Norma: I was lucky enough to have gotten such an opportunity. A couple of weeks ago a family flew me to LA to help their daughter with her first baby. The first day took a lot of work with every breastfeeding session to latch baby as mother had soft flat nipples and the baby had a very small mouth. Still the baby did latch, though mom was beginning to get tender nipples. The mom struggled in the middle of the night with breastfeeding and before I got there the next morning a nurse had already introduced her to a nipple shield (one that was too small at that). The family paid to have me sleep at the hospital in the next bed the next night to help her. It was an eye-opener re: how little rest a mom gets at UCLA medical center with drs., residents, dieticians, medical records, etc. streaming through. A little break between 11pm and 4am and then the parade began, with no regard for her breastfeeding privacy. Mama wanted to resort to the nipple shield almost immediately when the baby (and she) became frustrated. Sometimes the baby latched to the shield, but the shield that was big enough for mom's nipples was large for her small mouth and she gagged and struggled with it. By 8am I had ordered a pump and soon after had to order a larger size flange. Baby hadn't lost enough wt. by discharge day to elicit any suggestions for formula fortunately. Moms milk didn't come in until the 4th day. All that time we worked with baby trying bare nipple at first, then going to shield (thinking I could get her off the shield later). I squirted a little glucose water into her mouth to get her to suck at the shield which was as big problem as the bare nipple. She wasn't peeing any more, though passing meconium, by day 4 and I decided to give small amounts of formula to avoid a dehydrated baby, given with syringe. At her one week check her weight was fine. Through all this mom was willing to pump every 2 hours during the day and giving the baby every drop with a syringe before giving her any glucose or formula. Now at 2 1/2 weeks she is still only pumping 1 ounce of milk every 3 hours and given by bottle, followed by formula. Baby needs 2 ounces for her wt. and the supply isn't increasing. I had Mama ask her dr. about retained placenta, but she was told probably not and is planning on starting Domperidone. 
So, Norma, as a postpartum doula, lactation consultant, and friend of the family (I was her mama's "postpartum doula" when she was born 30 years ago) I was still not able to ensure success for this family, though it could have been worse if I hadn't been there. They felt I was valuable re: reassurance in other areas, such baby girl having vaginal blood, calming techniques, how much milk the baby needs, bathing, etc. My other comment is that I see so many women who have insufficient breastmilk and is often tied to delay in milk coming in. If this has always been the case, there must have been a lot of wet nursing going on in history. Are there any good studies re: the correlation between this and epidurals?
Vicky York, IBCLC, CPD
Postpartum Care Services
Portland/Eugene
http://mypeoplepc.com/members/vmyork/
http://vmyork.ikarma.com



------------------------------

Date:    Tue, 28 Aug 2007 15:18:12 -0400
From:    Norma Ritter <[log in to unmask]>
Subject: The first 24-48 hours

Dawn wrote:
>Sometimes I'd like to just move in for a shift with a mom and dad and
babe and help a little more! <

But isn't that exactly what is needed?
It was my priviledge (and pleasure!) to be the doula at the births of
all my grandbabies. Mostly I stood by and offered encouragement and,
when appropriate, information. I stayed with them for at least a week
after the birth to help with the breastfeeding.

I would like to ask a question of those other grandmothers on this
list who have done the same for their families, "Do you think it
really made a difference?"
Personally, I think it did, but of course I am biased. However, the
universal comment I received from all my children was "How on earth do
new famiies manage without such help?"


norma

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