One of the biggest problems I find with first-time moms is the confusing set
of "instructions" that they receive when leaving the hospital - because
people are afraid no one will see them for 3 - 14 days (or more) and so
there is SO MUCH to cover - everything from breastfeeding, skin care,
umbilicus care, baths, diaper counts, sleep, waking or not waking baby,
cradle cap, car seats, cesarean incision care, perineum care, swelling of
ankles, pain control, bowel movements of mom AND of baby, etc....  NO ONE
could remember all those instructions!  Then you add the fact that whatever
we said that applied for a newborn - doesn't apply to a 4 day old - or a 10
day old - and whatever we said about the breasts at 1 day was DIFFERENT at
day 3 and day 10 - no WONDER they're quitting!

When we had a project that was as simple as having someone call with
anticipatory guidance on days 3, 7, 14, and 21, (with referrals when
necessary) we were able to answer LOTS of questions - and they almost all
admitted "I don't want to bother people" but were FULL of questions when we
called.  At first, an masters' level nurse did the calling - but in fact we
were able to answer most of the mom questions by an experienced bilingual
health assistant - who knew when to call for help!  

I know that ideally moms should have home visiting - and support - but when
budgets are very tight it's hard to add that sort of service.  The moms who
are delivering now are USED to getting their information and help (from
friends, for school, and work, etc. ) via telephone and e-mail - and I bet
if a system were devised that provided that sort of direct service (calling
the MOM rather than expecting her to call US) a lot of misinformation and
misinterpretation could be clarified and a lot of fears corrected. Even if
not everyone continued breastfeeding, I really believe a lot MORE WOULD
continue!

We need to develop a system like the La Leche League Leaders I had in the
70's - bless them!  I called them DAILY for 6 weeks - with questions about
sore nipples, jaundice, crying and exhaustion.  Without those calls, I'm
SURE I'd not be an IBCLC today!

Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

 

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