I have developed the following strategy for talking to NICU moms when they
tell me how many times they're pumping and I know it won't be enough. I ask
them "What percentage of your baby's milk do you want to make? Do you want
to make enough for a couple feedings a day, or half the feedings...?" (I go
low to try to give them "permission" to answer with a low percentage.
Obviously there is still a social pressure where they know that I'm the LC,
but I do my best.)

Most of them say some version of "All of the feedings, I want him to get
nothing but my milk". I say "OK - right now you are pumping enough to make
about [half, a third, etc.] of his feedings. To get 100% you will need to
[get up at night to pump, pump more often during the day, pump while you're
at your mom's house, etc.] You can set how much of your milk he gets by how
much you pump." I sometimes say "I can't change the biology - I would if I
could! This is just the way it is."

Then I try to ask "What is making it difficult for you to pump?" These are
moms with lots of barriers - we can say that if they are just "choosing"
not to pump but that ignores the barriers that constrain their choices. I
ask that to make the assumption that they would pump more if they could and
send the message that I am here to help them problem solve.

I don't know if this is the right way to approach it. But I wanted to frame
the pumping not as "you must pump 8 times a day" but as "what are your
goals and how can you reach them". I liked Jillian's lines a lot!

Rebecca

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