I am writing a lot today, while I await a mom's call telling me whether she
wants to continue working on breastfeeding or wants to "chicken out" and go
to abm feeding. That's not nice, I know, but my ego is bruised this
morning. I worked her into a very hectic schedule yesterday and got the
baby feeding well. I called her in the late afternoon to see how things
were going. and the four feedings of the day had gone well. She cancelled
today's appointment because everything was so good.
Then last night at 10:00 she called on my home phone (I had turned off my
bus. phone) and was in distress--engorged and wouldn't let down. I gave
her some suggestions and said that she should call me this morning. She
was angry that I wouldn't come out last night. I have been known to go in
the night, but just couldn't put one foot in front of the other last night.
I called her this morning and she said that she decided to stop
breastfeeding. We talked for a bit, with my having her see how she will
feel in a few days or weeks if she stops. She breastfed her two other
children for 3 months each.
She is talking it over with her husband and will call me back. I don't
expect a call.
Well, that's not what I am writing about. I just wanted to share my
frustration about a case that could have been so easily resolved.
_____________________________________________________
"I wish I had" case:
I worked with a mother in February and March whose baby was having a
difficult time feeding. His suck was not strong. She fed with a
supplementer for a while, as she built up her milk supply. Early on, I
suggested that she have him evaluated by my OT who works with suck problems
and who does Cranial Sacral work. From the beginning the mother would
never entertain the possibility that anything was "wrong" with her baby.
She went to heroic measures to get her baby totally breastfeeding,
including using breast compression throughout every feeding for the 5
months that she fed him.
She came by to bring me a gift last week, and baby had a strange head
device. She said that, as the months went on, his head became grossly
misshapen and he was comfortable in only certain positions. The Ped
referred her to a physicial therapist who found that he had a distorted
muscle in his neck that prevented flexibility and that his misshapen head
was a result of that. There is a new specially designed head brace that is
re-shaping his head and they visit the PT regularly for work on his neck.
If the therapy doesn't resolve the problem, surgery is recommended.
He is 6 months old and is behind in motor development skills, caused by his
constraints.
I feel certain that his suckling problems reflected other physicial
problems that could have been easily resolved in those early days,
preventing this now-serious physicial condition.
"I wish I had" spoken with more insistence to the parents and to the Ped in
those early days about my strong feelings that there was a need for body work.
I won't be as "cooperative" next time. I try to respect the parents where
they are and to remember that the baby is *their* baby. And, of course, I
don't know that they would have listened even if I had been really pushy.
I am going to talk with the mother about having my OT see him even now.
I'll bet there is something that could be done by her skilled hands that
could prevent surgery. The mother has had to finally admit that her baby
isn't "perfect" and she might continue to be resistent to my suggestions,
but I will try.
Pat Gima, IBCLC
Milwaukee, Wisconsin
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