332 R.M. Shaw and M. Morgan
of relief when donor milk is used, as it reduces pressure on them to pro-
duce enough milk for their baby, although staff continue to support
them to express their own breastmilk. In some cases, not having their
milk production observed and calculated helps mothers to relax, which
in turn may increase milk supply.
Another group of women for whom donor milk is frequently used
are those women who are not expressing frequently or do not choose to
express, some of whom have never expressed or breastfed other children.
The experience of NICU staff is that young teenage mothers are a group
who are difficult to motivate to continue expressing for their premature
babies. These young women tend not to commit to the round-the-clock
demands of using a breast pump, although they are provided with infor-
mation and expensive top-of-the-line electric pumps while they are in
the NICU. Various reasons are given for these women’s reluctance to
breastfeed. For young women, this may include negative body image
as a new mother and/or perceptions of breastmilk and/or breastfeed-
ing as disgusting, unpleasant, embarrassing, or shameful (Kukla 2006 ).
Observations by NICU staff at Morgan’s workplace indicate that the
presence and views of young fathers regarding breastmilk expression
may also be influential.
It needs to be noted that sharing EBM is organisationally and often
logistically complex. It requires an assemblage of actors: donors willing
to share their breastmilk, babies, breast pumps, refrigeration processes,
and reliable institutions and communities willing to facilitate and man-
age the exchange process and delivery system. Breast pumping, even
under normal circumstances, requires considerable effort, bodywork,
and perseverance (Stearns 2010 ). Many women in the NICU strug-
gle with the long-term demands of expressing, sometimes enduring the
process for up to 14 weeks (see Carroll 2016 ). For young mothers who
have not chosen pregnancy, having a baby, especially one born prema-
turely, may be psychologically challenging. In such cases, using a pros-
thetic device such as a breast pump may be experienced as an additional
intrusion to a young woman’s embodied identity rather than a perform-
ative enhancement that assists the transition to motherhood. Many of
these young women will often choose not to breastfeed once the babies
are old enough to feed orally.
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