Melinda, you asked about my morning lecture.  Let me give you some
background.  I am the only IBCLC in a hospital where there are over
9,000 births a year.  I work half time, which is about 5 hours a day, 5
days a week.  IN that time, I have to help almost all the moms, plus I
am called to the children's hospital sometimes, to the gynecology ward,
and in any place in the huge medical complex where there is a
breastfeeding problem.  
AS a result of this impossible position, I have had to find ways to give
whatever I can to the most moms.  
I have a breastfeeding room where moms come to learn to breastfeed.  It
is almost always full.  I do not get to everyone, and often have to
decide who to help and whom to ignore.  
I do a lecture every morning at 7:15 for the moms and dads.  That is the
time that the babies are usually being checked by the docs, so most of
the babies are not in the room at that time.  
I call it the survival lecture.  I explain that most problems in
breastfeeding are not lack of milk, but lack of information, or lack of
milk transfer.  I explain that milk transfer is based on position and
latch, and I explain with the help of my doll and cloth breast how the
baby removes milk from the breast, how he feeds from the breast and not
from the nipple and how to position him to get the best latch..  I then
talk about what the baby feels in those first 3 days.  I really do not
believe that babies are hungry.  I think that it takes them 3 days to
recover from the birth and get used to life outside of the uterus.  I
describe it from the baby's point of view.  How would you feel if the
floor opened up under your feet and you are suddenly pulled by some
force by your head to another world where all sorts of strange creatures
are doing all sorts of scary things to your body, you can hardly see, it
is hard for you to breathe, and everything seems strange.  Suddenly, in
the fog, you hear your mother's voice or your dh, the voice that you
have heard all your existence.  You start searching for him/her with the
only part of your body that you have control over, your mouth.  I am
sure that you would attach yourself to your mother or other and stay
there for at least 3 days if not more in such a situation.  The baby is
lucky because when he breastfeeds, it is so much more than food: it is
warmth, security, it calms his stomach, cleans out his digestive tract,
etc.  We talk about colostrum and how it helps to prepare the baby for
this new world.  I think this helps the moms understand why the baby
cries every time she puts him back in the plastic box.  It is not hunger
but fear of separation.  
The lecture is about 1/2 hour.  I try to answer all the questions that
new mothers generally ask, so that later when they come in with the
babies, we can concentrate on latch and getting the milk to the baby.
If there is a mom who has missed the lecture, and asks one of the
questions that I already answered, I  ask one of the other moms to
answer her.  By the end of the day, when I have to go home, I am sure
that the new moms who come into the breastfeeding room in the afternoon
will get some help also. 
 
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
 

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