Literally from by first client as a private lactation consultant I discovered that the issues in New York were the same as those I had seen in St. Louis, Missouri. The lack of an intrinsic belief in the fact the breastfeeding and human milk are what all babies need is only the beginning. Next I discovered that the lack of knowledge about the physiology of milk production, the connection to pregnancy and birth as well as normal newborn behavior seem to lead to the problems that women and their families encounter. Whether in the Midwest or east coast the issues are universal. Whether I met women who had delivered in a well-known teaching hospital in the city or a more suburban hospital, from New Jersey or Connecticut the comments are often the same. These women all used similar descriptions of their experiences, "I did not get much hands on help with actually putting my baby to breast". They described their encounters with a lactation consultant as being brief and often "just checking in to make sure things was going ok". I am certainly not faulting the LC's because as is often the case there is not adequate coverage for busy nursing divisions. Staff nurses are over burdened with heavy assignments and as a result the breastfeeding mother and baby seem to get lost. The early hours and days after delivery are critical in how the BF relationship takes off. It sets the tone for what is to come. For all new mothers how she feels during this time is very important and we know from research that it can directly affect the relationship between mother and baby. So understandably with regard to BF a mother can either feel empowered about what to expect as she embarks on this new journey or go home feeling helpless and unable to deal with the frustrations of her early postpartum days. In a culture that does not support BF very well the likelihood of her giving up and not being able to achieve her goal of breastfeeding successfully is very predictable.

Most of the women that I have met during this time for many reasons are unrealistic about what a newborn is like, how much time and effort BF can take and incredibly "unsupported". Many do not have a family network of knowledgeable help with regard to breastfeeding and as a result find feeding their babies even more difficult. Issues related to nipple soreness and pain also seem to dominate the experience. This issue tends to be resolved with a knowledgeable person assisting and guiding them to correct positioning. I am often overwhelmed with a feeling of satisfaction when I help a baby to latch correctly and a woman's entire demeanor changes as she realized that this experience is not supposed to be painful and can actually be pleasant and comfortable. More than once I have had a client begin to cry after her baby begins to nurse without pain and she can actually imagine continuing to feed her baby her milk. It is difficult for me to realize how simple a fix this problem can be for some new moms and babies. Of course it is not always so simple, but in my experience much of what goes wrong for these women is so easily rectified.

Ironically for me, my anticipation of this new and exciting time in my personal and my professional life have been fraught with many unexpected experiences. Personally it has been so much more of everything than we imagined. But professionally it has been an eye opening experience for me in terms of some broad sweeping generalizations about many things. Whether in NYC, St. Louis, Missouri or anywhere else, we need to take hold as a country, as a culture and as women who birth our children and demand more of our care providers and anyone else that can help in this essential endeavor. We need to respond to what we know to be true. All babies are entitled to their mother's milk. We must help women give that gift to their babies with the assistance of those of us who care about this issue. We can no longer just give "lip service" to this important issue and we must do all of the things that support the women who want to breastfeed their children. We need to develop very tangible ways to do this, implement a plan and continue to support these women through the first year of their baby's lives. Nothing less will do for the women, their children or for us.