I have several thoughts and questions running through my mind.  I am
glad that now for once I have a source that I can turn to where you will
both understand and support me.
        First I am subcontracting to a WIC clinic as their LC.  I am going
to contact their clients before delivery, 1-3 days postpartum, 1 week, and 6
weeks providing there are no complications and of course they can contact me
at any time as well.
        I just started this arrangement.  My first observation is that they
hesitate to talk to me - why should they - they don't know me from Adam (or
Eve).  I try to ask questions and can get them talking.  My question is
this.  I thought about putting together a set of questions to ask at each
check point.  But then I thought maybe something already exists.  Why
re-invent the wheel.  Anyone out there have anything like this?
        I had two clients last Friday.  Both were so appreciative of my
services and expressed how much it was worth the money - that made me feel
good.  Both quit nursing in less than 24 hours after they left my office.
Now I know - especially after working with Bf women for 8 years - 1.5 years
in private practice that I shouldn't feel guilty - they made their own
decision but I love the challenge and I still have a goal of 100% success.
The one mother had severely sore nipples.  She had been talking with
volunteers over the phone and by the time I saw her she was emotionally a
wreck.  She told me that if she had seen me sooner she doesn't think she
would have quit.  Then I wondered - should I have told her to call me or
page me before she made this decision. And then if she couldn't bear it
anymore to possibly consider using another method such as finger feeding
with her pumping until her nipples healed some or possibly using a nipple
shield for a day or so to give her some relief.  I wonder if these could
have made a difference.
        The other mother had latch on problems - 4 day old term baby.  The
tongue did have a slight hump but the biggest problem seemed to be mom.  She
was tense at home.  In my office the baby latched right on - no problems.
In discussion I learned she had a two year old who had been sick for 3 days.
She tried going in another room - toddler cried and screamed for her.  In
the same room she couldn't relax either.  She had not succeeded with the
first child and was setting herself up with this one too.  After returning
home following the consult baby latched on pretty well the first time and
then returned to having problems.  I very well couldn't move in with her or
haver her move in with me.  We talked about ways to relax - she knew the
baby could do it.  What else could I do?  Again I wished I could have
changed her mind before she made the decision to quit.  She said she
couldn't stand putting her baby through the frustration of trying to nurse
because the baby became so upset and frantic.
        It was such a bummer.  I remind myself of all the other mothers I've
helped but just like fishing I think about these that got away.
        Thanks for the listening ear and any ideas or suggestions.
IBCLC in Evansville, IN
Rose Marie