I totally agree with Ellen that:

"Unsolicited advice, even that given with only the best intentions,  can be
percieved as "criticism" of a person's choice or decision."

However, we have found that if we call moms with a respectful attitude that
"you know what's best for your baby, but may not have
access/knowledge/strength to reach out", many moms are VERY grateful for
the calls and the help!

We have established a program that calls the moms on day 3 - 5 postpartum -
and we say that "we call all moms that delivered at ....hospital" (which is
true, although we only call the MediCal moms as that is the source of
funding).  

We then ask how THEY are feeling - have they been able to access their
baby's doctor for appointments, their doctor to schedule their own, etc.
How was the baby delivered?  C/S? Is her pain under control?  Does she have
help?   We ask about whether they planned to breastfeed (not whether they
are breastfeeding, as the answer is often they have given up due to sore
nipples or babies who didn't "get enough milk") and how is it going.   In
other words, we try to get THEM to tell US they're having problems.

By this time, the moms are aware we are helpful, are interested, and are
willing to offer information and assistance, and the words come pouring
out...  

I've been using this method since I learned it from a La Leche League
Leader in Evansville, Indiana many decades ago - and whether as a Leader,
as a Public Health Nurse or as an LC, the statement "they have to know you
care before they care what you know" really is true!

On the other hand, Ellen is totally right:
"I think we have to save our energies for helping those who want our help."

I stress to those who call to listen with an inner ear - and this is NOT
the time to PUSH a woman who does not want to, to breastfeed.  If the
mother has decided to formula feed, we ask her why, so we can keep that
information in our files and "just in case" the reason is totally out of
the realm of truth such as "because the doctor told me I couldn't take
Motrin" (true story).  

But if she says "because it's easier" - I don't find this is the time to
discuss that it isn't...she's postpartum, and, I've decided, my
time/efforts/energy must be spent on the many women who WANT to recieve
information, not those who have decided not to.  

We do let the staff that does the prenatal classes know of the decisions
and information the moms give us, so we can try to clarify this for the
next mom.  You can't "save" them all!

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA

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