Patricia Ellis wrote:
> A question re the super sleepy babies--I really like your suggestions, but the C/S moms I see would NEVER be able to express colostrum--they are like the babies, and so out of it, I can't imagine that they would be willing to day 1. That's when most of the supplements are given, because day 1 is a problem for all the moms, but the C/S's are really miserable. It's really sort of expected that they won't be able to feed, although of course some do and the effort is usually made. I'm not sure if we are treating them fairly or not, but they can barely move or keep their eyes open for the first 12 hours. How do you think we should work with them? Carol and I do go in and try, but they often say they want to wait until the next day.
Pat: Thanks for the info on Soothies.
As for this problem, it would be nice first of all if mothers could be
taught about this in prenatal breastfeeding classes, so that they come
in with the expectation of expressing colostrum if their babies can't
nurse, and their support persons (husbands, grandmothers, etc, could be
educated about the importance of this and help to support mothers to do
this).
Regardless, I look at it as a medical issue of preventing very real
complications. My example is the need for a C/S mother to get moving,
get out of bed and use the incentive spirometer in order to prevent
blood clots and atelectasis of the lung or pneumonia post-op. I know of
no nurse who would stand by and let a mother say "I'm too tired/in too
much pain" to get up. She will coax, explain (to the point of scaring
her to death about how if she doesn't get out of bed she will die of a
blood clot, etc)and physically work to get that mother out of bed if she
has to. She won't say, "OK dear, just lie there and rest."
I see no reason why the mother's tiredness should be treated any
differently with regards to feeding or expressing colostrum. After all,
if the baby weren't sleepy, she'd have to nurse it, so expressing
colostrum shouldn't be any more tiring for her. If the mother says
she's too tired, it needs to be made quite clear to her that if she
doesn't express her colostrum her baby will need to be given formula,
and I wouldn't mince words about why that would cause potentially
serious problems, including but not limited to inability to breastfeed
properly, sore nipples, engorgement, allergic reactions in the baby, etc
etc. She has to understand that it's important, and that there are
medical complications from not doing it.
As with any other medical recommendation, the mother has the right to
refuse anyway, but her refusal then can be documented (I think someday
we should have some form of informed consent or against medical advice
type of form for this type of situation). It may sound harsh, but unless
we start to treat this as an important issue, we won't get anywhere. I
think most mothers will be amenable once they are properly educated
(compassionately, of course), but if we just assume they won't then
we're not allowing them to make an informed choice.
> I will ask Carol about a meeting time. I know Mary Ellen had a plan to table the Task Force and "rethink" it, but we have heard no more, and when we leave her messages, she does not respond, regardless of the matter. It's sort of, "don't call me, I'll call you", but I believe she would be annoyed if we met without her, so we'll have to bring it up. I think she might be overwhelmed with the tech program right now, but I'm not sure what the problem is. Perhaps you should call her directly and propose a brainstorming meeting. She might be more open to you.
>
OK I'll try to give her a call. I'll keep you posted. Regards, Alicia.
> ----- Original Message -----
> From: "Alicia Dermer" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, February 25, 2001 7:27 PM
> Subject: Soothies
>
> > Hi, folks: Have any of you US folks heard of, or recommended, a type of
> > dressing for sore nipples that goes by the name Soothies? It's
> > purportedly made of glycerin, and I'm wondering if it's similar to
> > hydrogel dressings. A patient with sore nipples had picked them up at a
> > medical convention. Any and all thoughts and experiences would be
> > appreciated. TIA, Alicia Dermer, MD, IBCLC.
> >
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