I've been thinking more and more about the posts, including my own, about
women who say that they can't breastfeed because their lives are too tough.
I do feel it is the responsibility of every person who considers themselves
a health care professional to tell women the "truth" -- the "facts" -- as
best as scientific research can ascertain what they are at the moment.  I
don't believe in sugar-coating reality, or couching things in such a way as
to "not make a woman feel guilty" or pretending that babies are not designed
the way they are designed.  You are morally obligated to help women
understand the choices they are making and the consequences of those
choices.  If they choose to not place their baby's well-being top at their
list of priorities, you can come to LactNet and vent -- it isn't our job to
make their decisions, or set their priorities, for them, but it IS our job
to make sure they understand the decisions they are making.

From my perspective, it is clear from the research that babies are meant to
be held on their mother's bodies all the time; that they are meant to be fed
several times an hour, around the clock, not in feast-famine cycles of 4
hours or 3 hours or 2 hours or even 1 hour between lengthy feedings; they
are supposed to sleep with their mothers; they are supposed to wake up at
night to feed, they are supposed to be breastfed for at least 2.5 years
minimum.  This is NOT convenient for many American mothers.  No way around
that.  But we need to give women accurate and complete information,
including the risks of messing too much with this evolutionarily derived (or
God-given) system.  We need people to take a long hard look at their
priorities.  We contribute to the problem if we commiserate with them,
encourage them to think that their baby is "unusual" because it wants to eat
every 2 hours, encourage them to think that their baby has "sleep problems"
if they still wake at night to nurse at the age of 2.

American are masters of denial and of making decisions by default.

"I couldn't keep up with the housework and breastfeeding, so I switched to a
bottle because it didn't make any difference."  Instead of "I realized that
the choice was between a clean house and a healthy/happy/smart baby, and I
*CHOSE* the clean house, because having a clean house is more important to
me."  Or my personal favorite -- "I weaned because my big breasts were
getting in the way of my tennis game, and my tennis game is more important
to me than my baby's health."

"I couldn't deal with having the baby wake up five times a night to nurse,
so I moved him to a crib, let him cry it out for three nights, and put him
on formula."  Instead of "I realized that the choice was between me being
well-rested during the day and a healthy/happy/smart baby, and I *CHOSE* to
be well-rested during the day, because being well-rested during the day is
more important to me."

Many women would not make the choices they do if it were clear to them what
the choices really were.  But they find it very difficult to see exactly
what the choice is -- they don't realize exactly what they are saying with
their choices.

Or another example -- we have friends who have no savings for their children
to go to college, and no plans to start saving either.  Their kids are 7 and
4.  They say "We can't afford to save for college."  But they go out to eat
at least once a week, they go to visit her parents every year for several
weeks in the summer, and they drive a new car with monthly payments of $500.
They both have PhDs, but they can't see that they are saying that *going out
to eat and driving a new car are more important than their children's
college educations*.  They truly believe they can't afford to save for college.

Other examples: we (Americans) often look only at one side of things, either
the benefits but not the costs, or the costs but not the benefits.  Thus, we
look only at the benefits of the new manufacturing plant in town, in terms
of jobs and tax revenue, and not at the costs such as air, water, and noise
pollution, more traffic, more crime).  We look only at the costs of saving
the Headwaters Redwood forest ($43 million dollars) and not at the benefits
(redwood trees for our great-grandchildren to look at and enjoy).
Breastfeeding is like many others issues in the US -- people don't
understand the choices they are making.

Kathy Dettwyler