Dear Nikkie, I can hear you and can imagine how tough that night must have been on you and hard lump such experiences can leave in your throat for several hours on end before you can recuperate and gather yourself and begin to feel better and productive again especially when you know you intended to do your best. From what you describe, if my gut instinct tells me right, this mother was dealing with very difficult deep feeling of perhaps an abuse much earlier in life. Her instant behavior to intervene in a natural proceeding of an act such as attachment and breastfeeding calls for attention to possible history of abuse (an almost reflexive attempt to gain control of the situation by doing something - allowing the baby to attach and breastfeed is giving away control - an attempt to gain control in her helpless memory of abuse.) This is just my gut feeling and could be entirely over reading the event. Nikkie its the mother who was feeling helpless there not knowing how to deal with her feelings. Take Care Yasmin in Mumbai, India who is calming her nerves with just a day away from sitting the exam - a day I never imagined will be possible a year ago. :) Sent on my BlackBerry® from Vodafone -----Original Message----- From: Nikki Lee <[log in to unmask]> Sender: Lactation Information and Discussion <[log in to unmask]> Date: Sat, 23 Jul 2011 11:53:25 To: <[log in to unmask]> Reply-To: Lactation Information and Discussion <[log in to unmask]> Subject: cultural mishap (long) Dear Lactnet Friends: I am not sure what I want from you all; maybe just listening while I describe what happened will be enough, although suggestions are welcomed. Yesterday, the 22nd, a Korean gentleman, called me for a consult for his 6-day old baby. His wife wanted to breastfeed; they had been bottle-feeding formula.But now, she "has milk" and their baby would not latch on. I gave some suggestions before our visit, scheduled for 8 hours later. I told him she had to take milk out to make milk. They had a Medela pump. I suggested going to Youtube to look at videos of hand expression and to either hand express or pump at least 4 times before our visit later that day. I advised putting the baby skin to skin for 15 minutes before taking out milk. He met me at the door, and I came in, removing my shoes. The baby was in another room with the maternal grandmother. The mother and he and I sat together and chatted. I spoke about my personal and positive knowledge of South Korea; I have a wonderful figure skating coach who is from South Korea and has competed at the Olympics. I admire Yu Na Kim, the Olympic gold medalist in ladies'. They smiled and nodded, as Ms Kim in the leading celebrity in South Korea, singing and modeling as well as skating. I enjoy Korean food. That is all I know. I asked him to help me do the right things to show respect to the new mother; in some cultures, it isn't right to praise a new baby. He indicated that it is alright to praise his baby. He is a doctoral student, studying chemistry and plans to do a post-doctoral fellowship and then determine where would be the best place to find work, the US or South Korea. She did not speak English. She had a vaginal birth. They had breastfed only a few times in the hospital because the pain of her 3rd degree episiotomy took all her energy; mostly the baby had been bottle-fed formula. She had been breastfed herself. I showed my happiness about that, as her mother is here with her. In South Korea, mothers eat a special soup to make good milk. Her mother, the baby's grandmother, was making her this soup. She had taken out some milk, but could get only a little. They didn't have time to do any s2s, because of a pediatric visit earlier that day. I said that her breasts were full of milk and that milk can't be pulled out of the breast. Her breast would have to let it go and that we have to help the breasts to feel comfortable to let the milk flow. After all this conversation, I asked them where they would put a guest who was invited over for dinner. They considered the question thoughtfully, and he said, "At the table." I agreed and said that the baby had to be at the table too, indicating her chest. I then described skin to skin care, which they had done once or twice, and suggested that the baby spend as much time at the table, in skin to skin, as possible. This was a way to help the baby to breastfeed. I suggested the mother get into a position for breastfeeding. While he undressed his son, a beautiful baby boy, I demonstrated that I wanted her to find a comfortable reclining position. I slouched in my chair to illustrate. She chose to use that chair rather than recline in their bed. So I got up and she sat down, and opened her pajama jacket. I mentioned to him that her breasts were perfect for her baby.....they were. He was handling the baby so gently and gingerly while he undressed him, as if he was afraid the baby would break, the classic first-time parent. So sweet and tender. Once the baby was s2s, she closed her pajama jacket over him and cuddled him. The baby instantly unfolded and snuggled into her. I pointed out how her baby loved this and asked how she felt. She gave me a huge smile in return. I was sitting near hear, and did not touch her or her baby. After a few minutes, the baby made a beeline for her breast and attached! Yay!! Meanwhile I was talking to her husband about how babies are like kittens and puppies and can attach themselves. I asked him to tell her to let the baby do what it wanted, and just snuggle the baby close while the baby sought the breast. He translated for her. As soon as the baby started to suckle, the mother sat bolt upright and starting repositioning him the way she'd been taught in the hospital. The breast instantly fell out of the baby's mouth and he started wailing. The mother became alarmed and started patting and hugging the baby and repositioned him again on her chest, leaning back. There was a moment of calm and then he again attached and started suckling. Again she sat upright and worked to "fix" the positioning and again the breast fell out of the baby's mouth and he started screaming. I repeated my message about letting the baby do what he wanted to her husband, but now my voice was being drowned out by the furious baby. I suggested giving the baby her pinky to suck, to calm him. She put her pinky sideways, across, his lips. I suggested putting her finger on his tongue but she couldn't/wouldn't/ didn't do that; instead she stood up, turned her back to me and cuddled her wailing son close. I suggested she give some formula in the bottle to calm him and I would explain more and show them (I brought a great s2s DVD with me) what I meant. The husband went to her and spoke and she shook her head. Again the husband spoke, and again she shook her head. The husband told me that she did not want to continue with our visit. I felt so helpless. The baby had latched on twice and started suckling. The baby was mad because he was being interrupted. The husband said that he could see this too and said that he had to defer to his wife. I asked what I could have done differently. He said he didn't know, that I was the one with the expertise. (Ouch!) I then encouraged safe bed-sharing, saying that the baby very well could find the breast while the mother was sleeping. I suggested some video search topics on Youtube for delivery self-attachment and skin to skin care. I suggested that if she used her breast instead of a pacifier, and if she spent lots of time in skin to skin, they might find each other and discover how to breastfeed. He said that the mother was still in great pain from the episiotomy, taking Ibuprofen and some Percocet (a synthetic narcotic analgesic mixed with acetominophen). So he and her mother were taking care of the baby because she didn't have the energy to do so. No way I could accept any money for this visit. He wasn't comfortable with that, and said that I had spent some time, so we agreed to a small amount of money. I said that I was very sorry, and had obviously made things worse. I thought about them all night and called this morning. I spoke with him about her episiotomy. At nearly a week out, she should be a little better each day. If she isn't, she should be seen by her OB. It shouldn't be hurting so much after 6, now 7 days. He thanked my for that thought and said he would explore it with her. Does anyone have any ideas for how this could have gone better? warmly, Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC craniosacral therapy practitioner www.breastfeedingalwaysbest.com *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome