"It can be so much more complicated than we sometimes think."

Well said, Sharon, and right on. Not rambling, but serious, compassionate
stream of consciousness thinking. Our own past personal experiences,
positive and negative, have been given to us as a gift. A lot of us stand
on the shoulders of giants. Not all mothers are so fortunate.

I think it is important  to remember that guilt is one of the recognized
components of grief reactions.  Healing requires it to be worked through
as part of grief work.  We, as maternal-child health professionals need
to recognize this. We must actively strive to develop empathy and
compassion, and include the subject of grief and grief support  as part
of our continuing education if need be.

We are sometimes in a position to use these skills  for mothers who, for
whatever reasons, fail to meet their own breastfeeding goals, then need
to mourn the loss of a dream. Let us hope that we
have become insightful and skillful enough not to transfer our own fears
of "professional failure" to her by our facial expressions, body
language, or our choice of words.

Every mother must organize each day's priorities within her very own
personal life. Mental health is within our larger professional roles,
(all of us, not just IBCLC's). Sometimes, a mother needs help in "picking
up the pieces", if nothing more from her breastfeeding dream (or other
dashed maternal dreams) can be salvaged.

For the mental health of a mother and her family, and our civilization,
we need to recognize that the best thing for a healthy baby is a happy
mother (no matter what the baby is being fed). Feeding is only one part
of mothering. There is still a child(ren) to be loved, and reared for
years to come, and in most cases, a marriage or couple relationship to be
protected and nurtured.

More importantly, there is a self-esteem that may feel so battered that
it is black and blue. I once heard a psychiatrist say that anything that
injures a  mother's self-esteem has the potential to impact eventually on
the child's well-being. The mother's self esteem must be salvaged, at all
costs, IMHO.

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio

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