Hi Leah;
Adding to the previous post:

Sometimes it helps,  with counseling a new family with less common 
physical anomalies affecting breastfeeding, to discuss how much common 
ground the family is on.  Along with targeting their special concern, 
they can also feel that they are grappling with the information and 
practice everyone needs.  *All* new breastfeeding parents feel 
overwhelmed, and everyone is figuring out how to get a comfortable and 
effective latch (often the same thing). All new families need a lot of 
practical help around the house in the early weeks -- does she have any 
resources to draw on?  All new parents are empowered by being around 
other breastfeeding families that seem like themselves.  Can you help 
her find support groups for parents who are also blind?

She is already the expert about being blind -- ask her how she deals 
with other other daily skills -- cooking, getting dressed, brushing her 
teeth? *Everyone* hates all the fussy little parts that pumps have -- 
would laying the pieces out to dry in a particular order help her 
reassemble them? Could any tactile notches be added to help align parts 
and dials?   In the assembly/pumping practice sessions, move the flange 
from side to side, so she has a sense-memory of how it feels when the 
nipple moving freely, not rubbing on the sides.  Can she hear milk 
dripping in the bottles?   Can she use big bottles so she doesn't worry 
about overflowing them?

How important is the pump/bottle in the daily routine right now? Do they 
have a term baby able to breastfeed well?  Should feeding at the breast 
be the skill to work on first, to help her feel competent and connected 
to her child?  Mothers and babies are feeding as much by feel as sight, 
and they did it in dark caves at night for a long time.

In recent decades, LCs helping with latch encourage all breastfeeding 
parents to lean back a bit and use gravity to make both bodies secure 
and stable.  And to start with smart little baby mammal upright and wait 
for them to organize and start the search, and then keep the baby in 
contact while helping them search down the mother's body.   If she 
experiments with a feeding pillow, to remember that her body remains the 
contact point.

Someone who is blind tends to have a strong kinesthetic sense of their 
own body.  Describe the deep off-center "sandwich" latch. One good 
teaching tool to convey this to any parent -- have them plant the base 
of their thumb on their chin, with the thumb up past their nose.  To 
reach the thumb/nipple, they would tip their head back,  drag their 
lower jaw, and the thumb's base/areolaenters the mouth first and the 
thumb/nipple flips in last.

If the mother pushes her own head, she can see that it curls the chin 
into the chest -- not a good way to eat! If she's supporting the baby's 
shoulders with the neck/base of the baby's head in the web between thumb 
and forefinger, the baby's head can hinge back.

Can she feel the baby's chin on her breast and the nipple under the 
baby's nose?  With the supporting finger by the baby's ear, (or slipping 
a finger up under the baby's chin from the hand supporting the breast) a 
mother would be able to feel that slow, jaw-dropping suck, and to listen 
for the steady swallows and feel the breast softening, and judge whether 
it feels like a big, comfortable mouthful.

Everyone is worried about whether the baby is getting enough to eat, so 
diapers and weight gain are monitored carefully for the early weeks. 
Maybe a few pre-and-post weights would encourage confidence. Once a baby 
is gaining well, they will certainly not be polite about making sure 
they get enough.  It's healthy eating habits for a baby to learn about 
their own body and eat when they are hungry and stop when they are full 
-- we don't measure how much we as adults eat.

This is turning out to be a long post, and full of information that you 
and other readers already know -- so maybe the note was just affirming 
that you already have so many good tools for helping this new family!

Good luck to us all.

Margaret Wills, IBCLC, Maryland, USA





> Date:    Fri, 25 Feb 2022 12:22:31 -0500
> From:    Leah Rae Jongsma <[log in to unmask]>
> Subject: Supporting visually impaired dyads
>
> Hello all. My team and I have been trying to support a dyad where the mother is visually impaired, she is completely blind. The mother does not have support at home and she struggles with getting the pumping parts aligned on her breast as well as knowing if baby is well latched or evaluating the quality of the feed. It's an incredibly complicated situation that I know is very uncommon, however it made my team and I realize how little knowledge we have about supporting visually impaired families. I was looking for any information or education from this group about ways to support lactation in visually impaired parents and any adaptive devices that could be helpful.
>
>               ***********************************************
>

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