To Nikki Lee, and others discussing "failure"
I agree that we should use other language to describe situations that aren't
working as we would like, particularly to breast-feeding issues, but we must
incorporate the women who are "failing" into the problem. What I mean is they
don't always "listen" and perform as instructed. I'm sure you have all had
situations like this. I had a mom recently who was not getting her baby to stay
latched on, would fall asleep at the breast. I taught her proper latch,
breast compressions, discussed ways to keep baby awake. This mom had been giving
"alot" of formula to the baby because she could "force" the bottle into her
mouth and it would just flow. She would give about 15cc, but then the baby was
waking to eat hourly and mom was exhausted. This was a 7 day old when I first
saw her. I advised her to pump and give expressed breastmilk, at least 2
ounces "one feeding" to get volume up consumed by baby, and to feed the baby every
two hours. I suggested she give "ONE" supplement of formula (to achieve the
initial two ounces if she couldn't pump that much) to get baby enough calories
since 15 cc at 7 days isn't enough and get the baby more awake for feeds that
are further apart than hourly. I was worried her supply was down because of
the short feeds baby was doing. What she heard, and did was give the baby 2
ounces of formula after every 2 hour feeding! Yikes. I had her f/u several
days later with our LC thankfully. These gals are so tired and in pain they
don't hear you. Many just give up because it's a hassel to call or come in for
f/u, especially if their support is negative. I've had many cases like this,
as I'm sure all of you do. Sometimes the mom is just looking for permission to
"not" breastfeed, because mom has "tried everything", but not always. I can
only teach, I can't do it for them.
As far as "failure" in labor and delivery...we as nurses need to advocate
fewer inductions and encourage doctors to let labor occur naturally. I had a mom
a few weeks ago who wanted to VBAC, and docs aren't too keen on that in our
hospital. Mom came in SROM during the noc shift. She was told if nothing "got
going" in 12 or so hours they would have to "cut" her. I came on, got her
out of bed, on the birthing ball, into the whirlpool, doing nipple stim, all
with the docs knowledge. The mom VBAC'd successfully (almost w/o an epidural...I
got her to 8, then she gave in...) but she was jazzed about her vag delivery.
She credits me, but I just gave her the info and she did the work. I wish
all nurses could be doulas, many pts want that....but many just want to come in
at the appointed time, be given drugs, then they wonder why the baby doesn't
feed well! Sorry, I've gone on long enough.
Thanks, Jo Bogard, RN, CBE (soon to be IBCLC...taking the exam Mon!)
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