I think that there are a lot of reasons for people's hostility, and if this
is the case on the NICU listserv, it is sad, though  not unexpected.

When people are aggressive, it is usually because they are feeling
defensive.   I have given a lot of thought to this issue.  The defense
mechanism comes into play when are uncomfortable with something we are
doing, thinking, saying,..when it does not jibe with what we know to be the
truth...also when we perceive that we are being attacked.  There is an inner
conflict.

In many settings, and in some NICUs, there are often practices used that are
not current or research based with regard to breastfeeding...I believe.  I
knew  of one nurse who wanted to do LC work in a NICU in another state.  She
was told that her ideas were good on how to get baby to breast, etc, but
that there were several nurses there who had worked there for 20 years, and
well, "you know...they have their own ideas...ha ha ha."  wink, nod, look
the other way.....humor the staff who are practicing in outdated ways with
regard to breastfeeding.


This idea of winking, nodding and looking the other way as breastfeeding is
laid down at the altar of ignorance would not be a defendable position if
the same approach were used in, say, a diabetic clinic.  Can one imagine
winking and smiling at a professional who inSISTed on using outdated
practice with regard to juvenile diabetes teaching?  Well, it might hurt the
diabetic who needs the teaching, or it might not help them to live to the
fullest level of their existence, but , *wink, nudge* you KNOW how it is, we
wouldn't want to get behind the latest teaching and require the staff to all
be up to date, because that would offend those who have been using those
outdated techniques, and no one wants to go THERE, down that road.  To heck
with the diabetic who needs the help. Right? Wrong!

Is this position defendable, professionally?

In what other discipline would we allow ourselves or other professionals to
use outdated information or techniques to help our clients, in the name of
protecting our colleagues who do not wish to learn and change their practice?

Sigh.

Can you tell that this is one of my hot button issues?

I have also seen many folks demand for research based practice before they
change practice, protocols, etc.  These are the same people who have NO
evidence to back up their own practice, but who stubbornly refuse to change
their own practice, to update, etc.  The reason for this, I think, is that
breastfeeding is a singular issue. It is a woman's issue that strikes deep
to the bone.

When we support another mother in a mothering practice as important as
breastfeeding, we are forced, either consciously or unconsciously, to
examine our own parenting, our own mothering, and our own beliefs.  This
examination is painful for some, and hence the professional stubborness and
pain when we might have to admit that what we might have done with our
families, our babies, etc, might not have been the best choices...

Off the soapbox.


Kathleen

I was on another list serve for NICU nursing since I wanted to be more aware
of NICU issues. I do LC work for our 12 bed NICU. When I posted to that list
regarding Breastfeeding the preemie and advocating strongly for these moms to
BF I was percieved by many on that list as pushy(probably as more than
pushy). I was basically talking about informed consent and educating
regarding the difference betwen breastmilk and ABM and then encouraging the
mom to at least commit to expresing EBM as a start even if she didn't think
she wanted to "breast" feed.
When the discussion got heated it took me by surprise at how I was looked
upon. It felt like the same feeling I get when I know I am not always a
welcome person in the NICU (depending on who is staff that day).
Interesting how the NICU staff many times feel like we are too pushy and the
majority of the mothers that I have worked with felt totally thankful for the
support.
Jane Ciaramella


Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont
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