Chanita,

The answer to your question <"what connecting comments could I make to her
that would help build a bridge over her anger, from her pregnant self to the
loving, nurturing mother she had been with her first two babies">, would come
from the nurse in your initial statement <"I think that some mom's need
 extra stroking, after delivery, C/S or vaginal, and sometimes even despite
the ease of their delivery.  And a caring nurse can (put) babies into those
mom's arms and to their breasts, if she can find the right approach for that
mom">. A knowledgable *caring nurse*, would most likely sense the right
approach at the most opportune moments.  It would involve patience, empathy,
and a sincere, positive manner. That's the best anyone can do. As soon as
possible - should be within that first hour, develop a rapport, help her get
comfortable, point out baby's early cues, get some skin to skin going.
Hopefully fdg will follow. I never hear myself ask a mother IF she wants to
feed her baby. I offer all the ways I'm going to help her feed her baby.
Sometimes I get a baby latched on and the post section mother was so sleepy
she barely remembers it. I point out all the positive things that happened
during that feeding. The kind of situation that you wrote about is a real
challenge. I'm anxious to hear other comments on this topic.

One hospital (> 9700 births/yr) I am affiliated with instituted a policy that
breastfeeding be initiated in the first hour postpartum. Breastfeeding
initiation is one of the competencies that L&D nurses are expected to
demonstrate during orientation. It would be nice if a hospital policy was not
needed to encourage this practice, but it is improving care.

Deborah Tobin