It sounds like this woman has an obsessive-compulsive disorder and
probably an anxiety disorder or some other psychiatric thing going.
Unless you are a psychologist, I don't think you can help her much. She
needs to see a therapist and sort out her problems. You "holding her
hand" all the time only perpetuates her dependency and insecurity. I am
not sure how you can bring it up to her gently, to suggest that she
might need some counseling. I had a patient that came to me for weight
control counseling and she was extremely needy and non-compliant. After
I reviewed her chart, I found out that she had a psychiatric disorder.
So finally after many of these "hand holding" sessions I told her that
she needs to talk to her counselor to sort out her dependency and
insecurity problems and addictions before we talk about calorie control,
etc.

Larisa Walk, RD, CLEC

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Julie Johnson
Sent: Thursday, August 07, 2008 11:08 AM
To: [log in to unmask]
Subject: High detailed mom

I am working with a client that is very detailed oriented. So much that
she charts everything. She reads everything and she writes down
everything I say. She also mentions every minute detail of stooling,
wetting and feeding times and amounts and either it was
formula/breastmilk, etc and wants to tell me every detail when we are on
the phone of what is in her chart. I must be too laid back because this
is driving me mad, yet she really wants to do this and I really want to
see her succeed. How do I help her when she is so book detailed and I am
a more listen to the baby, go from there kinda girl. You can't learn
about your baby from schedules and charts and even books but she claims
that her charts and schedules are helping her. She calls almost 2-3
times a day because the baby or the situation changes and since what I
told her last time or her books don't tell her what to do next she gets
stuck with how to proceed forward.  She may be sleep deprived. She may
be just like that and learns better from text then intuition.  IF I told
her I need to come up to her and stay with her several mornings a week,
she would go for it. If I told her to do XYZ she does it but as we know
in lactation you tell a mom XYZ and she gets it and it may apply for the
next week or two or forever. I am telling this mom XYZ and it seems to
only help her for 3 hours. She may get tired of what I suggested and
wants a new approach. I am running out of fire in how to help. How do I
turn this around and how do I get her to figure mother intuition stuff
on her own?  
Another example is I discussed when I was there a couple of days ago
regarding emptying out the breasts effectively and often throughout the
day. I mentioned it was at least 8 times a day. I failed to put that in
her care plan and she did everything else I wrote down to a tee but did
not feed her baby 8 times at the breasts and now she is wondering what
happened to her milk supply as if it was my problem...  Maybe it is
because i didn't write it down and I didn't realize she takes everything
very literal.   
 ..
Julie

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