Jean Ridler says, “The pump is seen as an instant solution for most breastfeeding problems. So often I see mothers whose milk supplies are dwindling due to not understanding how, or how often to pump; not using the correct pump for the situation; no follow-up support.” Again, just my feelings, but it seems as though women simply trust this technology and think that if they use it a few times a day all will be well.  They are surprised after a month or two that they are struggling to produce minimal amounts and at this point are desperate to figure out how to increase their supply.  I don’t think this is surprising considering our reliance on technology in our world generally, and more specifically our reliance on technology for all aspects of pregnancy, childbirth, and child rearing.  I fear in some cases, women are taking what may at the time seem like the easy way out and in combination with a lack of support and education they are finding themselves in a position where the effort to increase a supply that has significantly drop due to poor expressing practices is, in their minds, simply not worth it or impossible.  This is all the more reason that the option of exclusively pumping needs to be discussed more and good practices shared.  

I think more than anything there is a lack of understanding of the biological reasons for breastfeeding: that breastfeeding is not a means of nutrition but a means of nurturing on all levels.  There is no fault to be placed on women however since I don’t believe this information is readily available.  It certainly isn’t broadcast by mainstream media and in many cases even if a woman is told of, for example, the connection between the birth process and breastfeeding initiation, there are hundreds of other advertisements or articles to assuage her guilt over not breastfeeding or to share the newest and easiest methods of bottlefeeding.  As has been discussed many times on LactNet, the “benefits of breastfeeding” have been well shared with mothers, but this only encompasses the milk.  Until it is seen as the biologically normal method of nurturing a baby and that there are only risks to not breastfeeding, mothers will always see it as a choice.

I do not hear from many women who are choosing to EP over breastfeed because of negative feelings towards breastfeeding.  I do though hear from many women who started pumping because of difficulty and just never go back to breastfeeding.  I think there are a few reasons for this: 1. Women do not know where to get the help they need to switch back to breastfeeding.  2. Once you have started the cycle of expressing and bottlefeeding, it can be a real challenge to start trusting your body and your baby to make the switch back to breastfeeding.  You get caught into a cycle of numbers and a worry over supply and are already dealing with the extreme stress of feeling as though you have “failed”.  I can speak from experience that this is a very precarious position to be in and I found it impossible to find the support I needed to make a successful attempt to return to breastfeeding.  3. Once women are relieved of the daily (hourly) stress of trying to feed their baby at the breast and facing what seems often like rejection, pain, and “failure”, it can be an emotional and physical relief to have found something that seems easier than the roller coaster ride that started the journey.  EPing is not easy, but it is not as stressful as what often brings a woman to EP.

As to the terminology, I agree with Lara that often it is easier just to say you are breastfeeding when you are expressing and feeding by bottle.  It gets exhausting being judged by both sides.  And this judgment also comes in the form of judgment as to why you would want to EP instead of the easier choice of formula (from LCs and doctors and well as family and friends).  I remember when my son was about 4 months of age and suffering greatly from undiagnosed reflux.  I took him for a paediatric consult and was asked if I was breastfeeding or bottlefeeding.  I explained I was expressing my milk and feeding by bottle.  The doctor asked me three more times how I was feeding my son.  For some reason, the explanation I was giving did not fit neatly into his check boxes and he couldn’t wrap his head around it.  Until breastfeeding is recognized as more than a method of feeding a child, I think it matters very little how you refer to it.  As I see it, the real problem is not with the semantics but with the larger understanding of breastfeeding.  For most people at this point in time, it is all just another delivery method.  And yes, the language does influence the way we understand things, however, I think the increase of women who are expressing is a symptom of a larger problem not the problem itself.

I sometimes struggle with maintaining my website and the fear that I am somehow encouraging or persuading people to choose the option of EPing.  But in reality,  there will be women who choose this means of feeding their babies, whether through necessity or choice, and without information available on how to do it, there will be even more babies who have no hope of ever receiving breast milk.  And as I always say to new moms who have found themselves pumping, they are protecting their milk supply.  As long as their supply is strong, they have options.  I encourage all of you who work with new moms to recognize the challenges of switching back to breastfeeding after EPing and help to guide mothers to that end. 

It has been suggested that research needs to be done in this area and I strongly agree.  Conducting research is not in my area of expertise, but I would welcome discussion of opportunities for research and how I may be able to help out through my website and communications.  Chris Mulford mentioned keeping basic records and this I will look into starting although as always time becomes a precious commodity and simply responding to questions is taking up more and more of my time.

Best wishes,
Stephanie Casemore

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