Brattleboro is a small town, but since 90% of our moms breastfeed (and I've
been an LC and/or LLLL for 24 years!) I've worked with lots of moms. And I
have to say thank you in particular to Lisa Marasco, who has done so much to
help us all understand the whys and wherefores of insufficient milk supply,
because in a town where everybody breastfeeds, it's a tremendously important
part of motherhood.

For many years I hoped that pretending would make the risk factors go
away. And like so many of us, I didn't want to ruin the confidence of the
mom.

But what I've found is that it's best to be very up front. I don't have to
get out the check off list. Many times these moms are already a little
uncertain about what will happen. And I can't promise that I can make it all
better. What I CAN promise is scrupulous and competent help, good
"management" of the breastfeeding in the hospital.

We seem to know pretty fast when there's trouble. I would say that over 90%
of our babies are doing remarkably audible swallowing and lactogenesis II is
evident right around 48 hours. Certainly there are a few times a year when
we see the delayed lactogenesis that you read about with long inductions
followed by cesareans. But because we still see quite a few normal births, I
guess I shouldn't be amazed when the hormones - and the milk - kick in like
clockwork.

I've been thinking about putting together a presentation on Breastfeeding
and Normal Birth! Oughta fly at both lc conferences and Lamaze conferences -
but isn't it sick that we don't all deal with normal birth every day? What a
waste of our time and expertise that could be used in other ways, to instead
have to try to fix things that are caused by our doctors, nurses and
hospital systems.

Dawn Kersula in Brattleboro Vermont
(no comments about our public nudity laws, I'm already quaking about our
Nurse Out)

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