> is there any particular reason they
 > can't um, BREASTFEED for even a couple lousy days?

>Actually, there may be...for a small number of women it may be culturally
>extremely difficult to do even this, and some of them may have suffered
>sexual abuse or have such severe problems with body image that the idea of
>using their breasts in this way is just not possible.

>We do well, I think, to remember that bf is more than just a great and
>healthy way of getting milk into babies... we know (us on this list) more
>than anyone that bf is a social and emotional and even psychosexual
>phenomenon. We can't really  begin to address some of the massive barriers
>that some women experience with regard to feeding their infants..

I have to jump in here.  While I can be very gentle with the individual
mother who demonstrates by her words (but mostly by her actions) that she
simply cannot bring herself to put her baby to the breast, I cannot for the
life of me understand how the individuals who make up hospital policies in
this educated day and age can promote the idea of breastfeeding and
alternative feeding as equal "choices" and, even worse, actually assist
mothers not to breastfeed.  Health institutions should promote healthy
practices.  Period. I am fortunate that in all the hospitals in which I do
consults (2 frequently, 2 infrequently) there is *no* choice - mothers are
expected to "BREASTFEED for at least a couple of lousy days".  Once they
leave the hospital the choice is up to them, but the message comes through
loud and clear - Breast is Best.

I think we have to remember, too, that the *main* purpose of breastfeeding
is extremely simple - it is to feed the baby.  The by-products - the social,
emotional and psychosexual aspects - are luxuries that we have the leisure
and resources to reflect upon when we are not involved in a daily struggle
for survival and that we can factor in when alternatives to breastfeeding
are both accessible and socially acceptable.

I am beginning not to "buy" having a possible history of sexual abuse as a
socially acceptable "reason" for a mother not to breastfeed.  I know that a
history of abuse sometimes appears to cause a mother to want to distance
herself from her baby - in our civilized Western culture - but I'm beginning
to wonder if it is the *culture* rather than the *abuse* per se which
provides the Western survivor with one more reason not to breastfeed.  And I
always wonder to myself how these women came to be pregnant in the first
place - the mothers who "don't want to breastfeed" that I work with are
*not* recent rape victims, and they usually seem to have loving, concerned
husbands around which leads me to believe that they are not averse to sex,
just breastfeeding.  Is this harsh?  I have recently learned to my horror
that, in the midst of this breastfeeding culture that I live on the edge of,
possibly one child in *three* is sexually abused! (Recent Childline
finding).  Unless this is a new phenomenon that has happened in one
generation (which I doubt) it is probable that a large percentage of mothers
giving birth today were also sexually abused themselves.  Yet, almost
without exception, they breastfeed. Why?  Because it is the cultural
expectation - to *not* breastfeed is unheard of - and without it the baby
simply will not survive.

Just my .O2.  And still trying to get my mind around the paradox that in a
culture where almost every child is breastfed and carried in constant body
contact with its mother for 18+ months, child sexual abuse can be so common.

Pamela Morrison IBCLC, Zimbabwe
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