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LACTNET Home

LACTNET Home

LACTNET  May 2006, Week 3

LACTNET May 2006, Week 3

Subject:

Re: Hands on or off, skin to skin (long)

From:

Nan Jolly <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Sat, 20 May 2006 07:09:38 +0200

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (195 lines)

Sorry I was too late reading your letter1
Love,
Nan
----- Original Message ----- 
From: "Ruth Fiedler" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, May 20, 2006 1:34 AM
Subject: Hands on or off, skin to skin (long)


>
>
>
>  Hi all
>
> I would like to share my experiences with using skin to skin and a little 
> of
> My history.
>
> Pam and others ask if s2s is used for all dyads and if it only used in the
> First day or so.
>
> I do not see babies at all until most of them are a week at least and up 
> to
> several months old.  The most common age  though is between 1 week and 9
> weeks
> With mum suffering  nipple trauma.  The session begins with questions 
> about
> the pregnancy,
> birth, the early days, behaviour, wet and pooy nappies in a 24 hour 
> period,
> sleeping and feeding behaviours.  This will often help me decide the level
> of investigation and observation that I need to consider.  I also find out
> who she has been talking to in relation the baby and feeding and the
> Shallenges she is experiencing.
>
> I ask the mum to show me what is normally done to encourage the baby to 
> feed
>
> That is the starting point.  When she shows me, I ask her the types of
> positions etc that she has tried.  I point out some good things that are
> happening (no mother gets it totally wrong).  If the baby is getting upset 
> I
> suggest ways to calm the baby - the most obvious being to place the baby 
> so
> That his/her head is between her breasts.  Often the mum has a shirt up 
> high
> over her chest and at least one breast exposed so that she can show me
> clearly  what has been happening.  At this point I talk to the mum about 
> the
> value of skin to  skin and share stories of experiences where s2s has been
> helpful
> Explaining that it is most often a good place to start.  One of the most
> powerful stories is one about a mother with a 4 week old who was screeming
> and mother had badly damaged nipples who was on the phone.  English was 
> her
> second language but Dad's was English.  He was about to but formula.  I
> suggested that he did but while he was gone encourage the mum to go skin 
> to
> skin.  I explained it Mum and Dad to ensure that they understood.  Dad 
> rang
> back when it was time to feed the baby again.  I asked about how much ABM
> did they give.  Dad replied that the was still unopened and mum had had a
> pain free feed.
>
> Then I give herchoice about trying it with me there or starting in the
> privacy of her
> home.  The other stories that I share, are those experiences of mums with
> very damaged
> nipples who have been able to feed with comfort despite the damage.
> What I suggest  next is very dependant on her response.
>
> I work under the assumption that there is no need to rush the baby to 
> breast
>  I give the mum space to make her own decisions.  I explain that it is 
> most
> Important  to feed the baby and share the various ways that she can do 
> this.
>   I encourage and explain the need to express to establish and maintain
> supply
> saying that she can feed this to baby and that when she is ready at least
> her
> breasts will be full of milk and so be able to encourage baby to stay 
> there
> at the breast when they are both ready.   I
> encourage her to spend as much skin to skin time as she can with baby and
> explain that she should not be surprised to see the baby making his/her 
> way
> to the nipple and attach her/himself.  If it feels comfortable just let 
> baby
> feed - if not you can break the seal and start again or offer expressed 
> milk
> in another way.  Skin to skin certainly  can not hurt the baby or mother.
> It is always however, a choice of the mother.
>
> If she does not want skin to skin there and then, I consider various 
> holds,
> or shaping, making sure that that baby remains close to the breast, is 
> able
> to extend head, have chin touch the breast first, detach when ready.   I
> talk about creating optimal breastfeeding environments.  For some babies
> this involves various techniques depending on how well they are or 
> physical
> challenges they may have.  I personally do not touch the mother though nor
> put the baby on.  What sometimes has worked for me though is, with mum's
> permission, hold her baby and give her some examples of how she could 
> could
> hold the baby, give bub back and then let her try out different things for
> herself.
>
> Skin to skin at any age, seems to have the effect of empowering the baby 
> to
> behave instinctually and innately.  I do not know how or why it works when
> birth and the early days have been less than ideal - I just know that 
> unless
> there is something wrong the baby , baby will attach if given time.   The
> time line can be different for different dyads.  I am not sure that we 
> ever
> have a precise pathway or method for approaching all dyads because of
> cultural backgrounds, personal history, human emotions and idiosyncrasies.
>
> I can not speak personally about engorgement as I do not see much of here.
> The hospital is very baby friendly and they actively encourage baby to go
> frequently to the breast in the first days and we find that engorgement is
> less.  I would expect that in these situations though, the mother would 
> need
> to hand express till her breasts are soft enough for the baby to suckle.
>
> In relation to reluctance for mothers to experience skin to skin - I 
> wonder
> Just how much of this is cultural.  In some cultures - being skin 2 skin
> Implies some form of sexual contact or immodesty or even kinky.  Some 
> people
> Are uncomfortable with the idea for all sorts of reasons.  Being naked 
> with
> A baby is something that most people do not talk about.   LC's are good at
> Though instill cultural change, drop by drop over time.  We can share
> stories, share research and offer support to let seeds grow.  We can
> encourage mothers to talk to each other.  We can show video of mother's
> experiences eg "Mandy and Matt".  We can talk about it at antenatal.  We 
> can
> discuss it at conferences.  We can share it with HPs and get hospital 
> policy
> changed.  We can write about skin to skin through for new born, and old
> babies in child birth books, baby/child care books and in our hand outs.
> There is much that we can do.
>
> In summary - Skin to skin is appropriate for all ages as a tool for
> self-directed feeding not just the first day or 2 of life.  I personally 
> do
> not touch the mother at all to help with attachment.  Utimately  it is up 
> to
> mother what she is prepared to do.  Sometimes there is a need for mother 
> to
> create a special optimal breastfeeding environment (e.g. Shaping the 
> breast,
> supporting the hips and spine) There is no rush to get a baby to 
> breastfeed
> in my opinion because a baby will self-direct their own feeding when they
> are ready.
>
>
> Kind regards to all
>
> Ruth Fiedler
> Australia
>
>
>
>             ***********************************************
>
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