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Subject:
From:
"Karen Kerkhoff Gromada, MSN, RN, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 21 May 1995 16:58:05 -0400
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HI Yaffa:

I guess my first reaction is to ask, "What has this mom and baby got to lose
by trying?" Short-term objectives, such as a three day commitment to really
work on interventions you and she agree on may help. Signing a self-contract
with herself (with a reward for follow through written in) can be very
motivating for some people. You may find out a lot about her level of
motivation through scaling--"on a scale of 1 to 10--one meaning you're not in
the least motivated and 10 meaning you'll do anything it takes, where are you
in terms of working with the baby to get him/her to breast?" You can also ask
her to scale her commitment level to continued pumping, etc. (Scaling is a
wonderful solution-focused tool and can be used to find out where the client
really is on any number of things--keeps me oriented to the client's goals
vs. my own--great for us types who have difficulty with "compliance"!)

Obviously in a case where there is a two month time lag, the long-term goal
would be flexible. And you just never know what a baby will do--I'd try to be
hopeful without giving unrealistic expectations. With a baby prone to URIs,
ear infections, etc., I'd really try to help this mom reframe the dual
difficulty of pumping and feeding. Taking care of a sick baby usually is even
more difficult. Please tell this mom I admire her hanging in there and giving
her baby the best. She sounds like she's doing a super job in a situation
where she's had to make a lot of adjustments in her expectations.

Karen

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