Margaret makes some  very important points:

" She is already the expert about being blind -- ask her how she deals with other daily skills." And
" How important is the pump/bottle in the daily routine right now?"

I worked with blind mother a *very* long time ago.  I found some info then via La Leche League, but basically this young mother was very comfortable navigating her own world and had already thought through many important parenting issues.  We did not consider pumping at any stage.

Just love the teaching tips Margaret  shared - this post is a keeper.

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa



-----Original Message-----
From: Lactation Information and Discussion <[log in to unmask]> On Behalf Of Margaret Wills
Sent: Monday, 28 February 2022 17:33
To: [log in to unmask]
Subject: supporting visually impaired dyads -- blind mother --

Hi Leah;
Adding to the previous post:

Sometimes it helps,  with counseling a new family with less common physical anomalies affecting breastfeeding, to discuss how much common ground the family is on.  Along with targeting their special concern, they can also feel that they are grappling with the information and practice everyone needs.  *All* new breastfeeding parents feel overwhelmed, and everyone is figuring out how to get a comfortable and effective latch (often the same thing). All new families need a lot of practical help around the house in the early weeks -- does she have any resources to draw on?  All new parents are empowered by being around other breastfeeding families that seem like themselves.  Can you help her find support groups for parents who are also blind?

She is already the expert about being blind -- ask her how she deals with other other daily skills -- cooking, getting dressed, brushing her teeth? *Everyone* hates all the fussy little parts that pumps have -- would laying the pieces out to dry in a particular order help her reassemble them? Could any tactile notches be added to help align parts and dials?   In the assembly/pumping practice sessions, move the flange from side to side, so she has a sense-memory of how it feels when the nipple moving freely, not rubbing on the sides.  Can she hear milk dripping in the bottles?   Can she use big bottles so she doesn't worry about overflowing them?

How important is the pump/bottle in the daily routine right now? Do they have a term baby able to breastfeed well?  Should feeding at the breast be the skill to work on first, to help her feel competent and connected to her child?  Mothers and babies are feeding as much by feel as sight, and they did it in dark caves at night for a long time.

In recent decades, LCs helping with latch encourage all breastfeeding parents to lean back a bit and use gravity to make both bodies secure and stable.  And to start with smart little baby mammal upright and wait for them to organize and start the search, and then keep the baby in contact while helping them search down the mother's body.   If she experiments with a feeding pillow, to remember that her body remains the contact point.

Someone who is blind tends to have a strong kinesthetic sense of their own body.  Describe the deep off-center "sandwich" latch. One good teaching tool to convey this to any parent -- have them plant the base of their thumb on their chin, with the thumb up past their nose.  To reach the thumb/nipple, they would tip their head back,  drag their lower jaw, and the thumb's base/areolaenters the mouth first and the thumb/nipple flips in last.

If the mother pushes her own head, she can see that it curls the chin into the chest -- not a good way to eat! If she's supporting the baby's shoulders with the neck/base of the baby's head in the web between thumb and forefinger, the baby's head can hinge back.

Can she feel the baby's chin on her breast and the nipple under the baby's nose?  With the supporting finger by the baby's ear, (or slipping a finger up under the baby's chin from the hand supporting the breast) a mother would be able to feel that slow, jaw-dropping suck, and to listen for the steady swallows and feel the breast softening, and judge whether it feels like a big, comfortable mouthful.

Everyone is worried about whether the baby is getting enough to eat, so diapers and weight gain are monitored carefully for the early weeks. 
Maybe a few pre-and-post weights would encourage confidence. Once a baby is gaining well, they will certainly not be polite about making sure they get enough.  It's healthy eating habits for a baby to learn about their own body and eat when they are hungry and stop when they are full
-- we don't measure how much we as adults eat.

This is turning out to be a long post, and full of information that you and other readers already know -- so maybe the note was just affirming that you already have so many good tools for helping this new family!

Good luck to us all.

Margaret Wills, IBCLC, Maryland, USA





> Date:    Fri, 25 Feb 2022 12:22:31 -0500
> From:    Leah Rae Jongsma <[log in to unmask]>
> Subject: Supporting visually impaired dyads
>
> Hello all. My team and I have been trying to support a dyad where the mother is visually impaired, she is completely blind. The mother does not have support at home and she struggles with getting the pumping parts aligned on her breast as well as knowing if baby is well latched or evaluating the quality of the feed. It's an incredibly complicated situation that I know is very uncommon, however it made my team and I realize how little knowledge we have about supporting visually impaired families. I was looking for any information or education from this group about ways to support lactation in visually impaired parents and any adaptive devices that could be helpful.
>
>               ***********************************************
>

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