People who shy away from the "pull of flesh to flesh"  may not be bad or
shallow.  They may be afraid.  Coming out of dysfunctional families, many
women either lack fully formed love templates of their own, or they have
been so hurt in the family dynamic that they protect themselves by investing
more in externals (career, material things, etc) than they dare to commit in
relationships.  Add to this the economic distress so pervasive in the US
where many families are teetering on the brink of disaster due to job loss
or no health benefits.  There is tremendous pressure on families and this
pressure undermines a lot of good intentions or makes certain choices seem
to be the luxury of the well-to-do.  Women have enough to worry about
without our judgementalism.

What I love about birth and breastfeeding is that they are such powerful
biological events that they empower and promote at an instinctual level the
profound attachment most desirable for the long-term protection of the
infant.  This is why it is impt to develop institutional policies to support
simple interventions such as uninterrupted skin-to-skin contact for an
extended period after birth. (See Step 4 of the BFHI and a new article
validating the effect of prolonged contact and its impact on bfg duration in
the new JHL.)  This is why our skills as lactation management experts are so
impt.  If we can accurately spot the moms who are at risk for problems, and
can effectively intervene to improve their chances of success, the
experience of bfg itself will kick in and protect the bonding. So may I
gently submit that we could spend less time agonizing over why people just
won't act right and try to re-focus on the things we MIGHT be able to
change?

 There was a wonderful study some years ago hidden in one of the Jelliffe's
books (Programmes to Promote Breastfeeding, 1988) by a team from Costa Rica
led by Leonard Mata.  Called the "Puriscal study", this team documented that
the simple intervention of postpartum rooming-in not only increased the
incidence and duration of bfg, it documented that among the enrolled babies
(from a poor section of San Jose) the extended contact was associated with
"A significant decline in the rate of abandoned infants...noted shortly
after effecting rooming-in and other interventions.  The reduction was more
marked for well than for ill infants, but the decrease in rate of
abandonment of the latter was also clear.  The socio -economic crisis
hitting the country since 1980 apparently correlated with an increase in the
rate of abandonment ..." so the surprising finding was even more striking in
this vulnerable population of poor moms and babies.

What does that mean to you as a change agent (yes, that is part of the job
description of an LC)?  Well, it means that we have a lot of wonderful
research and tools like the Ten Steps that give us hope that we KNOW how to
effect positive change.  We could throw all our frustrated energy into
lobbying for institutional changes that would impact on birth and bfg.  It
is not easy, but it IS doable, as team leaders like Bobbi Philipp have
demonstrated  in her hospt. in Boston that, against all odds, went Baby
Friendly.  We all can get involved in coalitions that put pressure on
institutions.  Seldom is it possible for the job to be done alone, so it is
impt. to get busy teaming up with existing organizations like your
professional affiliates (esp. ILCA), Healthy Mothers/Healthy Babies, NABA,
etc. to go after policies that create barriers.  Armed with research
literature (are you all reading and collecting these powerful weapons????)
one can mount a concentrated attack on regressive and obstructionist
practices in your institution.  If we remove even a few of the institutional
barriers, then the activities themselves of birth and breastfeeding will
protect bonding.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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