Dear Magda and Patricia--

When I work with mothers, I don't hide the relationship aspect at all.
In fact, I find that the relationship aspect is one of the biggest
motivations of the women I work with.  Maybe it is because I live in a
wealthy urban community (Northwest DC) where many of the mothers are
older professionals and the relationship aspect is the most important
reason they have worked so hard to become parents.

As nutrition and immunological support, breastmilk is best, but there is
a second best available (ABM) and a third best we consider totally
inadequate (concotted "milks" with inadequate vitamins, proteins and
fatsetc.).  As the basis of all human relationships, breastfeeding is
best, and there is a second best (being bottlefed by one or two
committed caretakers) and a third best (being bottlefed by a host of
caretakers, some of whom have little or no commitment to the child as an
individual.) Given what we know about human development, I don't know
why this third best feeding method is considered acceptable in a
civilized society, but it is.

When mothers have a very hard time with low supply and need to
supplement, they may think "Oh, what;s the point? I am using ABM any
way, why go through all this hassle?"  What I tell them is that even if
they never make one drop of breast milk, breastfeeding is still the very
best thing they can do for their baby.  THe breastfeeding relationship
is the concrete with which they are building a bond to get them through
all the later parenting that they do. It is also the way children are
meant to learn about the give and take of relationships with other human
beings.

Being an adoptive mother myself, I get lots of adoptive nursers referred
to me.  Working with them has helped clarify my thinking on this and I
am very upfront about it with every mother I see. I don't lecture on it,
but I certainly don't hide my viewpoint. It pervades my attitude and
philosophy of helping mothers with breastfeeding issues. I have never
had a mother "run off in the other direction" when I told her that the
relationship is as important as the food.

The problem is that talk like this is often tied to lectures about
staying home.  WHile I personally believe that children need to be with
their parents, I realize that not every family perceives this as an
economic option. Plus, as the mother of a teen, I am hard pressed to
argue that the preschool years are even the MOST important time to have
a parent at home.  Kids need there parents and parents have to work to
pay the bills (and to feel like productive adults in a society that
values work so highly.) In our society, that almost always involves some
separation.  I am quite undoctrinaire about separation with the mothers
I work with, both as an LC and as a "lay counselor".

Working mothers can breastfeed, not just breastmilk-feed, even if not at
every single feeding.  And working women I know do it because they
understand that breastfeeding their babies and toddlers gives them an
absolutely unique, unduplicate-able relationship with their young
children.

I know that DC is unique because we have the highest percentage of upper
income mothers in the workforce of any US city---but I know dozens and
dozens of women who have worked and breastfed for 1, 2, and even 3 or
more years.  And I know them from "non-breastfeeding" settings.  In all
kinds of social settings, when women learn what I do, they sidle up to
me to tell me that they breastfed for 18 months or 2 years or whatever
and they did it because they loved nursing so much! In DC, these women
are virtually all working women and this is their special way of
connecting wtith their baby.

I can't believe I am the only one who hears these "confessions" on a
regular basis.  And it is all about the relationship, not the "food"
alone.

I think all lactation professionals should talk more about breastfeeding
as the best start nutritionally, immunologically AND psychologically.
I think mothers do want to hear it--they just don't want to hear that
they have to stay home full time to make it happen.

With love--
Judy Gelman, IBCLC
Washington, DC