Mary Renard and others,
I agree- there are circumstances when ABM has its place. It's the marketing
of it that is the problem. IMHO, the legal doctrine of "first do no harm" as
it applies to infant feeding is that human milk directly from the breast is
the norm. Any deviation from the norm should be accompanied by obtaining
informed consent - why it's being proposed, any risks and benefits, and all
known reasonable alternatives. Once the mother gives informed consent, it's
her issue. All mothers need far more support than we give them, IMHO.

Guilt is anger turned inward, and something you can't make someone else feel.
I think the "guilt" comes from two sources - (1) those who had no idea BF
mattered, and found out later that it did. Solution: give enough information
that the mom doesn't have to say "if only I'd known." (2) those who wanted to
BF but couldn't (failed). Solution: provide sufficient teaching on technique
and management information to all moms, and a safety net of trained helpers
(lifeguards) for proper support and quick intervention if problems arise.  If
something completely unsolvable comes up, then support the mother through her
grieving - don't minimize her loss by denying its importance. If it wasn't
important to her, she (1) wouldn't feel guilty about not doing it, or (2)
wouldn't have tried in the first place. IMHO, the mothers who really could
care less don't feel guilty about their decision.

Linda Smith, private practice in Dayton OH