Dear Debbie,
I can empathize as I recently went through a very similar situation; so
sorry.
You wrote, "After going through years of infertility treatments and
miscarriages, she now has her precious baby in her arms and I get to rain on her
parade by telling her that one more body system is not functioning as it should. I
guess I didn't realize that my dream job would sometimes include being the
bearer of such bad news. Maybe I thought that privilege was reserved for
M.D.'s. "
I recently made a home visit for a mom and her 4 day old baby, and as I sat
next to her, before she even removed her shirt, I could see very small, widely
spaced breasts, and my heart sunk. Mom was referred by her pedi for infant's
weight loss, but felt it was a latching problem. Palpating her breasts, I
felt minimal ductal tissue. Based on her history of inadequate breast
development, no pregnancy breast changes, no feeling of fullness and baby's feeding
weight of neg 6 grams post 10 min of valiant sucking, no swallowing, I shared
information on PCOS of which she had symptoms, but also let her know the jury was
out at this early stage of the game. We proceeded to follow "rule number one"
and fed baby with supplementer at breast.
Amid her torrent of tears, I patted her, telling her I was so sorry and let
her emote. One thing I said to her several times was that she needed to grieve
the loss of the "perfect" breastfeeding relationship she'd envisioned. I
informed her of all the benefits of breastfeeding with supplementer, also and
reiterated rule number one and ways in which she may be able to increase milk
production. I left her still crying with her husband (who was visibly angry at
me). As I drove away, I hit the steering wheel a few times and swore out loud
on the way home.
I went home and ranted and raved that her OB had seen those breasts and knew
her hx and never raised the possibility of supply issues. I felt angry,
helpless, and frustrated but when I called her later that evening to see how she
was and ascertain baby being fed, she said she was sad and realized, as I'd
said, that she had to grieve this loss. I think that acknowledging this fact was
helpful for her and letting her know I was there for her to listen and allow
this process. I called her a couple of more times then respected her wish to
work on things alone for a bit and a week later saw her again to follow up;
best of all she came to my support group yesterday and will continue weekly with
group. There's more to her case but mostly I'm responding to your feelings of
"being the bad guy" and acknowledging that yes, it is hard, but often
standing by someone and taking their anger as normal and knowing it's not really you
but just a "don't shoot the messenger" kind of situation. So, Debbie, call
her and simply let her know you're available and that she can call you when
she's ready.
It isn't you she's angry with really, as you know. She has a right to be
angry and sad, acknowledge that to her. Please let us know how things progress
and feel free to email me privately should you need to emote and discuss your
feelings further.
Warmly,
Barbara Latterner, BSN, RN, IBCLC
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