Well said. Thank you, Jeanette
Melinda Harris- Moulton
Olympia Wa

Sent from my iPad

> On Dec 9, 2015, at 4:16 PM, Jeanette Panchula <[log in to unmask]> wrote:
> 
> I sent this privately to Christine - and now feel the need to share with
> others.
> 
> JP
> 
> Christine 
> 
> You are so right!  I also have had "growth" foisted on me with changes in
> work situations and venues - the moms, babies and environment are so very
> different - and if you have someone who has worked in hospitals for 20+
> years, vs. someone coming in now from the community (as you and I did), then
> you also have a difference in expectations.  Your employer's requirements
> are also very different and we have to work in the situation we find
> ourselves.  I worked in St. Louis just when epidurals were starting - and
> clearly saw the differences in behavior of both the mothers and the babies.
> Now many hospital staff rarely see mothers and babies who have not received
> medical interventions of some sort.   
> 
> When giving presentations I acknowledge these differences, and encourage
> each group (prenatal, L&D, Postpartum and community) to find a way to create
> networks among themselves to share and learn, such as participating in
> Breastfeeding Coalitions where case studies can be shared, ending up with
> brainstorming on how to improve education for mothers, family members,
> providers, etc.  These opportunities also allow us to see each other face to
> face, and then makes it easier to call each other when we question what was
> done and why.  Of course that question needs to be made in a "can you help
> give me a background on this situation" not a "WHY did you..?
> 
> As for the mom, I NEVER criticize what an LC or Nurse has done in the
> hospital to the patient!  It does no good to the mother except add to her
> stress, and does not change what she needs to do NOW.  If she asks me, I say
> "I don't know what I would have done in that situation, as I wasn't there -
> and you and your baby are totally different from the time she/he saw you.
> Let's see what we can do now."  
> 
> .and the reality is, I DON'T know what I would have done right then and
> there, at 2 am, or when MD said "get this kid fed" or when family is at the
> door needing to take her home so they can go to work, etc..
> 
> I truly believe we need "Rehabilitation centers" -equivalent for many moms
> whose families are not near or able to provide support, and who need a day
> or two more to recover from childbirth and to get to know their babies and
> increase their confidence.  Discharge in the US is far too quick, we all
> know they can't remember anything we said!  One day I heard 2 LCs talking
> about a mom who had been discharged - and they saw her and her husband,
> hours later, with him pushing her and the baby in a wheel chair around the
> hospital.  She was refusing to go home!  
> 
> Maybe nipple shields would not be used as much if hospital staff KNEW there
> was going to be someone evaluating and helping this mom and baby within the
> next 12 -24 hours.but if they fear this is the ONLY opportunity to get this
> baby latched, and after that they go into the "black hole" of care, where
> neither Pediatric nor OB services will perform adequate lactation assessment
> and appropriate interventions, they use whatever tool they feel will
> accomplish milk transfer RIGHT NOW and provide referrals, but they really
> rarely see "the rest of the story" thanks to the silos created by (at least
> the US) the medical care system.  
> 
> 
> 
> Jeanette Panchula, BSW, RN, PHN, IBCLC
> 
> Vacaville, CA
> 
> 
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