 
such thing) ect. 

In the last 15+ years of helping other women breastfeed, I have had to ask 
myself many times, "Mary, do YOU want this baby to breastfeed more than his 
mother does?" If the answer is "yes" there isn't much I can do. I have had too 
many sleepless nights in the past. It may sound a bit callous, but I really need 
to reserve my strength and energy for the moms who WANT my help. Often, 
after years of doing this, you can tell with the first phone call, and usually the 
first visit call if mom "wants to" or not. (Usually the higher number of 
common "myth" excuses, the less she really wants to really breastfeed.) Of 
course, educating a mom is fantastic, but if she is truly against the idea, 
anything you say or give to her will be discarded immediately. Moms who want 
the help soak it up, those who don't want to, refuse to participate or even 
engage you. 

I have begun being very honest with my clients. I ask them, not only what 
breastfeeding means to them (and don't accept canned answers like "It's 
better for the baby.") but, "Do you want to breastfeed this baby?" to 
then,  "And if not, are you willing to take the effort to pump, transfer milk to 
bottles and then bottle feed as well, with all that both entail?" If Mom is 
honest, we can find out if she is willing to do what needs to be done. We can't 
nurse the baby for her. We can't want it MORE than she does. We can give 
her tools, if she drops her hands and refuses to use these tools, we can only 
know we did our best, and then move on to the next mom, who, we hope, 
really wants our help. 

Most of us have seen women face enormous challenges, seemingly 
unworkable, and if she really wants it, we do all we can and SHE does the hard 
work, it often DOES work. We have also seen cases where virtually nothing 
is "wrong" except Mom doesn't want to breastfeed, or worse, really has issues 
with the process or the product. These moms can have the best of 
circumstances, and still not end up breastfeeding, and months and years later 
are telling stories of their "low supply" (which never occurred) and how "even 
the LC couldnt help me." (And often an LC is called (and then ignored) simply 
so this last excuse could be used.) 

I don't want to be a downer, but we need to know where our limits, as human 
beings are. And we can't make a woman breastfeed who doesn't want to. My 
LAST try with moms like this (my husband calls it "the parting shot") is to say, 
kindly, "Even though some women think breastfeeding isn't "for them", human 
milk IS always the best for every baby." I leave her literature, which she will 
probably not read, finish my charting, leave my number, wish her well, say 
goodbye to the baby and tell the mom how beautiful her child is, say good 
bye, "Call me if you need anything." and walk out the door, hoping the next 
client is different. 

And, she usually is. 

There are moms who will do ANYTHING to breastfeed their babies. But, there 
are a few who will do just about anything to not have to. You have to ask 
your self if this mom is one of the latter. (Similar to "Change what you can, 
accept what you can't change and have the wisdom to know the difference.) 
It's sometimes hurts to actually learn this particular wisdom, because we want 
to assume ALL moms want to breastfeed as much as we did/do. :) Good luck. 

Blessings. 

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