Nikki Lee writes about a Mom's reluctance to allow her to assist
w/breastfeeding during a postpartum visiting nurse visit.
Having worked as an MCH home nurse and supervised/assisted staff in regards
to the breastfeeding portion of this care, I developed a slightly different
approach . It was the philosophy of the agencies for which I worked   to provide
breastfeeding support on each visit for all breastfeeding mothers. This means
that a feeding was observed for every primip and most multips .   Most mothers
had the expectation that a feeding would be observed (probably delivered by
the hospital staff ).
However,during the telephone call to set up the visit I would address those
that didn't by routinely explaining the service to be provided and asking the
mom "will the baby be ready to nurse at such and such a time?" , this was a
segue into further explaining that we would need to see the baby at breast as
part of the assessment. This avoids the "he's not hungry now" excuse and prepares
them for a breastfeeding focus. Mothers are very invested in "doing it right"
thus for some, bringing up their difficulties makes them feel inept.   Making
the care seem *routine* allows the inevitable assistance to evolve naturally.
It also saves TIME, necessary when expected to perform many visits a day.

Lynn Shea Rn,Bsn,Ibclc
formerly Franklin, Ma.......now Lakewood Ranch, FL

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