Chris hits it on the head when she says:
"If more people are pumping and bottling now, are they people who breastfed with previous babies or people who bottle fed previous babies with formula? The former situation is a problem; the latter is progress."

At the last LLLI conference, one of the foundiung mothers lamented at the increasing trend for mothers to express and feed their milk by bottle (EPing).  Unfortunately, I see too many breastfeeding advocates that seem to feel this way. I truly believe that these are women who would otherwise be formula feeding (and I did point this out to her later-unfortunately, there was not an opportunity to go to a mikke and make the point at the session).  Their reasons for chosing this "third opotion" may not seem reasonable to us, but for whatever reasons they feel it best fits their situation.  We are in an interesting position in these cases.  We want to let them know that it is not equal to direct breastfeeding while at the same time supporting and helping them meet this goal and avoid using formula.  Without the suport and information they need, most, if not all, are likely to throw in the towel and give formula. 
While it doesn't fit our definition, many of these moms consider themselves to be breastfeeding.   They want to be sure they are not lumped together with moms who are giving formula by bottle.  I think there are times when we may want to use the terms "direct breastfeeding" and "indirect breastfeeding".  "Indirect breastfeeding" is a lot easier to say than "pumping your milk and giving it in a bottle".  "Formula feeding" is much simpler to say.  Yes, it is true that EPing is more work than just giving formulas in a bottle, but why make it seem such a gargantuasl task when moms are initially weighin their choices?  This is certasinly  true when we are talking with a mom making the feeding decision.  Do we ever offer this 'third option" or do we only talk about breastfeeding vs formula feeding?  I am not talking about the mother/baby for which there is a genuine medical/physical reason for not directly breastfeeding.  I am sure we talk about EP as an option in these cases.  I am talking about the mom that says, "I am not going to breastfeed, I am going to bottle feed(meaning formula)".  Do we discuss with her that while it is not the same as direct breastfeeding, she can still give her baby many/most of the benefits by giving her milk indirectly?  It's a fine line to tread, but I feel we do a disservice to moms if we don't let her know there is a choice between direct breastfeeding and formula feeding when she is leaning strongly toward formula feeding.
Winiw Mading IBCLC

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