Have to chime in...I like to use the term "effective"
latch. After popping various phrases around in my
head, I prefer this one. It is mainly free of value
judgement and it is clear: is the latch
*working*/effective, or NOT working/ineffective. I
try to clearly state the characteristics of an
*effective* latch for the mothers I work with.
The discussion on breastfeeding failure has me
disturbed. There are too many variables at play (at
least in the US) to point the finger at the health
care community. As a hospital-based LC, I have no
idea what goes on after I walk out of the room at the
end of a consultation. Sometimes I meet with a mom
and baby and some minor changes and teaching results
in a good, effective feed at breast. Mother seems
pleased and relieved. The next morning, preparing for
the follow-up, I see from the nurses' notes that the
baby has been bottle-fed for the past 12 to 16 hours,
at the mother's request. Typically, subsequent feeds
at breast become progressively more difficult and less
effective. By discharge, the baby is latching
painfully (small diameter of artificial nipple) and is
strongly flow-preferenced and very impatient with the
normal ebb and flow of the breast. Mother throws in
the towel. And I can just hear it..."those lactation
nurses were NO help at all...I TRIED to breastfeed,
but it just didn't work...I never made enough
milk...it hurt too much..."
I know I am going to get blasted for saying all this.
It's just my own experience, and I see this happen
fairly regularly. It is frustrating to me, as a
provider, to see mothers introducing artificial
feeds/AIM without a medical indication, then blaming
the LC's, or fate, or the baby, or their breasts, or
whatever. My role is not to "sell" breastfeeding; I
apologize, but for every mother on our unit who is
showing she is ambivalent and wants to be convinced,
there are easily 3 to 5 other mothers who want
desperately to breastfeed and need teaching and
support. I do not like having to take this stance,
but I have to direct my energy where it is most
needed. To survive with our sanity and our souls
intact, and to have energy available for our lives
outside our lactation work, WE CANNOT TRY HARDER THAN
OUR CLIENTS ARE WILLING TO.
Standing firm and ready for those flames...
Carole Jernigan, IBCLC
hospital-based LC
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