Cathy, bless you for your concern.  Blow me down if mom didn't ring late
today (Saturday evening) to say the breasts had been OK, but were becoming
overfull again and she needed a pump.

The baby's father brought her, but she didn't want him to come in so he sat
in the car while we tried a pump which was effective and she asked me
whether I thought she should stop all her medications because they were
making her feel so awful and start another drug which is commonly prescribed
as a galactogogue. I said I thought she should not change anything without
medical advice so she said she had phoned a psychiatrist who said yes, she
could do this, but must get someone to prescribe for her.  I suggested she
go to a private trauma centre, but she didn't want to do this and asked me
to phone her paediatrician.  She sounded so desperate, so I did.  Luckily he
was out, but his wife (also a doctor) confirmed what I was thinking, that
*her* doctor must do this and no-one else.  After this Mom told me she had
seen "her" psychiatrist twice in the last two days, but didn't like him, and
was planning to go to a neighbourng country for further help from her
previous doctors.  However, there are little anomalies in what she said and
I know I don't have even a fraction of what is really happening.  I dealt
with the suppression of lactation issues, listened to what she said, but
tried to steer her back to whoever it is she is seeing for psychiatric help.

The baby was not in the car, so I assumed he was at home with the other
children and the maid/nanny.  I regret that we have *none* of the kind of
welfare agencies that would step in to make sure the children were OK. I
explored this a while ago for an LLLL who suspected that a mom-baby pair she
was counselling were in a potentially risky situation.  We have a Social
Welfare department, but they are overworked and under-resourced and
apparently will only step in in the gravest situations, and as yet, this is
not.

We'll see what happens when she has to return the pump.

Pamela Morrison IBCLC, Zimbabwe

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