Hi all,

I recently had a case like this one, baby came in refered from another LC
with similar weight (un)gain numbers, -2 z score. He was struggling at the
breast, with that marasmus look, just struggling out of weakness. One of
those sights that breaks your heart. Mother was a 46 year old single parent
by choice.
We worked on position and latch, which needed a lot of work, and then I
gently explained to the mother that her baby needed more intake. Her face
just seemed to close off and she did not seem to understand. I went over
baby´s weight loss numbers with her, gently explaining that he was getting
the inmunological benefits of her milk, but that he needed more calories.
And she asked How can I do that? I explained about frequent pumping etc and
also about some formula supplementation until her supply had gone up. She
then said could not do any of those things. She could not take time to pump
because she was too tired and had no support, being alone at home, and she
could not give him formula because she felt that would mean her failure as
a mother.
I tell you, I was scared. I could see her deep sadness (probably postpartum
depression) and understood both her claims - but her baby was starving NOW.
I admit I had a big struggle with myself. My first reaction was anger, I
could not help but think This is not about you right now, it is about your
baby, a baby that you chose to have!! I had to swallow this hard feeling
and breathe deep. I knew this mom was suffering too. After much gentle
talking she agreed to move into her parents´ house (called them from my
office) and do power pumping for two days and then return to see me. She
did not agree to supplement the baby with anything else. When she left I
was extremely worried. I called her LC and we agreed she would call the mom
and encourage her to supplement the baby.

That evening I called the mother and... good news. She had been to the
pediatrician after seeing me because she felt she needed to confirm what I
had told her about the baby´s weight. The ped confirmed and convinced the
mother to supplement the baby with formula, and to work on the power
pumping as we had agreed.

Baby came in two days later and had gained 250 gr. Mother was more relaxed,
said she had not been herself on the first day she saw me. She is now
working with a perinatal psiquiatrist.

So my question is, how would you have spoken to this mother? Should I have
been more forceful as (I suppose) the pediatrician was? I guess I was
afraid to act on my inner feelings of anger and maybe that held me back.
This was a hard one for me.

Always learning...

Kika

-- 
Dra. Carmela Baeza
Médico de Familia
Consultora Certificada en Lactancia Materna IBCLC
www.centroraices.com
http://www.facebook.com/Consulta.Lactancia.Raices
<http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>

Autora de "Amar con los Brazos Abiertos"
http://www.amazon.es/Amar-con-los-brazos-abiertos/dp/8426904688/ref=sr_1_1?s=books&ie=UTF8&qid=1420813499&sr=1-1&keywords=amar+con+los+brazos+abiertos
<http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html>

Comprometida con el Derecho a Vivir
http://derechoavivir.org

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