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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