I want to just remind everyone that we have all seen a different mom and
baby - what looks like an easy solution to those who see mom on day 4 may be
totally different for mom on day 1. Hospital staff (and I don't work there,
so I am not trying to be defensive) see women who:
* have just delivered and don't appear to be taking in many of their
instructions
* their coordination seems affected and they handle the baby and their own
bodies like foreign objects
* they have little/no sleep and are often taking or have recently stopped
taking medications for pain or to initiate contractions
* their blood sugar is very low
(of course I'm not speaking of the mom who waltzes in to the hospital to
deliver her baby 1 hour after entering the hospital or the mom who has
delivered at home)
Our Public Health Nurses see moms on day 2 or 3
* Mom is still unsure of how to handle her baby, but is better with her own
body
* she still has not slept much and is overwhelmed by the 24 requirements of
her job
* she can find few positions that are comfortable to sit
* she may have had more food IF her family has been nearby, but if not, she
also has low blood sugar, having lost her appetite.
I get called in on day 5 - 10:
* Mom is handling baby very well
* Mom is handling her breast very well
* Mom is still sleep deprived, but her appetite is usually back and she has
eaten well sometime in the last 24 hours
* Mom's sitting positions are a little more comfortable (I needed 3 months,
but that was unusual)
My point is that what each of us sees is DIFFERENT and perhaps what was
appropriate on day 1 would be totally inappropriate on day 3 or day 10. I
can't tell you how many visits have made me look like an exceptional LC -
today I helped a mom to offer her breast to her baby - who latched on
"almost" perfectly (she did have to gently pull on the lower lip to
eliminate all discomfort) on a breast that "no one" had been able to get the
baby to take. I cannot say that if I had been there on day 1, 3, 5 or 8 I
would have done as well - today mom was relaxed, baby was alert but not
super-hungry, Dad was present, confident and helpful and mom could sit
comfortably on a chair. Mom had been pumping the side the baby refused - so
the milk was flowing beautifully...just enticing baby to come and get it.
Lets help each other by developing a network of collaboration so that none
of us feels we must solve everything IMMEDIATELY - if during each stop in a
new mom's journey she meets with people who know she will be seen by others,
then each will not feel deperate to solve everything TODAY!
I worked in the "ideal LC project" with the team that Jane Heinig created in
UC Davis - ALL moms could be seen ANY day they needed help - so we all were
confident that if we taught mom ONE thing today, we could confidently chart
what we had done and what we thought might work tomorrow - and another LC
would be there tomorrow to check on the progress and offer a home visit if
needed.
Currently those who see mom in the hospital fear the next time she will be
seen is 24, 48 or even 72 hours later - and when she is seen at the
pediatrician checkup ... Will it be by someone who will actually observe a
breastfeeding and provide assistance?
The importance of networking and creating a bridge of support people -
nurses, WIC, Home Visiting, Public Health Nurses, IBCLCs cannot be
underestimated.
Until these are in place, moms will be getting less than optimal help in
each step - for fear that "no one" is going to see her again. When this
happens, excessive interventions in the form of equipment, pumps, etc. are
often offered as alternatives that moms can fall back on if breastfeeding is
not going well. Moms then report that she was TOLD to do xxx or yyy. This
may be correct...or it may be the last instructions she received and the
only ones she remembers!
I urge you to develop Breastfeeding Coalitions, meet and discuss cases, and
brainstorm how to best create your own "bridge"...rather than criticism,
then all can benefit - including the next moms and babies.
Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
