Hello everyone,
   
  I want to first re-introduce myself.  I have been no-mail for about 3-4 yrs going back to school full-time.  I am so happy to be back in this thoughtful community that doesn't passively accept the status quo.
   
  Karen Seroussi--mother of 4 (growing up way too fast), La Leche League Leader, IBCLC, and now slowly transitioning to the other side of the exam table as I am in my second year of Medical School.
   
  On the subject of Moms with unrealistic expectations or who are overwhelmed and/or depressed. They can be challenging and frequently frustrating.  The comments made are good reminders to be patient and take the mom where she is.  
   
  I want to share some of my thoughts that haven't been mentioned yet.
   
  When the mom calls, I think to myself how brave it is to call and reveal these socially "inappropriate" feelings, probably makes it easier with an impersonal (not face-to-face) phone call, but nonetheless, they are calling (albeit sometimes for permission to quit).  Regradless, when I am able to think of her in positive terms, it colors my perception of what she says and enables me to use more positive tone as well as better language choice.  
   
  One thing I like to do (after first dealing with the problem or question) is to lead them to envision the stage beyond infancy when breastfeeding makes mothering/parenting so much healthier and easier --basically trying to take her to a time in the future so she can try on what her choice in the present will mean to herself, family and baby.  I like to point out the three things that keep babies and their parents up at night: hunger, teething, illness.  I try to paint pictures of what her life will be like with a breastfed vs. artificially fed infant, not telling her in a monologue so much as prompting with questions.  
   
  I try to help the mom understand that a conscious baby is a baby whose brain is developing.  These are opportunities to create a brilliant, sensitive and amazing child.  Cognitive levels are higher for breastfed children-- demonstrated through high school with thanks to all those yummy fatty acids, appropriate carbohydrates, etc.  A sleeping baby that leaves her alone is not one destined to put trophies on the mantel.  
   
  Lastly, two comments on the decision to quit.  There is some interesting brain research that when a person makes an irrevocable decision they are frequently happier than if there are lingering options or ways to reverse their choice.  I think this may be a factor in why the moms are (to our frustration) frequently happy they quit--to their minds there's no going back.  
   
  Second, the morbidities that stem from "lack of breastmilk" are temporally displaced from the act of weaning so are not considered connected.  When the baby is frequently sick, has chronic ear infections that result in hearing loss (a real case of mine from years ago), atopic disease transitions to asthma, etc.....how is anyone going to link that to something that was never really part of their reality--breastmilk?  That along with what mothering "looks like" are what I try to bring into the quitting converasation so that she can have an inkling of informed consent.
   
  Karen Seroussi, IBCLC, MS-2
  Des Moines, IA
   
   

 
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