Whew!  I got behind for a few days because of call, parenting, and
spousal responsibilities.  I've just scrolled though 22 digests.  I
passed over the limericks--I'm sure they were great.  I appreciate both
the info and comraderie, so don't stop rambling.  I would request,
however, that folks try to use short paragraphs and clearly separate topics
in order to facilitate scrolling.  I don't want to miss that great
tidbit in the middle of your post! I'll try to take my own suggestions, too.

Re: working mom/pumping:
I agree with both sides of the nursing/pumping question.  My usual advice
is to find child care very close by, as I think mother-baby contact is
essential.  Can mom work her schedule more flexibly?  She could still put
in the same number of hours but take a longer break.  I agree with
D.Zimmerman about keeping baby happy at day care--having all solids (when
they get to that point) at day care, and small amounts of water can
help.  Lots of night and weekend nursing, and pumping some on weekends to
get the supply primed for the week as well as stock the freezer, can
help, too.  Meanwhile, I'll stay on my soapbox, advocating for real
maternity leaves, baby-friendly workplaces, and on-site childcare.

Re: drugs
Many MD's are reluctant to use drugs in bf because if you look them up in
standard sources, there is "no information available".  Much of it is
ignorance about the importance of breastfeeding, particularly when baby is
more than 6 weeks (or 4 months or 1 year...) old.  Pharmaceutical
companies don't want to expose themselves to product liability, so aren't
going to say things are safe unless they are reasonably sure.  One has to
use more breastfeeding-friendly sources (including Pharm.D.'s like Tom
Hale) to get the real scoop on drugs in breastfeeding.

Re: all-or-none, thanks
A final comment.  I've been reflecting about my recent experience with
the mom with breast reduction surgery and inverted nipples.  I fear we
gave her an all-or-nothing expectation about breastfeeding.  She didn't
expect to fully feed without supplements but it seems we didn't give her
the option of trying breast and bottle with all our concern about nipple
confusion.  It was hard for me politically since I'm not the baby's
doctor, so I haven't been as closely involved since he was born as I
usually would be.  Anyway, thanks to all who responded.


--
Anne Montgomery, M.D.
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Olympia, WA