Diane
I really feel for you - I think we've all been
there ... You ask what can change the minds of
mothers who had said they intended to breastfeed,
but then opted for bottle-feeding so soon after
birth - is it the culture, the times, the women?
There's a clue in what you've written, "I do want
to respect their mothering and choices (as misguided as they are) ..."
Here's the thing - we can't respect the mother's
choice to bottle-feed if we believe that she is
misguided. And because we know what we know, we
_know_ she is misguided. It's only our training
that prevents us showing the shock/horror we feel
about her decision to abandon breastfeeding so unnecessarily.
Sad though it is, I don't think this dilemma is
going to change for us so long as the culture,
the hospital, the health system, and our own
training, shows that it's perfectly OK for the
mom to not to breastfeed if that's what she wants
- the whole thing is geared up to pretending that we respect her choices.
The only time I've ever been able to be
completely honest about this was during my last
six months in Zimbabwe between 2002 and 2003 when
formula literally became unobtainable. There was
just none in the country at all - not in the
shops, not in the pharmacies, nothing! As soon
as I found out how dire the situation was I told
the preggie moms at my antenatal classes that
they wouldn't be able to buy any breastmilk
substitutes, and then literally _begged_ them to
not even think about not breastfeeding because
their babies would literally starve if they
didn't. Then I told them how the milk comes in,
how to avoid engorgement and the absolute
necessity of generating and maintaining a really
excellent milk supply, and feeding their babies
every time they squeaked. And of course about
all the great components of breastmilk and how
lovely it all is. When doing hospital visits,
if a mom showed signs of not being totally
motivated to get breastfeeding going, I'd
honestly show great concern, panic even, and tell
her she absolutely _must_ because not to do so
was so dangerous. Did I feel guilty? Absolutely
not! It was a revelation to me to see that
there was no guilt on anyone's part and no shame
on mine. One of the very unexpected sequels to
this was that during this time I didn't have even
one case of low weight gain, or not enough milk -
problems that had been so very common
before. These mothers were totally dedicated to
breastfeeding as the only way to feed their
babies, because it was quite literally the only option.
And now I can never again see the breast/bottle
choice in quite the same light as I did before
this experience. Why should we "respect" the
choice of a lactationally competent mother who
clearly doesn't know enough to make an informed
decision and who is actually making a huge
mistake that will hurt her baby?? Formula is
crucial for those very, very rare situations
where there is no mother at all, or the mother is
absolutely physically incapable of making enough
milk - how many is that? Probably three in a
thousand, if that .... The rest are able to
breastfeed or breastmilk-feed, and we know
it. That's the dilemma. I think we need to
find a way to be completely honest about this. I
see signs that the US health system is gearing up
for it, so I think you're in with a chance. I'm
not so sure about my new adoptive country ....
and find it very distressing also.
Pamela Morrison IBCLC
Rustington, England
----------------------------------------
Date: Tue, 3 Aug 2010 13:18:31 -0500
From: [log in to unmask]
Subject: Exclusive breastfeeding?
I need to vent! After a day at work where 50% of
the woman who expressed a desire to breastfeed on
hospital admission are now almost exclusively
bottle feeding, and 25% of the other
“breastfeeding Moms” have supplemented, it
makes me wonder what I can say to them when I
make rounds. I do want to respect their
mothering and choices (as misguided as they are)
and not come across as a breastfeeding fanatic. I
do the standard education on supply and demand,
and baby’s needs, and how it changes the gut,
and listen to their concerns or reasons for
bottle feeding. Most of the nurses give good
education and assistance, we have prenatal
breastfeeding education in place. Can we really
change their mind, once they start with bottle
feeding and their baby is sleeping for many
hours? Is it the culture, the times, the women? Frustrated in Florida
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