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From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 27 Dec 2011 08:39:32 -0500
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Great posts this holiday season.  

I think that the issue with so many of the interventions we can suggest (be it talking, touching, or tools) is knowing which "intervention" to use at the right time.  While evidence tells us something about whether or not the talking, touching or tools might have an impact in a population, we have to decide which individuals in the population need those interventions and when they are applicable. Empathy is needed in order to determine whether the individual is receptive to the interventions.  Experience is necessary to make sound judgements.  

I have heard several lactation consultants recently decrying what they used to do and what many other lactation consultants are still doing.  Usually because of some set of "rules" that we thought were useful such as how to latch a baby that we come to understand may not be ideal.  Yet, the process of creating the rules and revising the rules for whatever problem we are trying to address help us understand our work in much more depth.

Rules are sometimes useful when we are learning.  I think about this every time I do my Martial Arts class because I realize that I NEED the rules in many areas of Martial Arts in order to learn.  If I had not done two and a half years of pushing front kicks with the instructors constantly reminding me to bring my knee up high first, then lead with my hips to push the kick forward, and hit with the ball of my foot I would have never gotten to the point where I can now sneak that front kick in past a hole in my sparring partner's defenses.  I still need practice with the kick, but now I don't THINK about the kick anymore when I am sparring.  I think about looking for holes in the defenses while protecting myself.  Someone in the class said you have to repeat a kick about 10,000 times before you really get good at it and I believe it does take that many times.  Practice to repetition applies to many things in life, including listening to mothers and applying the right type of intervention at the right time.  

There is a joy that comes when you have practiced something again and again to the point that you can become creative.  Depending on the activity, this may come faster or slower for some people.  I think this is true of mothers as well.  I think many  mothers that have not had much exposure to infants prior to having one need structure until they are comfortable enough handling their babies to become creative.  I think many lactation consultants in training need structure until they have enough exposure to many different types of mothers to become creative in selecting interventions that are more likely to work for THAT mother and baby.  Even the best intervention will not work if the mother won't accept it.  In these cases, we really need our creativity to dust ourselves off and modify our approaches so that mother can find a solution that works for her and her baby and not the one that works for us.

Even those with experience have to be attentive to complacency.  I fight this constantly.  Every time I become complacent and assume I know what's up, I have a client whose situation comes back to bite me the in butt because I didn't investigate fully.  

Anyway, many thanks for the many thoughtful comments this holiday season.  I am still constantly learning from Lactnet.

Best regards, 

Susan Burger, MHS, PhD, IBCLC

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