In a message dated 99-12-09 09:49:03 EST, you write:

<< From:    lisa mooney RN <[log in to unmask]>
 Subject: Re: Nipple Shields

 Dear lactnetters, I saw a mother a few days ago with truly deeply inverted
 nipples bilat. Her four sisters also have this condition and all failed at
 breastfeeding, They pumped and gave emm via bottle. I was going to try a
 nipple shield with her as baby was doing very well on her part but just
 couldn't get stay on the Breast.  Mom was receptive as she had never heard of
 this device but the fellow LC I was working with said not to introduce a
 shield until at wits end.  Would I have been in the wrong to try this. Mom
 went home renting a pump as her sister's had done.... TIA, Lisa Mooney RN BSN
 IBCLC >>

If mom went home on a pump and no direct breastfeeding was occurring, it
sounds like wit's end was/is close. But the big issue here for me would be
related to informed decision making and a mother's "right to choose" the
intervention(s) that might work best for her and her baby. (And this is only
one example, but I can think of many situations in which intervention options
may be available for which this applies.)

Obviously, we don't offer nipple shields to every mother, but this mother had
a problem for which a shield might help. If we discuss this intervention and
its potential advantages AND disadvantages, it seems to me that a mother
should then decide whether or not she wants to use it.

Who are we to make these decisions for mothers? When there are options, who
are we to decide which intervention may or may not "fit" an individual
mother's reality? Mothers have a right to all the information and they then
have the right to be the one to choose which information/intervention may
best work for them. Since mothers know themselves and their situations
best--and they are the ones who actually have to implement the plans we come
up with, maybe breastfeeding would work more often and longer if we let them
in on developing strategies!

So, Lisa, were you "wrong" to let the mother know her options and give her
control over her own plan of care? I think you were right on...

(Sorry, didn't realize I'd stepped up on the soap box!)

Karen

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