Today I made a f/u call to the mom who felt bf was going well on Wednesday,
but I didn't. To recap: It wasn't a serious situation but the mom had very
red nipples and some areolar bruises where baby had latched in the wrong
place. The baby was sleeping at breast, not really latched, and mother only
wanted to use the cradle hold. Today, she was doing pretty well, other than
still having some nipple pain and using a sample tube of lansinoh that she
had, and she reports she is using the football hold now. Wets and dirties
happening fine and her breasts are full. We reviewed the latch stuff and I
recommended she call me if her nipple pain or trauma is increasing rather
than decreasing.

I appreciate the posts on counseling skills. I do agree w/ Barbara that
establishing some rapport first is impt.,  esp. asking about the birth
experience. It is very impt. if possible to act like you have all the time
in the world (when, in fact, the LC in a hospital setting has serious time
constraints) when you make your visit. I liked the song about not judging
and offering suggestions. I also appreciate the post about the tenacious LC
who was a little bit assertive and was instrumental in getting the mother to
stay w/ the bf. It's always a fine line to me.

On a related note, many many mothers state they will be doing breast and
bottle. They are bf once or twice a day and giving formula the rest.
Sometimes they had bf in delivery first or attempted, then begin formula.
More often they initiate bf after a night or day of formula feeding. I
usually have many of these each week. Here is a situation where counseling
skills and meeting the mom where she is can be difficult for the LC. But the
song DO NOT JUDGE would still apply and the "many mothers have found" would
work too.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

_________________________________________________________________
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