Hi, Mardrey:  As in other situations where no one is really sure how
breastfeeding is going to play out, I give mom the information that I've
researched, telling her no one can predict what will happen, while
reassuring her that she can nurse her baby.  She just might not be able to
exclusively feed her baby from her breast.  I encourage her to begin
breastfeeding and to keep an eye on her supply.  If it appears she is not
able to make the milk her baby needs, we can talk about ways to supplement
her baby.  I review all options with her, help her select a method that she
feels comfortable with, and follow up with her, modifying the feeding plan
as need be, based on how well she and her baby do with it and how
comfortable they are.  Remember it's not exclusively about nutrition.  Help
the mom feel good about breastfeeding and feeding the baby and she will
continue for a longer period of time and report much more positive feelings
about her nursing experience.  It's not about breastfeeding at all costs.
This particular mom may not be able to produce the milk her baby needs
because of her medical history - that's not something she can change, so
it's the LC's job to help her and her baby achieve an enjoyable nursing
experience.
A personal note here.  My oldest daughter turned 24 last Tuesday and
graduated Friday with honors with her doctorate in Occupational Therapy.
It was truly a multi-hanky day for me!  She is interested in specializing
in pediatric feeding issues, but not sure she wants to do children as young
as babies - I'm working on her!

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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