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From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 6 Dec 2013 08:34:10 -0500
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In terms of women who are obsessed with storing milk in the United States, I think it is always important to consider that the last time I read something on the percent of baby unfriendly hospitals it was 95%.  I'm not sure if Marsha Walker has an update on that one - perhaps that percentage is lower, but it takes a long time to change the cultures of large institutions since by their very nature they must implement protocols to "standardize" care.  In an environment that pays lip service to "breast is best" while subtly undermining the ability to initiate breastfeeding with bad policies and overtly undermining the ability to sustain breastfeeding with family unfriendly policies in the workforce - it is no wonder that you end up with mommy wars and angry formula and/or bottle feeders.  They get the mixed message of "it's best", followed by "everybody makes enough milk you just don't have enough confidence", followed by "there there dear it didn't matter anyway, formula is just as good".   

I find whenever a second time mom calls me to find out about help for her second baby that I spend a fair bit of time praising her for what she did do under adverse circumstances and often it was much more than any mother who either breastfed easily or chose formula right from the start. Apparently, not many women in the New York City area have someone who takes the time to look at all the hard work they did and the value of that work.  Instead they feel a range of emotions from shame, to guilt, to frustration, to anger.  The worst is when that they were duped into doing way too much work in a futile effort that failed and didn't matter anyway.  Of course they can't see the value of the milk or the feeding at the breast they did manage to do because they don't know what would have happened had they not done it and the impact of their choices is not immediate - it is delayed and not directly associated with their actions.  These women don't need the patronizing pat on the back - they need all the small successes pointed out to them so they don't feel like they failed.

I see a lot of iatrogenically-induced low supply and it is just as real as physiologically-induced low supply.  Unfortunately, our "fee for service" system in the United States is better suited towards the immediacy of dispensing pills or undergoing surgeries than the slower process of counseling and gradually improving practices.  It is as expensive a system as our system of dumping food and other items into emergency situations rather than putting more money into preventing those emergencies from occurring in the first place.  So in such a world it makes total sense to me that mothers obsess about milk supplies, jumping on the pump - but also downing huge quantities of galactogogues as well even when they have a copious amount of pumped milk.  I actually think if you studied it that the galatogogues are used more than the pump.

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