I've been following the lively exchange on various philosophies in
helping breastfeeding moms. Like many others, I have developed my own
opinions and philosophies of baby-rearing and breastfeeding counseling
over the years. But, the most important thing that I have learned and
continue to learn is about flexibility. My tool chest used to have a
limited selection-- I am glad to say that selection has expanded over
the years, mostly because sometimes my tools just couldn't solve the
problem. Change............. is hard.  What has helped me along is
dealing with "fringe" babies who just don't fit the norms. Helping
mothers with fringe babies sometimes requires breaking the rules that I
have been used to. Rules tend to apply generally to groups, but rarely
apply effectively across the board. Whether it's swaddling or herbal
teas or touch-help or non-touch-help or syringes or SNSs, we need to be
open to having many tools for those special situations because no one
tool works well on all babies.

When it comes to swaddling, I have moved pretty far away from that for
the many reasons that have been posted. But on the other hand, I am glad
for the reminder, because there *are* babies who benefit from such an
intervention. This past summer I listened to Nancy Williams talk about
Sensory Integration Disorder-- the bottom line is that these kids may
need more of one kind of stimulation and/or less than another. I
realized as I listened that I do not always pick up on such needs, and
that I need to explore more options with some of my harder babies. I
need to stay open.

I have also learned, sometimes the hard way, the wisdom of providing
information vs attempting to persuade. While I believe strongly in
mother-baby attachment, I also know that I am often in the minority. If
I try to change a mother's outlook and she senses the pressure, it often
results in her withdrawal and more guardedness. When I show her that I
value her goals and do not judge her choices, then she often is much
more open to other ideas. Do I like early use of bottles for the sake of
dad and grandma feeding the baby?  Nope.  I usually try to address the
"how do babies bond to people" to show that feeding is not the only way
to bond. But, if that is a perceived need on the part of the mother, I
give her guidance on the best way to do this while preserving the
breastfeeding relationship.

I have a mother with twins whom I have worked with for 6 mos. There were
some milk supply struggles and latch issues with one baby. This mom was
high strung and used to having her space, and was overwhelmed at the
idea of having all the nighttime responsibilities for the babies. I
explained to her the ideal plan to get everything on track, and she did
her best. Mom could not pull off everything I would have recommended,
and in fact had I been strong and insistent, she probably would have
thrown in the towel. I had to work within her world and what she felt
capable of at the moment. I count this mom a success-- though she never
reached exclusive breastfeeding, she surpassed her early goals and was
thrilled with herself and her babies. Is that not the most important
thing?  The best part is that if these moms have more children, they
often have learned well from their experiences and go on to have greater
breastfeeding/mothering success in the ways that I would personally
define them.

Lisa Marasco

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