My take on the above situation:

I am the lactation consultant, I consult with almost all mothers who are
nursing their babies. A few times, before I have had a chance to get a
report from the primary nurse, I have stopped by to visit a mom whose  infant was
listed as breastfeeding in our nursery book, but she tells me she is  not
and was not planning to nurse. I apologize for "bothering" her, telling her
that I had the wrong information, and wish her well. Then I leave  promptly.
 Occasionally, if it is somewhat slow day ( not too many of those  with all
the moms who are having lactation problems), I will stop and visit a  mom
who has changed feeding methods, and ask her how it is going with the bottle
feeding, and ask her if she felt she got enough support and help with
breastfeeding. She will usually tell me that "she didn't like breastfeeding, she
 was only going to try it a few times, it was too hard, or the baby wasn't
getting enough, etc." Very infrequently she will tell me that she didn't
get  enough support. Regardless of her response, I offer her good wishes in
her  journey as a new mother, and tell her that if she ever has any questions
about  breastfeeding or care of her breasts postpartum, I would be happy to
answer them  and myself or one of the staff nurses is always available to
answer questions.  The nurses routinely teach about postpartum breast care for
all mothers, so  I know that mothers are getting that info.

I strongly feel that it is the medical community, read OB care providers'
and their nurse/CNM educators', responsibility to be "promoting, supporting
and  protecting" breastfeeding, and that they should use the "Best Start"
counseling  method to do this at the first prenatal encounter. What a
wonderful opportunity to do this when the care provider does the initial  breast
exam, and tells the woman "your breasts and nipples look like they would  work
just fine for breastfeeding. Tell me what you know about breastfeeding."
Then they can go on to give a specific targeted response to whatever answer
the  woman gives. This will get to the heart of any barrier the woman she
perceives  that she has. It is succinct and doesn't close the door to further
discussions.  I used this approach routinely when I worked as the
nurse/educator for the  CNMs in an OB-GYN office. We had an almost 90% breastfeeding
initiation  rate.

In our county, there are three OB offices. They are supposed to give out a
prenatal packet of information, which has been developed by our local
breastfeeding task force and is updated annually. ALL mothers are supposed to
get it, regardless of their stated feeding decision/plan. Does this always
happen? I don't know. All the pediatric providers in our county have their
names listed on the letter in the packet, strongly supporting and
encouraging breastfeeding. I so wish the medical community, including  pediatric care
providers would "walk the walk", not just "talk the  talk" when it comes to
breastfeeding support and promotion. But that is another  topic for another
day.

Mary-Jane Sackett, RN IBCLC
Pittsfield, MA (in the Berkshire Hills of Western Massachusetts, USA)


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome