Oh, oh, I feel that I am about to climb onto a big soap box.

Terriann writes:

<< I would like to discuss the issue of our being sensitive to the mother =
 in giving pumping advice verses giving the mother the best/ latest =
 information and letting her do "plan B" if she needs to.   >>

I never see these moms, not being a professional, much less in the hospital.
But because of my non-threatening, non-professional, informal role, I am a
likely place for these same moms to come three weeks later, when they have
gone over quickly to exclusive formula feeding and are eager to prove why
they "won't see" lactation consultants -- even, I have heard more than once
from mothers I know well and who are genuinely smart and devoted to their
children, why they "hate lactation consultants."

Being sensitive vs giving the best advice is not a choice:  both are
indispensable.  Not either or, but both and.

A mother who knows no reason why her own milk is more than slightly better
for her baby -- a couple of ear infections over three years, and that only on
statistical average, say -- who is already terrified and overwhelmed -- cf
our conversations on taking in, and then quadruple that! -- needs
information, but she needs first and foremost to have information in a form
she can use.  Otherwise, to her it's basically no information at all.   And
that means sensitivity is needed in delivery of information -- not
distortion, but listening to and empowering the mother.

Here's my saddest case study.  My s-i-l's oldest had a tracheo-esophageal
fistula, as well as other very terrifying but more transient problems at
birth -- she was shaking with fear for his life, and had not had any chance
even to touch him when the hospital LC -- no doubt overworked and highly
frazzled, I don't mean to be insensitive to her! -- came to see her the next
day.

The advice she HEARD from the LC -- notice I don't say what the LC said, who
knows, but what the LC said that the mom was able to hear -- was that she
"had to" pump every two hours, starting now, or bf was going to fail and it
would be her fault.  She did this, weeping and nearly delirious for perhaps
six hours, after which her husband (a physician in the same hospital, with no
bf knowledge naturally) said, "You know, this is your decision, and if you
don't want to do it you are allowed to stop."   With grateful relief, she
returned the pump immediately.

What is sad in this story is that she never heard the LC say those same first
words:  This is your decision.    If she had heard that, she might have
decided to pump out of a more empowered position:  not because someone "made"
her but because it would help her baby.

Or maybe she needed to hear the LC say:  To bring in a full supply you need
to make a big committment, every 2 hours etc.   If you pump less, you'll have
less milk for your baby, but still some, and the more you are able to pump
the better a chance that your baby will be substantially nourished by your
milk.    Your baby has a gastric problem, and your milk can be a great,
important part in helping him heal from his surgery.  My job is to help you
do as much as you can to help your baby, so let's make a plan together.

That lets the mom respond with "Every two hours is best?"  if she wants.  It
also lets her respond with, "Every two hours sounds impossible," if she feels
that way.  It lets her respond, period.

Maybe the result would have been a full supply.  Maybe it would have been a
partial supply.  Maybe it would have been no supply at all but a friendlier
feeling toward bf generally that might have resulted in a bf second child
(weaned at three weeks, when the help I could provide myself became
insufficient, bc mom unwilling to see any LC at all for help).

Notice I am not saying the LC should pull punches, and certainly NOT that she
should decide FOR the mom to make it "easier" on one party or another.   But
the LC's explanation of the physiology -- and I think even the 14 year old
moms, the NICU moms, etc can handle a surprising amount of physiology and are
empowered by it if it is in non-technical language -- helps the mom make her
own decision, and one less likely to turn the mom off at the outset.

More information **goes with** more sensitivity.  More orders -- more
"instructions" -- do not.

Or, as Coach Smith says, She's the mother.

My .02, from where I sit picking up the pieces after the train wrecks are
over.

Elisheva Urbas
Not affiliated with any bf organization at all, leaving aside Lactnet, in NYC

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