Laurie, I disagree with the LCs approach to mothers who are committed to
breastfeeding or not.  Being committed or even informed isn't enough to
handle the hospital birthing scene in most hospitals.

I work with a lot of mothers who were committed to breastfeeding, some of
whom met with me for a "preview" consultation. However their birthing
experience--from the time they walked through the hospital doors--was
programmed to interfere with normal breastfeeding. And we have to fix it
several days later.

I am not being critical of hospital-based LCs or nurses who would like to
assist mothers in breastfeeding. With current birthing practices in the
U.S. it is a rare mother and baby who find anything resembling a healthy
beginning.

There is the fetal heart monitor, the IVs, the bed-bound laboring woman,
the epidural, the pitocin, the prolonged labor, the vacuum
extraction...this is in the "uncomplicated" delivery.  Often there will be
a c-section. (I'm beginning to wonder if OBs know how to assist in the
delivery of babies any more.) So now we have the baby out.  She is drugged,
stressed, has either an elevated temp. or a lowered blood sugar calling for
other interventions.  Of course, she is weighed, blood drawn, measured and
labeled. Poor little thing doesn't know that hit her.

She comes to the mother...*after* the bath which we have painfully
discussed before on Lactet, and after the obligatory warmer because of
lowered body temp after the bath.  She is worn out from crying and is given
a pacifier to quiet her.  She gets to Mother's room and SURPRISE! she
doesn't know who this woman is.  And Mother doesn't know who she is either.
 Baby doesn't smell right, and all she can see of this baby is a face.

Baby is worn out and so is Mother. And Mother feels so inadequate and
disoriented.  This is not how a mother of a newborn is supposed to feel.
This mother has been stripped of everything that Nature offered her to
assist her newborn to survive.  All of her prenatal preparation didn't
prepare her for feeling so unlike a mother.

So, now comes in the LC you wrote about.  She assumes that the above mother
didn't care enough to make herself informed or is half-heartedly committed
to breastfeeding.  Well Tough!  She is not going to waste her time and
energy on such a case. And besides mothers of newborns can't learn or
retain what is taught.  She is certainly assuring herself a "manageable"
work load.

Maybe mothers of newborns aren't receptive to teaching.  They were
programmed to follow their instincts and know how to care for their babies.
Classroom instruction is not in the program.

But compassion and guidance and understanding are in her program. A
listening ear and assurance and praise are in her program.

Hospital nurses and LCs are at a loss to change the unhealthy birthing
practices at their hospitals but they must not write off the mothers who
may have known a lot about normal breastfeeding, but who didn't know that
they would have all of their strengths drained and all of their knowing
dismissed. They must also not write off the mothers who didn't know
*anything* about breastfeeding, but with some caring guidance and rejoicing
in this new life, they can go on to a beautiful breastfeeding experience.

I go to hospitals occasionally and am amazed at the state of the mothers
and babies.  I do a lot of listening and assuring that the mother will
arrive at the place she wants to be.  And I tell her to unwrap the baby and
place her on her chest and to uncover her baby's hands so she can touch her
mother. (Of course, I show her how to cover both of them for warmth.)  I
invite Mother to tell me about her baby. We talk a while.

As I leave I recommend that either mother or dad be with the baby at all
times--tests, examinations, everywhere baby goes, a parent goes.

Well, Laurie, all you have to do now is take the replies to your post to
your managers and I'm sure that they will see the folly of the judgemental,
underworked LC at the other hospital.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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