I have seen a couple posts on this subject and have yet to see anyone
comment on the most common reason I see why a woman will not put her baby to
breast. Yes we do have woman that have a lack of support and understand that
breastmilk is best, however this is the minority that I see. Others want to
know for sure how much their baby is obtaining and will not even go by what
a scale tells me; again not my majority.

Mothers that I have seen both in the hospital and at home who are showing a
reluctance at the breast but are persevering through obvious discomfort that
is not from pain or even show some degree of pain with nothing to show for
that (trauma, mouth, etc) many times after several sessions or even at the
first visit will tell me they either suffer from self esteem issues and many
resulting from some sort of abuse, many times sexual. Some of these women
cannot separate any human touching their breasts from what happened to them;
even if not a sexual act that was done to them. Breasts are their personal
space and breastfeeding is a very personal action for some women, others
just do it because they know it is best.

For the woman that wants to pump I gently probe as to why to try to find a
fear of "not getting enough" and needed to quantify how much exactly the
baby took and deal with those fears and if that shows me nothing I support
the mother and if she wants to tell she will, if not we talk about why her
method of pumping will be so important, what kind of pump she will need,
time, storage, etc...every mother needs our support regardless of method. I
would never treat a mother who chooses to pump different than a mother who
is forced to pump professional wise. The empathy and manner is different,
but tools and tricks still the same.

Emily Lindsey, BSPsy, CLE
Private Practice
Merced, CA

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