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From:
Karleen Gribble <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 27 Apr 2003 18:22:32 +1000
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Hi Darillyn,
Thanks for the discussion. Stimulating as always.
I honestly think that we should be very careful with how we present the idea
of milk production expectations to women. I certainly don't think it is
helpful to say "you won't have a problem making a lot of milk" but equally
"you won't be able to make much milk" is just as bad and then there are
those who say "if you do relactation/induced lactation in this way you will
get this much milk and if you do it that way you will likely get that much
milk"- there is no basis for making such statements. There is just too mauch
variability to know how any one woman will respond which is why I personally
don't like to be prescriptive. After my other post I wondered if maybe I had
given the impression that we should tell women "no worries you'll be able to
make a full milk supply" but this is not what I think at all. I do think
that what is currently the norm as far as written materials is unnecessarily
pessimistic and has a very negative impact on women wishing to breastfeed
their adopted child. I think that we should give women the information we
have about relactation/induced lactation and let them know that women in
developing countries are generally better at making milk than those in the
West *and explain why this might be the case!* while also telling them that
there no way of telling how easily they will make up, that many of the
variables that impact milk production are under their control and that there
is every chance that they will be able to stop supplementing at some stage
if they breastfeed for long enough.  I feel comfortable that this is a
balanced approach that neither sets women up to believe that they can't make
milk nor gives them the idea that they will certainly be able to make lots
of milk. My reasoning behind this is not just associated with maximising
milk production (though I do think that this is important) but because I
believe strongly as you do that the breastfeeding itself if just incredible
when it comes to helping children attach and heal from past hurts/trauma.
Encouraging mums to do the stuff that helps increase milk supply is useful
because all of the things that you do to do maximise milk (ie keeping baby
and mother close together, breastfeed frequently, comfort with the breast,
cosleep and baby carry) all promote attachment.  These things are
counter-culture and another reason to encourage that style of mothering
(increasing milk supply) is to be taken advantage of if possible.

I believe passionately that for hurt children (and many many adopted
children, including all post-institutionalised children- have experienced
dreadful hurt in their lives) the breastfeeding itself is much much much
more important than any milk that the child might receive. I can't emphasise
this enough.
I also think that it is important for adoptive mothers to be able to
celebrate all their victories because it is true that some women don't make
a lot of milk. It is also true that many women make milk but their children
do not breastfeed. Some children will suckle at the breast but don't want
milk. It's not an all or nothing thing. If women are looking for perfection
they may well be disappointed. That said, I have yet to come across a mother
who regrets attempting breastfeeding. I think one of the hardest things for
adoptive mothers to overcome is the effect of absence of a breastfeeding
culture has on their baseline knowledge level, they understand so little
about breastfeeding to start with and have a very steep learning curve
because (especially with cases of adopting an older child) nothing comes
naturally. So much to learn, so many potenital obstacles and an unfriendly
culture. It's amazing that any woman manages to breastfeed.
 Darillyn, I'd love to here your opinion on why many children do not wish to
be weaned from supplementing systems and while I'm asking questions, there
is another problem I am hearing more and more often. Many families adopting
children via intercountry adoption find that the baby they end up adopting
is between 8 months to 14 or so. Mothers wish to breastfeed but biting is
often a real problem. Sometimes I am pretty sure this is because the mother
has been too pushy, the child is just not ready to breastfeed, can't
tolerate the intimacy associated with breastfeeding. The solution in these
cases is easy, just more time and attachment/trust promoting activities.
However, for some children the problem appears to be that they have been
adopted just at the time when they are teething. The usual ideas for
stopping biting don't seem to work that well and the bites can be really
really nasty. I've heard from quite a few monthers whose child was
breastfeeding quite well but after she reacted with pain when bitten the
child has never breastfed again, the disruption appearing to be too early in
both the mother-child relationship and in the breastfeeding relationship and
at a time when the child is emotionally fragile. Any ideas of solutions for
this difficulty? I had wondered whether use of a nipple sheild might help
and actually heard from a mother the other day who had used one and found it
helpful for biting but I'm not sure just whether this would be helpful in
many cases?

Karleen Gribble
Australia

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