My husband laughingly says that most of my phone work (typically follow-up
calls after visits) are mental health counseling sessions.  New mothers
often need a confidential, detached listener to bounce things off of. I'm
pretty good these days at keeping these calls affectionate, helpful, and
brief.  Occasionally a client needs more.  I had a call from a client today
that illustrates this.

 First baby was preterm, small,  very fussy, hard to establish.  I felt the
baby was experiencing pain or some distress, and urged the mother to respond
warmly and faithfully in spite of an Ezzo-pushing friend.  Baby finally
established and was doing great, gaining well, but got suddenly ill.  He had
a hernia that had been misdiagnosed at birth as a hydrocele, and he ended up
having emergency surgery at 4 months old.  Now baby (only 2 weeks post
surgery) is clingy, wants to eat constantly, etc.  This mom needed to vent
about how difficult this all has been.  She wanted to know how to handle her
family when they ask about his "schedule".  She wants to know if it's ever
going to get any easier.  We talked for about a half hour, after which she
was much consoled.

  This woman doesn't specifically need a long-term counseling relationship
to deal with her current dilema, but she does need a person she trusts who
can listen and can share information she doesn't have or even know she
needs.  The LC is in a position to help parents gain knowledge about child
development, share stories about how other parents live though similar
crises, and to just care.  It's hard to bill for such things, and I know we
all do this.  It takes time, and that really ought to be billable, although
I seldom bill for this type call.  Sometimes I know that this is just one of
those times when if I love someone a little, they'll make it through.  I
think the fact that the majority of my very high-risk clientele typically
breastfeeds for at least a year is a result of  willingness to take calls
like this. Usually these are not the type of mother or situations that take
too much advantage of my time.  If that happens and the mother is
tremendously needy, I'm likely to suspect depression and refer on.

Cynthia wanted to know about referral sources.  I have 2 female counselors
who I know bfed and are warm and relaxed about different parenting styles.
I don't really stay in contact about the progress of the counseling once I
refer.  I figure the counselor or the mom will tell me if there is something
I need to be further involved with.  If they need extensive on-going help, I
don't want to be that involved since I can't bill for the time.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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