Barbara,
When a mom proposes pumping and bottlefeeding, I usually ask her why.  I then
tell her that this is a HEROIC thing to do, as it is MUCH more work than
breastfeeding - she can't feed in bed, she has to always worry about having
bottles with her, she needs to pump AND feed the baby AND wash the pump AND
wash the bottles.  Then I tell her that she can always do that if feeding at
the breast does not work out, and then tell her the benefits of nursing right
at the breast (tooth, jaw, speech devel; responsive immunization; binocular
vision...).  All of this is done in a "let me give you some more information
on this subject" attitude.  I make it clear that the decision is still up to
her, but often they reconsider.  With moms who have been sexually abused, I
mention that nursing baby at breast can be healing, it is a way of "taking
back" her body and showing herself that her breasts are good and "work".  I
have had several such moms bf successfully, though they required a lot of
on-going emotional support.  A lot of times the crux of the issue is fear -
they are worried that they won't know what the baby is getting...then we
discuss output and other ways of knowing.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]