Opinions please-

I am a clinic-based LC, doing mainly breastfeeding promotion, classes and
clinical postpartum consults with OBs.  Occasionally I get a call from our
sister hospital to do a consult on difficult issues (across the street) the
hospital does not have an LC on staff .  Yesterday I was asked to see a
37y/o primip, all I was told was that she wanted to breastfeed and was
having problems.  When I entered her room the baby, (a healthy 6 lb boy, a
relatively uncomplicated, vaginal birth,) was crying, intermittently sucking
his fist madly and when I picked him up he instantly rooted at my breast.  I
asked the mother if she wanted help.  She was on the phone. I waited.  And
waited.  Her conversation was of a trivial matter, she was giggling and
laughing, ignoring me and her desperate baby.  Finally, when she got off the
phone, I asked her when she last fed her baby and she said "about 2 hours
ago", she added that the nurses had "helped" (she scoffed).  I asked her if
she would like to try now, pointed out the hunger cues and she said, almost
shocked, "I can't now!! I have to decide on a name, we only discovered the
baby was a boy after it was born, we were told it would be a girl."   I
asked her if she wanted to breastfeed and she fervently answered Yes. THEN
she got back on the phone (when I was mid-sentence) and called someone and
began another non-essential, social conversation.  She basically threw me
out.

O.K. - the issues were obvious to me and to the RN in charge of her.  The RN
told me that she would like to recommend formula. My gut reacted.  But when
I got back to my office I wasn't sure how to handle it.  What I did was
recommend a social worker speak to her, and that the RN who had successfully
latched the baby try again, that failing, try formula on the nipple, dropper
feeding, and finally bottle feeding if there were no successful feeds at the
breast.

Has anyone had experiences like this?  Are there steps that I should have
followed which (in my shock and pride) I didn't?

Libby in El Paso -





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