Winnie said, "We need to inform her of the ways EP differs from direct
nursing and the amount of work involved. " Since we've been on the topic of
exclusive pumping, I was interested in hearing what you might say to a mom
who is asking if there is a diffierence between direct nursing and just
giving her own milk in a bottle.  What sort of advantages besides less work
involved does the baby and mom receive by direct breastfeeding that they
would miss if the baby just received EBM in a bottle? 

This is a very interesting question and one that I am sure I will not answer
adequately so I welcome all of you to chime in and add to my feeble attempt
to explain myself!

I believe that breastfeeding is not just about the milk.  I have seen
mothers with scant supplies offer all of their feedings at the breast,
despite the need to supplement every single one.  I have seen mothers who
must separate from their babies maintain just enough of a supply to nurse
their babies when they are together, at night and on weekends only.  These
mothers would argue that there are uncounted benefits to putting baby to the
breast instead of just feeding breast milk.

In my own experience, having the breast as a parenting tool has been
indispensible.  I have tried nothing that works as well as a quick nursing
to get a toddler through a squabble with his big sister during a cranky time
of day or a little mamma-milk to dry the tears of a preschooler who just
fell off her tricycle and scraped her knee.  When I came home after a
morning at work, it was such a comfort to my babies that they could have a
nice, long nursing, and such a comfort to me that no one else could do for
them what I was doing.  No one could replace me, their mother.

It is physically impossible to breastfeed without using attending behaviors
toward the baby being fed.  You can't prop up a breast and let the baby feed
himself.  You have to hold the baby.  You can't help but look at the baby,
and most of the time (unless you're typing or talking on the phone, which
happens a lot), you also can't help but to coo and smile at the baby.
That's not to say these things can't happen while bottle feeding, but the
physical closeness just isn't guaranteed -- it's something a mother or other
caregiver has to strive toward and be very conscious of.  When I see studies
comparing intelligence, health, and other attributes of breastfed babies vs.
bottlefed babies, I have to wonder how much of the benefit comes from the
milk and how much from the physical closeness that breastfeeding guarantees.

Having mother close by because she's the food source seems to be nature's
intention for babies.  Babies prefer it, too.  This breastfeeding mother
found it impossible to stay away for very long while my babies were young
and my milk was plentiful -- when they needed me the most.  

Of course, there will be situations where mothers do not wish to mother at
the breast, they prefer to bottlefeed their expressed milk for one year, or
there are other issues at play.  I find it difficult to share my feelings on
the importance of feeding at the breast with a mother who has a real
obstacle, be it physical or situational or emotional, with putting ber baby
to her body to eat.  In those cases, I need to offer information and support
to the best of my ability.  Perhaps lactation is simply about a breast and
the milk it makes, but to me, breastfeeding is about a whole lot more than
nutrition. 

I hope I've stated my case! :)

--Diana in NY

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