You know, this discussion has gone on and on about how bad this
intervention is and how bad that one is and how different home birth is
and we have talked about the validity of literature as well. We are
beating a dead horse here, colleagues.....................We are also
preaching to the choir!
We all come from different institutional environments,different walks of
life, some here from countries other than the US, and we all bring our own
family backgrounds and experiences as well.Like us, our clients all come
from these dissimilar backgrounds. Cultural practices can also make a huge
difference. Talk to some of the LC's on this board from South Florida, for
instance. I have learned a terrific amount about how different cultural
practices are even there.
We are never going to have the perfect breastfeeding world. We are all
going to have sitautions that bother us. We are always going to think it
was Dr.X or hospital X that screwed up the baby's breastfeeding. It
probably was Dr. X and the hospital, but there is absolutlely nothing we
can do after the fact. I could go on and on. So, let's pick up the pieces
and help the mother to start from NOW.
We are never going to be able to change the climate of OB care completely..
We are never going to be able to fight the formula companines and be
totally successful. I think we all know that. This to me is a good example
of the expression "...you can't fight City Hall." There are always going
to be situations that are beyond our control to a certain extent. As I
said once before (and as I tell all my mothers in breastfeeding class and
at the bedside as well), babies do NOT always read the guide books.
As LC's,we have a terrific amount of power, really, to start each baby and
mother off with as much success as we can. We just need to take that
couplet where they are now, right now, forget yesterday,forget the
interventions and put aside what didn't go right and concentrate on the
now. So they had a low sugar and had to have formula.....let's put that
behind us and work with getting that baby to breast now, so he will do
well and maybe he will breastfeed for a year or two. We cannot change what
a neonatologist said to a parent, but it is now, and Mom wants
breastfeeding to go well and so let's concentrate our efforts on something
that we CAN control.
I have just closed a VNA case (yesterday) with one of our own babies who
was readmitted to us 2 days after D/C with a high bili. Not only did I
have a mom and baby with the potential for an ABO set up, but the baby
didn't breastfeed well from the get-go. The infant had a significant
weight loss. It was one of those things. So, who's to blame here: her
c/section, her small breasts that made latching difficult, her blood type,
her baby's blood type, the fact that she had a pretty flat affect and
needed to be more assertive, the need for phototherapy, the pediatricians
(who are really pretty breastfeeding friendly) or what? What or who shall
I blame here? All of those factors are water under the bridge right NOW. I
needed to take this baby and mother where they were: whether it was when I
was still working with them during her initial admission or at the time of
re-admission. It didn't matter what happened before, because I needed to
deal with NOW.
Long story short, regardless of what interventions the baby had to have
during both admissions, the baby finally went to both breasts effectively
and is now being exclusively breastfed. This is at day 16. This happened
in spite of the doctors, nurses, phototherapy, small amounts of formula
the baby had before Mom's milk supply caught up, and any of the other
myriad of interventions that may have had to happen.I don't know because I
wasn't there 24/7 and lots can happen.
The point is I probably could have sat around and bemoaned all the
problems this baby had had and what might have caused them. But the
parents are already stressed enough and don't need me telling them what
should not have happened. I took this baby where it was at the time. We
put away what happened last week, yesterday, an hour ago, and concentrated
on the now and the mother's desire to breastfeed exclusively.
I guess I am also feeling that I think due to our collective efforts or
not, many babies go on to breastfeed exclusively despite what heppens to
them in the early days. Let's concentrate on helping the mothers to be
successful. It will be because of consumer breastfeeding success and
consumer demand that changes will maybe come and force OB's, pediatricians
and the formula companies to back off a bit.
We are never going to get to everyone and we have to accept the fact that
some mothers just do NOT want to breastfeed and really don't care about
the nutritional benefits of breastmilk. There will be others who
exclusively breastfeed for only a few weeks or months. Who cares as long
as the baby has had some benefits of human milk. They are still better off
that those babies who didn;t receive breastmilk. All we can do is spread
our knowledge and expertise to as many mothers as we can through classes,
WIC, articles, you name it.
Think how many children would be at even higher risk if it weren't for
LC's all over the world........................
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