One of the points I often make when asked about my life experiences (which
gets too long for anyone to really listen to, now that I approach my 60th
birthday), is that having the degree in Social Work FIRST before either
being a LLLLeader, IBCLC or a nurse, was, in fact, the most important of the
basic, essential knowledge in helping mothers.

Many call it "three step counseling" and/or the "reflective listening."

The point is I FIRST find out where she is emotionally - you're frustrated,
you're frightened, you're worried, you're anxious (or on GOOD days: you're
proud, you're madly in love with your baby)...

Addressing mom's feelings FIRST lets her know I'm "with" her - not against
her - even when I provide information that she may not want to hear:

Your baby needs you close, your baby loves to be against your skin...

In all my trainings - whether to MDs, nurses, peer counselors, etc.  I
always cover a section on this topic (as I always include a section on
ethics - even if only ONE slide) and I ALWAYS get an evaluation that THANKS
me for reviewing and renewing the knowledge that when we KNOW a lot but
don't address mom where she is EMOTIONALLY - she can't hear us!

So whether we are talking prenatally to a mom: is she happy about the
pregnancy?  Is she frightened?  Is she worried about returning to work?  Is
she concerned about how her husband - or xx previous children will handle
this?  She needs to address THOSE feelings - before she can take in any new
information.  

If we talk to a mom right after delivery - frankly, I believe staff in the
hospital has the most difficult job in terms of what the expectations are
compared to what can be accomplished at the stage their patients - both
mother and baby - are in.  
...She still wants to talk and talk and talk about the delivery - and the
nurse needs to teach and teach and teach about infant safety, infant danger
signs, infant positioning for sleep, car seat safety, etc....
...Baby just wants to adapt to this extrauterine life in a location as close
as possible to where intrauterine life was...and the "system" wants baths,
weights, measurements, eye prophylaxis, etc....

Postpartum we make visits to a mom whose responsibilities have suddenly
tripled (yes, I think it does feel like that to mom) and the house, the
family, etc. want her to be "fine" "lovely" "enchanted with her baby" when
she doesn't yet know if she can have a bowel movement! (I'm speaking about
the US with our 24 hour discharges).

When I come in as an LC and just SIT and LISTEN and REFLECT FEELINGS -
suddenly mom has the opportunity to think and talk and finally make
decisions and plan.  This all takes TIME...but Oh, is it worth it!

...and I have to remember that "the mother is RIGHT" 

So what, in my estimation is the "right way"??? - the way we go when we let
the mother lead us based on her feelings and needs.  

Even with moms that had used drugs, were low IQ, were abused themselves - I
have had the experience of their choosing the RIGHT thing for their
babies...when she felt respected and listened-to.

Sorry this is so long...but it really hit a nerve today...a truly difficult
case!  Someday I'll write about it when I know the outcome!

Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

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