This is an extremely tense situation, but I think it's important to
point out that Hanny's doctor is only offering advice.  It's up to
Hanny, and if she chooses, Bracha, to decide whether to continue to
express milk on the uninjured side.  Hanny's doctor may have forgotten
this, in his understandable desire to apply his best, although limited
knowledge, to the situation.  The only way he can "force" this mother
to quit offering her breastmilk to her wounded baby is by social
contract between the mother and doctor.  He says, "You must do as I
say," and she responds "I agree, I must do as you say."

Social contracts govern all our behavior, so I'm not trivializing
them, but I do want to point out that they are limited by our
agreement to go along with them in any particular situation.

When we accept this type of contract, knowing at times that we are
accepting undesirable care for ourselves or our children, it tends to
have repercussions on our future ability to come to peace with our
decisions.  In the worst case scenario, imagine for a moment that a
mother in this position agrees to submit and withdraw her breastmilk
from her child, and that the child subsequently dies.  How would a
mother in that position reconcile her willingness to engage in that
social contract?  It is also possible that she chooses to negate the
contract that "forces" her to do as the doctor says, and finds that
her path to healing is a rocky one.  Breaking the contract doesn't
guarantee a better outcome either in the particulars or overall, but
it does give her the latitude and control to apply specialized
knowledge and consider feelings and beliefs of instrinsic importance
to her which may not come into the doctor's decision-making schema.

It may help to start thanking this doctor for his advice whenever he
offers his opinion.  His opinions have value in the overall
decision-making process.  This valuable resource needs to be factored
into the overall equation, so that those who will live with the
decisions feel at peace with the decisions they have freely made.

Arly Helm, MS, IBCLC

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