Revision for previous post re: mother's current location incorrectly stated below:  she presently resides in Trenton, New Jersey, not Pennington NJ as stated below in the original post.  

Greetings All,

With the mother's permission to post "anything and everything" of the her history, am seeking recommendations on the mother's behalf for a therapist or counselor or licensed clinical social worker in Pennington, New Jersey USA for 30 y/o mother of a 3-month-old breastfed daughter with sickle cell anemia and GERD.  Searching for clinical support for the mother's history specific to chronic depression and past but not current history of reported extensive self-mutilation; history of campus rape during undergraduate program; childhood molestation involving coercion by sister; sister was sexually abused by their father during her prepubescent years; their father was charged and convicted, served 5 years in prison.  MOB reports she was conceived prior to her father's incarceration as a strategy by her parents in the false hope that he would not be sent to prison if a baby was on the way.  MOB is a single parent to her only child, and states that her baby has "saved my life."  

MOB currently receives counseling once weekly from a social worker who comes to her home, and reports that this support is "OK".  MOB states that although she experiences joy when nursing her 3 m/o daughter, she experiences flashes of memory of her sister "making me caress her breasts," and these memories can occur during nursing sessions.  MOB is highly intelligent, well-spoken, and not yet a college grad.

I have not had face-to-face contact with this mother, as she resides in New Jersey and I reside in Florida.  MOB initially contacted my adult daughter in order to obtain my contact information in July, having had my daughter as a history professor in an undergrad course and learning that her professor's mother was an IBCLC.  Initial telephone support was for c/o ongoing breast and nipple pain following a bout with diagnosed mastitis and pelvic infection soon after birth.  Although I provided education and support with referrals to IBCLCs via ILCA's Find a Lactation Consultant in her area for a thorough breast assessment and feeding assessment, MOB went to Planned Parenthood for care but reported that a breast examination was not done by the nurse practitioner at that time, in spite of mother's reported c/o breast pain.  Breast pain has not been a recent stated concern in the two past weeks.  Health insurance is limited to Medicaid.  For those outside the U.S., Medicaid is a form of limited health care coverage in the U.S. for low income and no income recipients, and by the mother's report, Medicaid does not cover IBCLC services in the state of New Jersey.     

Information that I've sent MOB includes links to Kathleen Kendall Tackett's handouts on depression in mothers with a history of childhood sexual abuse, and the mother expressed her deep gratitude for that content.  MOB reported that prior to reading Kendall Tackett's handouts, she was unaware that mothers with a history of childhood sexual abuse can experience breast pain during lactation unrelated to any breast pathology.   More recent lactation discussions have been in response to mother's concerns re: advice from her neurologist (who treats the MOB for migraines); neurologist recently prescribed gabapentin to MOB for migraines but advised MOB that this med was not safe during lactation.  I advised MOB extensively in this regard per current Hale edition and LactMed, and also referred MOB to the Infant Risk Center.  MOB was already familiar with the Infant Risk Center during her baby's NICU stay, as the neonatologists consulted with IRC re: maternal meds during babe's NICU stay.  What would we do without these resources that are steeped in current science?  

Due to the mother's ongoing bouts with depression, am asking if anyone can recommend a skilled and compassionate therapist, counselor, or clinical social worker in the Pennington, New Jersey area who provides care to patients with such maternal histories, and who can bill Medicaid for services.      

In gratitude,

Debra Swank, RN BSN IBCLC
Ocala, Florida USA
More Than Reflexes Education
http://www.MoreThanReflexes.org

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