There is a real correlation here between intervention of LC's with
problems and what happened to Obstetrical care.  The Obstetrician entered
into managing childbirth which should be a very natural event.  The reason
the OB entered the scene is because too many people were dying  from
complications.  The result in the US anyway is that Doctors manage Pregnancy
and delivery as a disease that might work out OK rather than a normal event
that might have a problem.  Nurse midwives bring the balance to birthing that
is so desperately needed.
    As Lactation support people, we need to do the same for breastfeeding.
We need to encourage mothers that breastfeeding works well for most people
and you only need help if a problem develops.  Prenatal classes are ideal for
teaching this.  We give mothers information on how to know a baby is getting
enough because they leave the hospital before they even have milk.  We use
numbers of wet and dirty diapers, number of feeds, Dr. Jack's term "drinking"
at the breast, and weight gain as guidelines.  At the end of this sheet, we
remind them that once the baby has good output and is gaining weight, forget
the clock and counts and just feed the baby.  Because of lack of knowledge
about newborns, parents really need guidelines.  We also have a "free" Moms
and babies" group that meets weekly.  Though it is not just for breastfeeding
mothers, it is run by a Lactation Consultant who can answer questions, weigh
babies if necessary, etc.  We have difficulty giving guidelines because every
baby is different.  At our group I had a mother come in who was very
concerned because her 3 month old now was nursing only 4 times in 24 hours
and friends had said to wake the baby up, this was not enough- sounds scary.
Only I was looking at this slightly chubby baby who was thriving (with plenty
of output).  My advice to her was "Nothing is broken, so why try to fix it."
Judi Hall, RNC, IBCLC

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