Alice - I absolutely hear what you are saying. Just recently, I was
contacted by a mother who had expressed milk long-term for her baby
because of serious difficulties with 'direct' breastfeeding. She
wanted to know how her feeding would be 'classified' and it was
important for her to feel there was an official difference between
what she did, and how bottle feeding with formula was classified.
I told her that in international definitions, breastfeeding and
bottle feeding with EBM are treated the same.....the baby who gets
nothing but breastmilk by whatever means is counted in studies as
exclusively breastfed.
She was very pleased at this.
BUT.
Breastfeeding and breastmilk feeding is *not* the same. We cannot
fudge this, when sharing information with mothers when they are
making choices. Sparing the feelings of mothers who are unable to
get breastmilk into their babies in any other way than with a bottle
is a laudable aim but it does not help other mothers make an informed
decision.
Mothers who express long-term should **not** be divided into categories of
i)women who have to because their baby has a cleft palate (for example) and
ii) women who make a lifestyle choice because breastfeeding direct is
not appealing to them for some reason
because who are we to judge which cartegory to place a mother in?
A mother who has a history of sexual abuse involving her breasts
might make a 'lifestyle choice' not to battle these feelings but she
is under no obligation to share her reasons; a mother with a baby who
will not attach to the breast because of perinatal factors may decide
not to keep persevering with direct, and may make a 'lifestyle
choice' to use a pump instead....whatever, not everyone fits into a
category and nor should we expect them to.
Instead, we need to support and enable women who want to/have to
express long term, and explain to them that breastmilk is absolutely
worth giving instead of formula. That their efforts are worthwhile,
and their wonderful gift should be celebrated.....but their equally
wonderful gift is their *presence* at the time of the feeding.
Breastmilk feeding needs to be done *as if the mother was
breastfeeding direct* when possible.
On purely bio-medical grounds, it means the mother shares the same
pathogenic environment as the baby and therefore the antibodies she
makes will go into the milk.
But on other *relationship* grounds, the baby whose exclusive bottle
use means *anyone* can feed the baby, the baby whose exclusive bottle
use means the mother can take a holiday away from him :( :( :(, the
baby whose exclusive bottle use means he can go into day care at some
ridiculously early age....is a baby who is *missing out* (and a
mother who is missing out, too).
Mothers who are using bottles of EBM exlusively need to value their
own presence and their own relationship with their babies. They need
to give the bottle as if they were breastfeeding (skin to skin when
possible, paced bottle feeding, responsive bottle feeding, bottle
feeding in bed, in the bath and anywhere they want to be close). This
will go some way to close the gap between the experience of direct
breastfeeding and breastmilk feeding by bottle. Mothers are
*mothers* and not just suppliers of breastmilk.
Alice, your mothers need to know this too.....and they are more
empowered by this than by a pretence that what they are doing is 'the
same' and that the difference doesn't matter.
Heather Welford Neil
NCT bfc, tutor, UK
--
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