Tina writes:

When  does 1:1 instruction take place in other communities?  By whom?  At  
what point do you consider that the family needs this  information?



~ Hi Tina, 
I figure there is a difference between what a new mom in the hospital needs 
 to know, when milk volumes and intake needs are not so high, and baby and 
mom  are just finessing their breastfeeding relationship, especially after a 
 relatively normal birth. As an  IBCLC who goes to a home post-partum, most 
 moms I see have not had an unaugmented, unmedicated birth. They may have  
Lactogenesis 2 delays,  swollen feet/ankles ( I saw a mom this week who was  
edematous up to her knees until 8 days post-partum), and a very hungry ,  
possibly still drugged/disorganized baby in need of caloric intake. We try  
to help the baby come to a receptive state, try to help the baby access  
their feeding skills and latch themselves on. Many of them can't, or can't  stay 
organized long enough to get satiated. We always try either hand  
expression or pumping, or some combination, and in the event that there is not  
enough mother's milk for a decent feeding, I then discuss types, preparation,  
storage, use, delivery options, etc of AIM to fill the gap between what the 
mom  produces and what the baby needs, knowing this will hopefully shift 
towards more  or full mother's milk, hopefully at breast, with work and/or in 
time. This  is the way the 1:1 teaching happens with most private LCs I am 
aware of. Hope  that helps.
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA

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