Dear all:

Just as women have different learning styles, they all respond differently to different approaches 
when we counsel them.  I happen to be the "good cop" lactation consultant by nature, but I have to 
disagree that the "good cop" approach always works.  This can be the slippery slope downhill in 
some cases.  When I was in training, my two supervisors fell into the "good cop" and "bad cop" 
modes.  Once was gentle and intuitive, the other was analytic and direct.  Since I followed them 
around, I could watch how women interpreted them and it was especially interesting when they 
saw both.  Sometimes the "good cop" messages would get watered down into what the mother 
wanted to hear and the "bad cop" messages were what gave her the shove to get started doing 
whatever it was that would fix the situation.  Sometimes, the "bad cop" message would be too 
forcefull and she would get her strokes from the "good cop" routine.  And to make it clear, the 
"bad cop" routine was merely at the level of what a good personal trainer would do of pushing 
mom to stretch a bit beyond what she thought was capable and telling her the truth.  For instance, 
if you only pump 2x/day you really aren't going to get a milk supply that will satisfy your 
nonlatching baby.

It dawned on me that I have unconciously used this approach with my colleague.  Since we have 
support groups in 3 locations, I can sometimes send the Upper East Siders with the baby nurse to 
my colleague and after they have had a little warm and fuzzy from me, they then get the personal 
training (not quite boot camp) message from my colleague that gives them the push to make it 
over the top of the mountain.  

The "tag team" approach worked really beautifully with one mom with an anxiety disorder who I 
talked through "giving up" because she had pain with both feeding and pumping.  She was one of 
those who I suspected would change her mind when she was given permission to give up.  Once 
she slowed down on the pumping, she realized she missed her baby on the breast and started 
back up again.  Then I sent her to my colleagues support group, who gave it to her straight about 
pumping 8x/day to get the milk supply back up.  My colleague actually thought she'd never do it, 
but she did it even though she went on a long family trip and took that huge hospital grade pump 
with her.  Voila - 100% milk supply and happy mom.  I think the timing was crucial.  Had she been 
given  the hard-care message first, it might not have worked

My apologies to those who have heard the term "Battle axe nurses" which is just as bad as 
"breastfeeding nazi", but I was actually snickering to myself when I called a friend who just had 
twins.  She is a total wimp about setting boundaries and during her preeclamptic session was 
calling everyone in one of those misguided efforts to make sure that everyone knew why she 
couldn't do all those things she had promised.  The "battle axe nurse" (bless her soul) "yelled at 
her" for using the phone and made her stop.  Even though my friend resents it, but I think it was a 
good thing because my friend did stop using the phone.  Its a very thin line, but sometimes an 
appropriately timed strong message can be appropriate, mixed in with lots of other measures to 
gain enough trust initially that we can deliver that message.

We do want to make sure that we don't do so much "good cop" that we turn into codependents to 
use a pscyhobabble term.

Best, Susan

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