>
>
>Another question is: could it have been that that WAS the right choice based
>on the situation at the time, but NOW it would NOT be the right choice?
>This happens a lot to me, as I see moms on day 4 - 5, and they tell me what
>the LC or nurse told her in the hospital - now I see an alert baby, a breast
>brimming with milk and what I do/recommend is very different from what the
>person that only had her for 24 hours immediately postpartum.
>
Excellent point.

I also point out to mothers who receive "inconsistent advice" that each
mother-baby dyad is different, and that the mother, who knows her baby
best, should make the decision based on what works for her and her baby.
Our job is to provide the mother with lots of options -- so there should
rarely be *one* piece of advice that will differ completely from the
next LC's, because there are so many approaches to each challenge. We
give them complete information about each option, including how to know
if it "is working," signs that require a watchful eye, when to change
the approach, why this is suggested as well as "how" to do it. I think
that some "bad advice" can come from a mother groping to figure out
"how" to do it without having a good sense of "why." This can lead them
to misunderstand the suggestion, which they are attempting to place in a
conceptual framework with missing elements. "This will help stimulate
your milk supply while your baby is learning to latch more effectively"
is an example of this kind of "why" in understandable terms.

Sometimes, I think, we feel that a mother is overwhelmed. For the same
reason, we tell pregnant mothers not to attend prenatal classes too
early or we choose not to focus on breastfeeding or coping with ppd
during pregnancy. On the contrary, I think that a steep learning curve
increases the ability to absorb information. A mother whose baby is in
NICU or has a discoordinated suck learns a lot very quickly. Every
explanation is valuable. So "provided info on reasons for... " should be
on the chart of every consult.

Jo-Anne

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