Dawn,
I agree with you. So many problems could be averted if those red flags got proper attention, but who do we rely upon to recognize them?? I have seen some very upsetting situations in the past few weeks--all of them should have been at least partially averted. It is as if many practitioners both in and out of hospital have a formula (no pun intended) for how they treat "breastfeeding problems" and there is no other thought process. I had a mom with apparent hypoplasia --missed completely by 2 LCs, a baby with extreme molding at 17 weeks (not days, weeks!)? and can only feed passively on a shield with a very good supply, another mom with very flat nipples, so was given a shield as her solution--the tongue-tie was an obvious red flag. Another mom with the tips of her nipples sucked into little blisters and shaped like a lip-stick. Nurses told her he was latched just fine. You all must know how painful it was for me to be the one telling a family they have to supplement b/c baby is sleeping so "perfectly", mom's supply is low and baby is yellow! Oh, yeah and I was thrilled to refer to the ped who said, "Yes, the baby does look tongue-tied, but we really have no evidence it interferes with breastfeeding or that clipping makes any difference". Of course, mom is nursing every hour w/ no effective feeding, can only pump about an ounce every couple of hours, baby is yellow, bms are scanty and mom is in pain--makes no difference. Yes, we need a full assessment, but there is this almost "unwilling to believe it" response that comes from mothers when you point out the obvious thing that was missed and then they ask "Why didn't the ped, nurse, LC, midwife tell me that?" Now they are weary and they have so much more work to do than was ever necessary....

It was an exhausting week!


Jennifer Tow, IBCLC, CT, USA

Intuitive Parenting Network, LLC








From:
Dawn Kersula in Vermont

Jessica, Cathy and Colleagues,

Don't you find that one of the challenges during any assessment is to look
at ALL the factors - not just settle on the one obvious one. We try really
hard here in the hospital to make sure we do an excellent job of what we
used to call "management" (remember the first LC series info on poor milk
supply -- thank you Marsha Walker!!). It is a crime that there are still
moms who have poor milk supplies because of inadequate assessment and
teaching in the hospital. And the concomitant sore nipples, engoregement,
etc etc etc.

Heaven knows we're not perfect. But if there are any red flags ahead of time
it's a disservice to the mom not to address her issues and to really sit and
watch a feed, assessing baby's issues as well!





 


 




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