I am an assistant midwife, birth education teacher, labor and postpartum
doula, and member of the Nursing Mothers' Counsel.

I have worked with several different women who "tried" to breastfeed,
"failed," and happily bottlefed their infants.  I think that these women
were not comfortable with breastfeeding, were relieved when their problems
wouldn't resolve, and were much happier and more comfortable with using
formula.  One case in particular was memorable because the father of the
baby had two children from a previous marriage who were successfully
breastfed, one for a few months, one into the toddler years.  But even his
influence was not enough to overcome the mom's distaste for nursing.

I bet there are many, many women out there who "know" that breastfeeding is
best, but "feel" that bottlefeeding is the way to go.  In many cases, they
try breastfeeding, and if the baby does well without too many problems,
they have a good experience.  But when there are early problems, many of
these women give up in relief.

I think it's an interesting cultural phenomenon, and when I deal with
expectant moms, I try to get them to look at what images of baby feeding
they grew up with.  I encourage reading of course, as well as networking
with moms who have successfully breastfed.  I think that if people are
aware of the attitudes around them they go into parenthood much better
prepared than they otherwise might be.  For example, I knew that my family
would offer little to no breastfeeding support, so I was prepared to deal
with their questions and not rely on them for support.  I also encourage
pregnant women to envision what their lives will be like with a
breastfeeding baby, and plan ahead with how they might deal with some
potential problems, such as dad feeling left out.  I think this kind of
concrete thinking can help women who haven't had much exposure to
breastfeeding.

After the baby comes, if there are breastfeeding problems, I think we have
to realize that many people are culturally unprepared to breastfeed, and by
the time they are adults there is little lactation professionals can do to
change that.  Of course we help them with whatever means necessary, but for
some women, even getting them to "try" breastfeeding is a victory.  Several
teens that I have worked with fell into this category.  One brought bottles
and formula to the hospital with her, and I had no thought of even bringing
up nursing.  But she did try (although the baby didn't latch on right away
and she gave up in ten minutes! still, even that attempt is better than
nothing).  Once they make the decision to go to the bottle, I talk to them
about what went wrong, with the goal in mind of encouraging them to try
again with the next baby.  What a leap forward it would be if every mom in
the US at least tried to breastfeed!

Of course, my personal opinion is that everyone should breastfeed through
the toddler years, and that breastfeeding is the most important health
issue in the US today, etc. etc., but when dealing with the general public,
I feel that I must tone it down a little.  :-)

Katherine Woods-Eliot in Portland, Oregon