I also work with low-income women - mostly Hispanic because I'm Puerto Rican
and can communicate with them!

I understand how you do not want to "push" or make a mother feel badly about
her decision to not feed at the breast for fear that it may be an issue with
sexual assault, etc.

In my experience, women who have chosen not to breastfeed are often trying
to be protective - sometimes it's to protect themselves from physical pain
(nipples will be hurt) or psychic pain (like the assault).  However, many
times the protection they THINK they are affording themselves (I don't want
to start breastfeeding because I'm going to have to go to work and it will
hurt too much to leave my baby) is actually preventing them from one of the
most wonderful relationships they could have!

When reaching out to these moms we have to LISTEN to their feelings -
acknowledge that many women are feeling similarly - then ask more questions
about what their experience has been with other disappointments, challenges,
etc.  Many times they speak about fathers who have left them, mothers who
were emotionally not present, etc. 

If we agree with them too soon - we don't give them the opportunity to work
through what their fears are - and what alternative they COULD use.  

We don't have to be disagreeable...in fact we MUST be very approachable,
open, understanding and willing to listen instead of judgmental or
overbearing.  No matter what the age of the mother - she is very vulnerable
at this time in her life - and we can make a big difference - or close the
door forever on the opportunity to develop a warm, loving relationship with
that very vulnerable and priceless entity that is her newborn.

Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

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