Dear Friends:
Yesterday, I was called in to visit a mother of a month-old baby girl.
The mother wanted to breastfeed. Her baby was born early, and spent 10 days
in NICU. She was shown how to use a pump, but if she was told how many times a
day to pump, no one ever checked to see if she understood and if she was
actually pumping frequently enough. Twice, she brought her milk in for her baby,
and it was thrown away 'because it wasn't clean'.
This mother and father are refugees from Sudan, having obtained asylum here
as they would have been killed if they stayed. If she had had her baby in
Sudan, her mother and sisters would have stayed with her and helped her learn to
mother. She has no one here. She wants to breastfeed so she can sleep at
night with the baby. She finds bottle feeding very noisome.
She says she was told and shown how to use a pump, but no one ever told
her how often to pump. She pumped twice a day for a while, but gradually
stopped as her supply dwindled. The emotional impact of having her milk thrown
away was (and still is) enormous. I don't know if the emotional stress of her
life changes and this premature baby and her lack of fluency in English
combined to make her not understand a pumping schedule or if there was a gap in the
education she received in the hospital. The hospital where she delivered has
a part-time LC.
Neither she nor her husband have any recollection of anyone teaching
them how to collect milk for that particular NICU. Her husband, who drives a
taxicab, is fluent in English.
With all her cultural norms about breastfeeding, I saw a distance
between her and this baby. She doesn't like the pump. She rejected the notion of
hand expression. She wasn't interested in a SNS. She puts the baby to breast
once or twice a day. There is still milk, she leaked today. I suspect the
impact of the separation plus the lack of follow-through about her pumping and the
discarding of her milk all added up to send her hormones in the wrong
direction for lactation.
She is distant with the baby; perhaps because she hasn't had anyone
officially show her how to mother? She needed prompting to pick the baby up and
cuddle her when the baby was crying.
At the same time, both she and her husband were both perplexed about the
lack of integration of breastfeeding in the hospital. In Sudan, a mother of
a premie would be living at the hospital, and collecting her milk for her
baby.
I can't imagine what her heart is living through, having lost her home,
being worried about her family and friends that are still in Sudan, becoming
a mother in such dreadful isolation, and even loosing breastfeeding which has
become another casulty of her life changes.
I spent two hours with them, many times sitting in silence while they
talked together. They asked several times if their baby would be fat if she
kept bottle-feeding. They were ignorant of many of the health benefits of human
milk.
I don't know what she will do. I will continue to call and keep you
updated.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative
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