I am having a very difficult time right now and need some wisdom.  Inconsistent information and breastfeeding assistance by staff seems to be running very high lately.  I am used to this, but this time I feel really upset.  In my hospital, a large 7000 births a year facility, breastfeeding initiation can be difficult for moms.  In this case, I saw a mom at about 10 hrs postpartum.  The nurse reported to me beforehand how "great" the mom was doing, because she had helped to latch the baby, etc.  When I entered, the mom was attempting BF and I saw that her nipples were red and had dark red abrasions.  I was confused because she had only had the baby at the breast three times, twice with the nurse's "help."  Mom reported that her nipples had not been red prior to receiving "help," but she was finding it difficult to latch the baby herself.  She was extremely sore.  I assisted her and the baby latched well with no pain on the better side.  I worked with her for a long time and felt that with better "help" she would be all right, and gave report to the next shift re instructions.  

You know the rest of the story--the next day, she told me that she had decided to switch to bottles.  Are there commitment issues?  I think not based on my conversations with her which included an intention to continue BF and pumping when she returned to work.  I offered some "open door" suggestions about pumping and waiting for more healing, then attempting breast again after milk coming in, but I think she is finished.

The nurse is a 40yr RN, and bragged to me about how "she gets those babies on", demonstrating with the "screw the head on to the breast" motion.  I cringed even then, and was furious when I saw the mom.  I need suggestions for how to handle this situation to prevent future problems (I am too upset to act immediately), and I also need support or advice for handling my own feelings.  I know I can't win them all, but this seems so needless and sad.  I am used to lots of things going wrong here.  This time, I am really emotionally upset personally.  

Thanks for listening.
Patricia Ellis RN MA IBCLC

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