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Lactation Information and Discussion <[log in to unmask]>
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Fri, 1 Feb 2008 22:05:02 -0500
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 While I do not think there a right thing to say to all moms, I do have a general approach. First, I try to find out what her agenda really is. Sometimes a mom just isn't happy not breastfeeding and wants to give it another go, sometimes she realizes she had bad information and is fully committed to doing whatever it takes, sometimes things outside of her control happened (like serious illness post-partum), sometimes her baby is sick from AIM. The incentive is the first thing I try to understand.

I will be honest, though, that I don't go in with tons of encouragement--instead, I try to let mom talk herself into it. I ask questions and try to help her think through what her level of commitment might be. I will, as others have said, walk with the mom the whole way, but she has to choose the journey. 

It is very seductive to want to jump in with both feet and shot-gun the approach to bringing in supply when the mom claims to be fully invested. Unfortunately, it is often the mom who says she will do anything who will do almost nothing. I try to get the mom to look at who she is as a person--how she resources under stress and what would make her feel encouraged and supported, so that we can work accordingly. 

That said, it is my personal preference to shot-gun it for several weeks (as someone else also said), b/c it often brings the best results. OTOH, there is the reality of the mother's situation. Does she have other young children? Is she back to work? Is she willing/able to pump? Will she take galactogogues? In what form? What about a lactation aid? Does the baby latch or not? What were the reasons the baby didn't feed early and often? Maybe the baby needs structural support. such as chiropractic/CST. Is there a tongue-tie? If we have to teach baby to latch as well as build supply, that is a whole other issue. If baby is sick from AIM, mom may need to modify her diet as she brings in supply. There can be a lot of variables mom did not think about. I try not to overwhelm her, while also getting a handle for myself on these issues.

Normally, except when there is an obvious reason to do otherwise, I offer all the possible interventions and see how mom responds to them. Then we make a very short-lived plan to see how things go. If baby latches, my preference is a lact-aid. If not, we make changes in the bottle-feeding to move towards breastfeeding. Pumping is usually included in some capacity. I love galactogogues, b/c moms get better results faster and it can be so encouraging. I also like having mom get supportive therapies, like chiropractic. I teach mom to use a sling if she is not and teach her about co-bathing. I mix Bach Flowers for mom and baby. We make dietary changes. I tell mom that she needs to become an opportunist--creating opportunities for progress, whether that mean opportunities to pump or to feed at breast or just to re-orient the two of them to the breast. I tell her I would like her to behave "as if" she is a breastfeeding mom and I will do so as well. I let mom know that there is almost always going to be something else to try and we can do that until everything is working or she decides she is satisfied as is, or she decides to stop. 

Yes, there are moms who have physiological reasons for low/no supply. But. mostly, everything is a head game. I sometimes teach moms EFT (emotional freedom technique) or TAT (Tapas Acupuncture Technique--no needles involved). I have seen moms who "should" not be able to make much milk make a full supply and moms who could if they just would, make almost none. Because, I believe that we get what we pay attention to, I pay attention to making milk/feeding at breast and try to keep mom's focus there, too. 

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

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