Hi Libby,
I have seen this very same response in moms but they are usually "Very"
young, have a history of drugs (a self centered life style) or in all
actuality didn't want the child themselves but had it for their "husbands or
other family member"- the family thing to do or doing my required family
duty, as I have heard it described. The breastfeeding "desire" usually
again is strongly encouraged or demanded by other family members. This
situation definitly should have a social service consult and a serious look
at maternal history. Could there be a possible mental disorder history
there? Of course there is only so much you can do. I know that it can be
so frustrating. But remember one important thing we as LCs, RNs, and health
care providers - We must first be the baby's advocate, for they can not
speek for themselves. If mom "won't feed her baby then nurishment must come
from somewhere, somehow.
We know that breast is best and this mother may know it too, but for what
ever reason she can not let go of her self centered requirements. Of course
all of this is said with out really knowing what is going on and only viewed
from what was told in your post. Take heart, and know that you went when
called, waited patiently and tried to help.
Maybe she is just taking longer to leave the "Dependent phase & enter into
the Independent phase" as described by Bobak & Jensen" in the Essentials of
Maternity Nursing (text book for RN program). I had to pull an old text
book to jog my memory.
" During the first 1-2 days after delivery, the mother's dependency needs
predominate". During this time them other SHOULD be able to divert
her psychologic energy to her child rather than to herself. She needs
mothering to mother. "For a few days following birth, mature and
appparently
healthy women appear to suspend involvement in everyday responsibilities.
They rely on others to respond to their needs for comfort, rest, nourishment
and closeness to their families and newborn".
Would like to hear how this situation turns out. Write privitly if you
want.
Keep up the good work
Ann Slaughter RN, IBCLC
-------------------
Date: Tue, 28 Jan 2003 09:03:50 -0700
From: "Lizabeth Berkeley, MPH, CHES, IBCLC"
<[log in to unmask]>
Subject: Q about mother not bonding (I think)
Opinions please-
I am a clinic-based LC, doing mainly breastfeeding promotion, classes and
clinical postpartum consults with OBs. Occasionally I get a call from our
sister hospital to do a consult on difficult issues (across the street) the
hospital does not have an LC on staff . Yesterday I was asked to see a
37y/o primip, all I was told was that she wanted to breastfeed and was
having problems. When I entered her room the baby, (a healthy 6 lb boy, a
relatively uncomplicated, vaginal birth,) was crying, intermittently sucking
his fist madly and when I picked him up he instantly rooted at my breast. I
asked the mother if she wanted help. She was on the phone. I waited. And
waited. Her conversation was of a trivial matter, she was giggling and
laughing, ignoring me and her desperate baby. Finally, when she got off the
phone, I asked her when she last fed her baby and she said "about 2 hours
ago", she added that the nurses had "helped" (she scoffed). I asked her if
she would like to try now, pointed out the hunger cues and she said, almost
shocked, "I can't now!! I have to decide on a name, we only discovered the
baby was a boy after it was born, we were told it would be a girl." I
asked her if she wanted to breastfeed and she fervently answered Yes. THEN
she got back on the phone (when I was mid-sentence) and called someone and
began another non-essential, social conversation. She basically threw me
out.
O.K. - the issues were obvious to me and to the RN in charge of her. The RN
told me that she would like to recommend formula. My gut reacted. But when
I got back to my office I wasn't sure how to handle it. What I did was
recommend a social worker speak to her, and that the RN who had successfully
latched the baby try again, that failing, try formula on the nipple, dropper
feeding, and finally bottle feeding if there were no successful feeds at the
breast.
Has anyone had experiences like this? Are there steps that I should have
followed which (in my shock and pride) I didn't?
Libby in El Paso -
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