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Subject:
From:
Karleen Gribble <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 9 Jul 2011 17:18:55 +1000
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Katherine,
There is lots that is concerning in this story. I'm wondering though what
you're looking for in trying to help this mum. Information to support her
position? Or advice on how to handle the powers-that-be. My experience in
dealing with health professionals and social workers is that the path of
least resistance is the one that often gets the best outcome so if it were
me, I would be working my hardest to show my understanding of the concerns
of the staff and working to alleviate those concerns until such time as I
was no longer under their care and then do what I thought best. The
suggestion from someone else that the toddler is weaning is a good
suggestion. She could also emphasise how infrequent the feeding is and that
it is "only comfort sucking not for milk transfer." Being super compliant
and understanding of the "need" to bottle feed (once out of supervision
transitioning to breastfeeding as is appropriate) and not to cosleep. On the
pain killer, is there a drugs during pregnancy and lactation service that
staff can contact to ask about this for themselves??
In these situations, it sometimes does not matter whether you are right if
you are in the position of weakness and so getting out of the situation
rather than winning is the goal. Unfortunately, a proportion of people in
the helping professions have a pathological need to be needed and if this
need is challenged by someone challenging their advice or assistance they
can become quite aggressive and exhibit bullying behaviour (all couched in
terms of concern- a particularly horrible form of nastiness!)
I hope this is of some assistance
Karleen Gribble
Australia

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Katherine Goodwin
Sent: Friday, 8 July 2011 8:07 AM
To: [log in to unmask]
Subject: Mother referred to social services because of concerns including
those relating to breastfeeding and co-sleeping

Hi all,

I'm new to lactnet but am working with Morgan Gallagher of Nursing Matters
to try to help a mother who has been struggling in hospital with her
pre-term baby.  I have limited access to her due to distance/transport but
we are working to try to put together an advocacy statement with regards to
breastfeeding and co-sleeping to try to support her.   I'm a breastfeeding
mother but don't have any official training so any help and advice on the
issues here would be really appreciated.

 I've put together an outline of the situation which she has been able to
read, but its obviously not exhaustive, and she only has access to it via
her phone, so she is not able to easily work on it herself.


Carys was born on 1 June at 34 weeks.  Claire has had a struggle with
jaundice and other things normal for a premature baby, and she's exhausted
from having been in hospital (or travelling in and out) for 5 weeks.

Staff at the hospital have, along the way, expressed concern about a few
things, but it seems that rather than trying to help, they have escalated
their concerns and have brought in child protection and social services, and
are saying she can't take Carys home with her.  Out of nowhere they are also
expressing concern about the well-being of Isabel and Sian.

As you can understand, Claire is emotional and very, very tired but she's
been trying to keep up with what the medical staff have been expressing
concern about.

The main items seem to be:

 - her tandem feeding Sian (who is 2.5) (they seem to think this has somehow
affected breastfeeding Carys, with suggestions that she express before a
feed as she is apparently making too much foremilk.  However, she has not
been able to nurse Sian much at all while being in hospital)
 - the danger of her falling asleep while breastfeeding Carys - they will
not consider any co-sleeping arrangements and are worried that Claire will
sleep while breastfeeding when she gets home.
 - 'non-compliance' with feeding plans (Claire has followed requests to give
bottles of expressed milk and and formula where necessary, but
understandably wants to be able to feed at the breast in the long term, so
wants to be able to continue feeding at the breast whenever possible - some
staff are being very unsupportive in this)
- they are convinced that if Claire takes Carys home, she will only
breastfeed and will not continue to give topups
 - her taking co-dydramol for her existing conditions and its affect on
breastfeeding

Carys had some small weight losses (Claire has some sample weights including
these losses and how much 'topup' she was getting which I will add later)
but at the moment is a pound over her birth weight.

Claire says:
"We expected too much of her in the early days and she went too quickly to
the breast. She couldn't keep up, she lost almost 10% of her birth weight
and her liver wasn't functioning properly. They put her on bottles to try to
get over both those issues, EBM as a first choice and Nutriprem as a back
up. I'm hoping to use it as little as possible because she throws up (and I
don't mean a little dribble after a burp) after every bottle of it but never
mine (which is a little dribble after a burp)

I'm amazed at how this stay has gone, to be honest. I've never known
anything like it with the other two. Some things I've accepted have been
necessary, like the move to bottles but the way people have treated me is
shocking. I don't think there is a group of people from the domestics to the
drs who haven't earned a complaint."

Claire had a meeting with social services on 7/7/11 and said the following:

"Just come out of the meeting. Social Worker was quite positive and said we
should just need some extra support at home and can't see why we shouldn't
leave but it's down to her manager.

I'm shaking now but just kept reminding myself she didn't refer me. They've
told her I've stated I *will* breastfeed when I leave here. I told her it's
a lie that I've only ever wanted to know where we go from here. I'm pumping
every two hrs and feeding her every three. The plan the Dr wrote I took to
be to preserve the breastfeeding so I've assumed the plan is to get it back
when she's strong enough. This is not a long term solution so I need to know
what next. Do we work on reestablishing the breastfeeding or move to a more
realistic bottle pattern."

She's still trying to follow what the medical staff are asking her to do,
but she is finding it difficult:

"I've been told I have to feed her every time she's awake because I don't
know the difference between rooting and looking to be with me. So I've just
spent 20 mins giving her 10ml. Just glad it was nutriprem!

I think they're not used to a month old baby who wants to be sociable but
I'm trying to force feed her just because she wants a cuddle :( it's like
she's being punished for being awake, being a normal month old baby!"


Please let me know if you can offer any advice on this.  Claire is desperate
to take her baby home, but is so scared they will try to separate them that
she does not want to bring up the subject of breastfeeding (not even the use
of an at-breast supplementer that she now has available).

Thanks in advance

Kat Goodwin


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