Anytime I can, I recommend that parents who choose to have their baby boy
circumcised, do so after 8 days.  I explain my reasons for this
recommendation and often parents accept it.  One was told that insurance
wouldn't pay for it if it weren't done before they left the hospital because
it is elective surgery, or some such excuse.  So the parents didn't sign the
consent form, went home and established a good breastfeeding relationship,
then told the ped that they had changed their minds and wanted it done and
it was done at day 10 , covered by insurance.

There are so many medical procedures, medications, lifestyle choices, and
expectations that became entrenched in the years of bottle feeding (while
other healthy practices *faded* in importance) that it is of monumental
difficulty to return to breastfeeding in the sea of all of these "aliens" to
the human experience. That is where we LCs run into so much trouble,
particularly those of you in the hospitals where the "business" of medicine
(in the words of Sue Petracek) "begins to compromise ethics when they take
on a life of their own and lose touch with the human beings they serve." We
in private practice encounter it with parental expectations that insist on
detachment/distance as the ideal, because as Debbie A. said, "it feels like
home."

The causes of breastfeeding problems are so legion that we often don't even
know where to begin--bottles, epidurals, heel sticks, IVs, routine meds,
tests, treatment protocol, plastic baby beds and seats, cribs, clocks and
scales... The AAP gave one suggestion for hospitals in their recent
guidelines: "Procedures that may interfere with breastfeeding or traumatize
the infant should be avioded or minimized." They have also inferred that
human milk for infants is a goal that is worth major consideration and
changes. That is a beginning.

It is hard for many people who weren't nurtured at their mother's breast and
in her arms and beside her in sleep, to believe that they missed anything or
are, in any way, less healthy as adults for this deprivation.  They don't
see anything going on when a baby feeds at her mother's breast other than
milk transfer so what's the big deal? Breastfeeding can be made to fit into
our bottle-feeding structure if that is what women want to do. And it is
people with these attitudes whom we are expecting to change the unhealthy
practices and help us return to the job of growing human beings.

When I hear Kathy D. speaking about the Mali mothers who are in tune with
their babies and whose babies are healthily connected to their mothers, I
wonder how long it will take for us to let go of a lifestyle that doesn't
serve our children or ourselves. But then I remember the many women
(including myself) who have, with the help of breastfeeding, allowed
themselves to connect to their babies at a level of intimacy that they never
knew existed. So, in my opinion, our abandoning of breastfeeding ushered in
a lot of unhealthy practices and breastfeeding can lead us back.  We've
already seen it beginning.  This work that we do matters more than even *we*
can imagine.

Patricia Gima, IBCLC
Milwaukee
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