Dear Caren:  I read your post on Lactnet and it touched my heart because
it reminded me of when I started to do this work about 23 years ago.
You must feel constantly frustrated.  Having been in the US over the
last five years, it is clear to me that what you are dealing with here
is a social problem and that in your hospital and among the patients who
come to your hospital, there has still not been any clear attempt to
protect, promote or support breastfeeding, probably except for your
efforts.

The US is still basically  a bottle-feeding culture and women's
expectations in many parts of the United States are still intimately
related to bottle feeding.  Their obs do not disabuse them of this
notion and they never talk with the pediatricians before the baby is
born and/or pediatricians are not conscious so the discussion doesn't
even take place after birth. So, essentially, one is alone or next to
alone.

Are there other groups in the hospital or in your community that are
promoting breastfeeding?  LaMaze classes?  Parenting groups?  La Leche
League?  Are there environmental groups in your community?

One way to begin to change these perceptions, in a general, social way,
not individually (which is the most difficult way to do this because you
are confronting the mother with her prejudices) is through community
education and support group meetings.  Are there support groups for
prenatal and postpartum mothers in the hospital, or are you just out
there slogging it out every day on the wards?

If there are any other groups, perhaps you could get a coalition
together and begin a task force.  World Breastfeeding Week for this
year, with its theme of ecology (Breastfeeding: the Natural Way) would
be a good way to enter the world of task forces or coalition-building.
There is so little in the mass media that is positive about
breastfeeding, but in developing a coalition, especially in smaller
communities (and if you are in central NJ, you are in a much smaller
community than Phila. or NYC), anything like a task force, is news.

Could you try your hand at writing a column for your local newspaper for
a while?  You are quite articulate.  I used to write a weekly column
"From Mother to Mother" and it was quite successful in raising people's
consciousness about breastfeeding.  One can use such a column for more
general education as well, for example, why health workers do what they
do.

When we first started to work in hospitals about 15 years ago, we worked
mainly with government hospitals.  Mothers used to "sneak in" bottles,
as the hospital adopted a policy of "no bottles for normal, full-term
newborns.  After a while, in our first hospital, some women would pass
up going to a private clinic in order to come to our hospital because
they  knew that no one would stop them from breastfeeding.  Times change
quite quickly when there is a concerted, strategic effort to impact on
the entire community context.

I hope that some of this gives you some help.  If you want to continue
the discussion privately, thats fine.

Judy Canahuati, MPhil. IBCLC
PO Box #512
San Pedro Sula, Honduras
[log in to unmask]