<So I have come to feel that management is really key here. Bf really needs to be something they DON'T need to worry about -- something default, pretty easy, normal, and extremely WELL SUPPORTED. If it is tough it is just going to get triaged out from these kids's lives, and in sympathy with their overstressed parents I can see why, sad as it is to me.> Pearls of wisdom, Elisheva! I find myself confronted with this so frequently in dealing with WIC moms! I find myself constantly thinking about how I can improve my semantics so as not to insult their priorities, yet add to their possible options, on their terms. Example: I was called to the front intake area by a clerk who was following her instructions that any mother who was breastfeeding and asked to be issued formula must first talk to one of the LCs. Perhaps the clerk was trying to spare her from walking unnecessarily, or maybe she just wanted to hear the conversation so she could make her computer entry sooner, but it was a pretty public place to talk. This mother was 4 days postpartum, and had come in to get formula coupons ASAP. I could see the defensiveness in her expression when I approached, and her plan and her reasons tumbled out. "I am going to continue just long enough to relieve the swelling, and then wean completely because I am going to need extensive dental work, and the medicines . . . . . . .etc." Her first child was 4, and not breastfed. Her second child was 2, and she had combined breast and formula for 6 months or more "and I didn't see any real difference in their health" I surmised that one of her main goals at the moment was to relieve her engorgement. I recommended that if she was going to do this, that it be done gradually, over a period of a week or more, so as to lower her chances of getting a breast infection. Her eyebrows went up-that got her attention. I played the economy card, reminding her that the amount of formula WIC provides does not increase beyond the amount needed for a newborn, and that she could avoid the expense of later having to buy extra on her own every month if she would keep up at least a partial milk supply. Then, I assured her that many mothers need medications for dental and other conditions, and very few meds need cause interruption of breastfeeding, and that we could look them up for her in the latest specialized reference books to be sure. Only then did I mention immunities briefly. I assured her we would go ahead and honor her request for a full allotment of coupons, but that it was not an either/or decision and that we heard from several mothers each week who changed their minds and went back to breastfeeding. I let her know it was part of our services to help. I supplied her a handout on the relief of engorgement, and tucked underneath it, I gave her the clever LLL graphic sheet on early establishment of comfortable feeding. I knew there was one paragraph on warm showers and massage for the relief of engorgment, so I was TECHNICALLY telling her the truth when I told her "Here are some comfort tips on getting past engorgement!". (I will confess that I afterward put in the mail to her three of my favorite, easy reading level sheets of Diane Wiessinger, such as "What if I want to Wean", "Breast or Bottle" and "He Can't Be Hungry-He Just Ate!") Were I to have the opportunity of doing it all over again, I would bend my knees more and position myself slightly below her eye level, look up at her and validate that when moms are experiencing discomfort in sitting, temporary swelling, and interrupted sleep, it's not a good time to make an important long-term decision, and issuing the coupons requested gives moms more time to get comfortable and think about it some more. I plan to call her in a week just to find out how (and what) she and the baby are doing. Sometimes I have to remember that "Half a loaf is better than none!" Jean ******************************* K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html