Dear Friends:
On Wednesday, I called a day 4 postpartum mother to set up an
appointment for a well-child check-up, in my role as nurse. When I called her to set up
our visit, I asked her how breastfeeding was going. She said 'great' and
told me that her son was pooping a 'yellow-brown' stool. She'd had a cesarean
section. I was happy and eager to meet her.
When I arrived on Thursday, she was sitting on the couch, with a rosy,
lovely baby boy sucking her finger. We talked about that a little bit, about
the need for babies to nurse lots but she said she had just fed him 20 minutes
ago, and didn't seem as though she was hearing me. I said that I loved to
work with breastfeeding mothers, and that I could be helpful and that I would
love to see him at breast. Again, she declined. I wondered if she was being
modest in front of her husband.
We chatted for a while. I asked her again how breastfeeding was
going. Again, she said "Fine" and then we moved into the interview/paperwork part
of the visit. Meanwhile, baby is sucking her finger steadily and starting to
squirm a bit.
After I had been there at least half an hour, and we were talking about
lots of things very comfortably, the baby started to show stronger feeding
cues. Only then, did this mother say that her nipples were sore, and the left
one was bleeding.
She did put him to breast. He was sucking in his top lip, and stretching
her because she was holding him with his mouth too far away from her nipple.
She also needed to lift and support her breast underneath. I love it when
some fine-tuning can make the difference! I spent two hours with her, and she
was able to position comfortably herself, even on the bleeding side. Her
husband watched, and said he would be her memory if she forgets about the
fine-tuning. When I called her last night, she was happy and feeling better.
The big lesson from this situation is about women automatically saying
'fine' when they are asked a direct, open-ended question. She didn't volunteer
that she was in trouble, in pain and bleeding, until the third time I asked.
If I hadn't been there, sitting in her living room, she probably would have
ended up by quitting breastfeeding.
Maybe breastfeeding question are like feeding cues, and have to be
repeated until the best answer comes up? Maybe her pain kept her from hearing me?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative
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