Lynn Shea said:
[the hospital staff's] response was that the Mom was dc'd with clear,
documented, appropriate advice regarding use of the shield (although no
mention was made of use of both sides) AND that she was telephoned once
home and according to documented info. (Mom's recollection of pees and
poops-don't get me started on them!) the baby seemed to be feeding well.
It is still rooted in our brains that what we SAY to a mother in hospital
or in the moment of discharging her baby from NICU is 1) understood, 2)
remembered accurately, 3) followed to the letter and that 4) if she had any
questions, she would ask or call.
The REALITY is that mom is so overwhelmed with recent circumstances totally
foreign to her experience (most people have never been hospitalized except
for childbirth) that she 1) Can't understand even the simplest
instructions, 2) can't remember that we even GAVE those instructions, 3)
can't remember much of anything and 4) is so overwhelmed that she will
often not call even her closest friend, much less a total stranger!
I guess we need to have evidence-based studies on what a woman actually
hears, sees, remembers and acts upon when being discharged from the
hospital.  Even if she delivered a while ago and is now taking home the
baby who has been in NICU for a few weeks, she has difficulty
remembering/acting, though in my experience she is more capable than the
newly-delivered mom.
Having spent the last few years making home visits to moms who would never
have called for help (we call them, ask questions and offer to visit), and
also having participated in the study by Kay Dewey and Jane Heinig which
reinforced that this is NOT just because my moms are low income and often
not of our country, it seems clear we need to promote the idea of creating
postpartum services that are proactive, not reactive.
How to fund this and how to give insurance companies and health departments
the ammunition to prove their value is another problem.  With the current
budgetary crisis, fewer, not more services will be the norm.
For this reason I try to locate and give an IBCLC visit to my family
members when they deliver.

Jeanette Panchula

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