Hello,
I'm a volunteer breastfeeding counselor in Philadelphia, PA. I would like
to ask for advice from others who support bfding mothers, about what I
should do in my current situation. I am really worried about a particular
mom/baby dyad.
I have a counselee that has a 6 week old baby. The mother is an immigrant
from Asia, and we have a bit of trouble communicating in English, but
mainly I think the gap between us is related to cultural differences. As
discussed in archives, this woman is one of many Asian women in the USA
who believe that the baby should not be breastfed until the milk supply
matures.
So, as a result, she insisted on bottles while in hospital.
The baby did go to breast on day 3, but mother reported that she didn't
have enough milk. And that it hurt a lot. Yet, she said she REALLY
wanted to breastfeed.
I supported her in this decision, and also tried to very strongly but
politely suggest that a) she would make enough milk if she'd lay off the
formula and b) that it's not supposed to hurt and that she needed help
with latch & positioning.
The mother told me that the latch was fine, that her mother had come to
stay with her for a month from their home country (and her mom had
breastfed 6 children) and that the problem was with her breasts. They
didn't make enough milk and so the baby had to suck too hard in
frustration. Furthermore her sister had had the same problem -
genetically they were not able to produce milk. (!) She was extremely
polite the whole time.
I didn't want to be "rude" by contradicting her, so instead I tried to
gently suggest another way to look at it-- that the baby was having some
trouble for some reason getting the milk out of the breast, perhaps it was
the way that he was sucking that was causing the discomfort (after all, he
could be nipple confused, for sure)... But she kind of politely told me
that the problem was also just the size and shape of her breasts, and that
her nipples were flat.
At that point, I began to think I was out of my league in helping her over
the phone, and that it would be better to have her see an LC who could
really evaluate the claims the mom is making. Maybe do a before and after
weight check to see how much the baby actually was taking in at a feed.
But when I suggested an LC to the mom, she flatly said she didn't need
one.
So, off and on, for the past 6 weeks, I've been calling her to provide
some support, but I am finding it increasingly difficult as the mother's
soreness gets worse and worse, she gives more and more formula to make up
for the lack of milk production... and she seems really depressed and
unhappy. I feel ineffective and like my calling her might just be putting
pressure on her to continue breastfeeding when she might really want to
quit. And, without the appropriate interventions to manage breastfeeding
comfortably, it's no wonder. The baby is unhappy, crying a lot, wants to
nurse every hour, but doesn't seem ever satisfied at the breast.... I
think milk transfer is not happening right. I can't say for sure because
I am just a telephone counselor and I have so much trouble communicating
with the mom.
So my question is, what should I do now? Keep calling and bite my
tongue when I want so badly for an LC to assist this mom? Stop calling
and let her be? I don't think she has much support and I am worried that
she is getting depressed and that the baby is not getting well nourished.
Thank you for listening- It feels good to have written out the problem!
Pam Chaplin-Loebell
* Feeling sad and frustrated in rainy Philadelphia and also not having a
very good day for other reasons
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