""I feel like those of us who use the scales intelligently are not having
our posts read.  We do not simply judge a single feed based on the number
alone, PARTICULARLY when it is a first visit or only visit. On the other
hand, I cannot tell you how many mop up visits I have had because someone
did a quick assessment (without a scale) and saw a "good feed" but didn't
listen to the mother's complaints about the "bad feeds" and completely
dismissed the mother's concerns."    Susan E. Burger, MHS, PhD, IBCLC

-------------

Ah Susan, thank you for saying exactly what I am feeling.  I am not feeling
heard on this topic by any means.  Sadly, I have felt that for many years in
my own community, seeing things and talking about them only to have my
colleagues tell me I am not seeing this or that, that I am just plain wrong
or blowing me off completely - only to be proven right a few years later.
(However, I do know I can come on strong and that may very well have
something to do with it...)  As a result, I am sadly not even mildly
involved in my own community anymore - something I do plan to change.  But
not feeling heard is a huge frustration and it can cause serious
professional frustration and burn out...which I am struggling with right
now.

Many of us have varying styles of practice.  We all have varying levels of
experience.  We all have our own comfort levels of what we will or will not
work with.  There is nothing inherently wrong with this.  We all need to
remember this though - and when someone mentions that they do use this tool
or that on a regular basis, perhaps we should consider asking WHY, and
getting more information before just stating that they are wrong or
overusing, etc.  

I, for example work with babies who have terribly difficult suck issues,
structural issues and tongue ties.  I do not see sick babies or babies with
metabolic issues or birth defects (except for the baby with the cleft palate
last month - my first).  Rarely do I see a baby anymore who does NOT have
tight muscles issues of some sort which saddens me terribly.  But when you
look at the stress levels our pregnant moms are dealing with (which will
easily cause stress for baby), the medicalized births they almost all go
through, vacuum extractions, forceps, pitocin, cytotet, epidurals,
etc...Even the moms having homebirths are not immune to babies with tight
muscle issues and tongue ties...and I see them too.  And they are shocked
that they are having issues because they had the idealized birth...

It is a wonder that any of our babies have any instincts left at all at this
point.  I routinely see babies who do NOT know how to search for the breast.
They are sleepy, lethargic, bodies are way out of alignment - neck
compression, torticollis, lopsided jaws, huge fluid filled lumps on their
heads from either 3 hours of pushing or a vacuum.  I see tongue ties all the
time now - ones that are understandably missed (Types 3 and 4) and ones that
even my kids and wife see and say, " Wow - that one has a tongue tie," and
the hospital help and pediatrician and 3 other LC's ALL missed it!   Talk
about frustrated moms!  

I see babies who are unable to move their arms and lift their heads for the
laid back position for BF due to overly tight muscles.  These poor babies
are NOT able to act or function normally.  I cannot use the basic tools we
have to help these moms and babies - I have to step way outside the "Normal
Box".  Hell, if a mom came to me for a simple latch and positioning issue
and baby had no issues at all, I'd likely pay her for the visit!

So - how does this all relate back to the scale  and not being heard?  Well,
please hear me:  my scale is a vitally important tool.  It helps me catch
the stealth nurser - like baby Sophia whose face was pushed off to the
right, so badly out of alignment that even the parents knew something was
really wrong (most parents don't seem to notice when their baby is
lopsided).  Her Jaw tilted horribly, she had horrible torticollis (diagnosed
within 3 days of birth by the Ped who actually noticed this kid had an
issue), and her body curved to the right so badly she looked like the letter
'C'.  Babies shouldn't look like that.  I just knew there was no way she was
going to be able to breastfeed and was very upset.  But, she did breastfeed
- and she did very well and did not hurt mom!  I was shocked!  We put her
into treatment to take care of the body issues.

Then there was baby Ella.  Who grew over a 10cm fibroid in her momma's
uterus.  While her body was shaped like a 'C' and she also had torticollis
and a lopsided jaw, no visible neck (very tight neck muscles put her little
shoulders nearly at lower ear level), her Dr missed all of this and declared
her in perfect health but called me (which was cool!) to help with the
nursing because mom felt there was a problem (even tho the Dr didn't).
Well, there was a problem.  Baby could nurse till the cows came home but, it
hurt like hell, and there was NO milk transfer even though we heard lots of
'audible swallows' (which was why Doc felt all was fine with nursing).  This
baby had such severe muscular issues that it took her 10 weeks to learn to
breastfeed.  We put her into treatment also.  

Both babies are doing quite well - developing normally and both still
nursing - Ella is now 15 months old and Sophia 9 months.

So I guess my point is that we all need to remember that the vast majority
of us actually have a clue and are smart enough to not just judge one
feeding as this or that, and that we are able to look at the big picture.
There are people we have on this group that no one ever second guesses
because they have made it clear they know what they are doing - they have
written books and have spoken at our conferences.  Their 'words' are taken
as near gospel (and that is fine!) because of their experience and because
they make sense.  But you know what?  There was a time when they didn't know
much either, and they were learning too.  But they, and those like me, have
worked our asses off to learn more, to help more, to understand more - to be
able to make a difference.  We have learned how to have our nice big tool
kit and use it for all our moms as they need - not do 'cookie cutter'
lactation treating each dyad the same...they all deserve individual
treatment, do they not?  What works for one, may very well not work for
others.

Just because some of us are not prolific writers/posters on LN doesn't mean
we don't know what we are doing.  And time in practice doesn't always mean
anything either.  I know of LC's who have been in the business for twice as
long as others - but those others are cleaning up the long time LC's train
wrecks...  I may have only been doing this for 16 yrs, and I don't know it
all, but I know what I know and I am damn good at it.  And the fact that I
have been supporting my family for several years now on ONLY my LC income
says something... 

Ok - enough rambling for now.  I haven't been on LN for quite a while - been
lurking, just haven't had much to say for a variety of reasons.  But this
one is near and dear to me.  We must treat each other with respect, and we
must not assume that because one posts on a particular point that she
doesn't 'get' the other points that may go along with it...does that make
sense?   Anyway, I am really enjoying the other thoughts along this
thread...

Warmly,
Jaye

Jaye Simpson, IBCLC, CIIM
Breastfeeding Network
Sacramento, CA
www.breastfeedingnetwork.net

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