Ann Marie writes
> I rarely post here, except to ask a question, because, honestly, I
> don't
> feel smart enough to answer questions sometimes!  (that and
> homeschooling
> four children plus having a 6 month-old could have something to do
> with
> limited time for the computer!)
>
> I have been thinking about that and decided I would ask here, how do
> you
> convey what you know in an understandable manner?  How do you boost
> your
> confidence enough to share your knowledge?
>
> For me, I am savvy on the anatomy and phsiology of breastfeeding,
> and
> technically adept with the computer.  My greater challenge is the
> one-on-one
> communication and lactation counseling face-to-face - doing so w/o
> overwhelming the mom with facts and data.
>
> Any input from you wise ones?>

Your dilemma resonates with me Ann Marie. I am not sure I have come too
far in solving it in my case, as my best friends have been known to tell
me! I am in awe at your ability to home school your children, as I always
seemed to get too detailed when I tried to get the simplest things across
to my kids, with a huge amount of resultant frustration. (I needed the
mental reward of escaping to the hospital for a few hours of part-time
work with adults after my husband got home in the evening.) Perhaps some
of your best methods with your children might be adaptable to teaching
breastfeeding moms.

For my own satisfaction, I first have a need to get a thought out of my
head and articulate it on paper or monitor where my vision can appreciate
it. (I did a lot of private journaling when I was spending many hours a
day with people 3 feet high!)

Then repetition of re-reading it gets my sense of hearing into the act.
Then, after I see and hear my thoughts, they seem to re-enter my brain in
some different way, so that I can spot the 'kernel' of the message more
clearly, and how removing a few words here, or changing the order there,
might make it a little clearer. Substituting one- and two-syllable words
for three-syllables and beyond wherever possible helps immensely. That's
the first half of my communication process, the part I need to do to feel
the satisfaction of articulating it, and "getting it out of my system".

But communication is only half done at that point. Getting the symbols
transferred out of my brain then requires me to think of the other
person's understanding, so I can aim to attach my message to the familiar
symbols in her brain, if that makes any sense. Maybe she can only take in
one or two simple messages without losing them during further
explanation. I find that many moms are 'kinesthetic learners'. That is,
they learn easily by touching something, before I try to stuff too many
words into their ears! Genuine praise is the one set of words they always
seem to "get". It primes the pump for their self confidence, and perhaps
further learning.

I eventually create a "script" for the simplified point to keep me from
falling back into being too technical, and I practice it out loud when
I'm alone, and fine-tune it when I watch the mom's body language to see
if there is a glimmer of understanding. You can often tell by her body
language when you've 'gone too far' or 'lost her', and 'back up' to the
wavelength or channel where her understanding is tuned, which is often on
the baby's body language, in which case, I'd better tune there too and
use that to explain some things.

These are some of the "scripts" I have come up with to explain things to
moms, even well-educated ones, at WIC. I believe that understanding about
the MER is very empowering to mothers. So I say "Nature has a wonderful
way to send signals to the back of the breast to tell it to squirt milk
forward where the baby can reach it. You can help nature do this if you
need to."

A picture or model can truly be worth a thousand words. I often use the
CBE demonstration breast to familiarize them with the fact that there is
no milk stored in the human nipple. (They usually seem amazed!) I peel
back the outer cover, and tell them this is just a cartoon breast to give
them some idea of how their breast is made. I point out the subareolar
ducts, (which on the model are really about 3-4x larger than I sense them
to be in the human breast) I tell them to pretend they are like little
toothpaste tubes, and the contents comes out more easily if pressure
starts at the far end. That leads to the importance of chin and tongue
placement in off center latch.

I also use a toothpaste tube analogy for breast compression, especially
over the phone. I tell the mother to use the hand opposite from the side
she is nursing on, put her thumb on her breastbone and four fingers
across the breast to the armpit, and pretend she is slowly squeezing a
giant toothpaste tube. (I invariably find myself closing my eyes and
doing it right along with her as I describe it, and ask for feedback as
she does it! I too am partly a kinesthetic learner, and learn to do by
doing.)

I never mention foremilk, nor the word ''hindmilk', but I refer to "the
milk that is creamiest" coming when the breast is feeling the softest as
the feeding ends, and that it "calms the baby's digestion down so there
is less chance of colic." Other scripts for overactive MER often describe
the desired result of anti-gravity positioning so that the baby gets the
milk "coming uphill out of the breast, like a drinking fountain, instead
of struggling under Niagra Falls". Diane Wiessinger often refers to that
as "the firehose effect". (For the master touch, visit Diane's website. I
don't know what I would do without her handouts, which you can duplicate
to give or send to moms!)
http://people.clarityconnect.com/webpages3/wiessinger/bfing/index.html

Etc., etc. You get my drift. Good luck. As Eric Berne wrote, "Everything
in life is games. It all depends on which games you choose to play."

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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