Dear Denise:  You have handled this difficult situation beautifully by
reassuring the mom of the value of loving parenting -- in other words that
breastmilk is not the whole story.  Her ability to hear your message and move
on to enjoying the baby w/o breastfeeding may well depend on her mental
state.  My experience with moms who are depressed postpartum (and I don't
just mean having a little difficulty adjusting) is that they will fixate on
the lack of breastmilk and obsess on what damage may now be done.  A more
balanced mom will mourn the loss of breastmilk but then take the attitude "I
tried my best but breastfeeding just isn't going to happen - this time."

I do provide handouts on postpartum depression (easy things moms can do to
help themselves feel better) and refer to counselors specializing in this
area.  Sometimes these moms will already be under psychiatric care (or were
prenatally) - a tip-off that emotional difficulties postpartum will be more
than we are equipped to handle and that rational discussion may not work.

One mom I worked with asked me every time she spoke to me (she made perhaps 8
oz q24h) "has he had enough antibodies yet?"  No - she wasn't looking for
permission to wean.  She couldn't let go of this question.

Joanna Koch, IBCLC in Los Altos, CA