Dear Jeanette, in regards to your comment about me telling you

> what we need to
say to them.

Unfortunately, once again my message wasn't clear enough.  Please don't
interpret my words as a prescription to be telling a person to "relax", or
necessarily telling anyone anything.  I was talking about exploring with a
person 'how they are", how they feel, not making assumptions about what is
going on for them....the words used depend upon the person asking and the
person being asked and the relationship between them.  What I am talking
about is for those of us who are "helping" people to provide practical
information and assistance as required for sure and seeking ways to correct
the physical problems (as we have mentioned before - without neglecting or
avoiding the emotional aspect of the human being, recognising that our
emotional selves are intimately and intensely bound up with what affects us
and what is happening to us.   Simply asking someone how they really are, in
a way that transmits true caring about how they are, plus providing a forum
wherein they can tell you, can provide a visible relaxation response as the
issues are identified and discussed. And I don't mean by us telling them
what we think about what they come up with or any other prescriptive
stuff....(that can or could or may come later if they are wanting it).  I
would suggest that counselling (we use two lls in the English version)skills
such as reflection of feeling, clarification, summarising and such like are
useful tools to use side by side with physical fixing...this does not damage
egos and in fact, can result in the person feeling "heard".

for example, a young woman was giving up her baby for adoption. she was 30
weeks gestation and the child was the result of a violent rape.  I met her
in the delivery suite, she was in prem labour.  As we were discussing labour
and birth, whilst taking temperature etc,  I asked her how she was feeling
about everything, acknowledged she was giving the baby up and asked her how
that was for her.  I could add here that the adoption was being talked about
in whispers in handover and the rape pointed out in the notes, not actually
verbalised, the subject being taboo amongst the staff.   She started talking
avidly about her feelings, the emotional pain, the ambivalence, the need to
give the baby the best start (ie breastmilk) etc.  She seemed to appreciate
the opening to talk about a very difficult subject.  I kept reflecting what
she was saying, and asking her how she felt about....whatever.  She did all
the talking.  She came back to labour ward the next day and told me she was
thinking about changing her mind about relinquishing her baby. She had been
expressing heaps of colostrum and already had 90 mls stored for the baby.

>I well remember being under stress - my dad was dying and I was pregnant
with >my second, had a toddler and needed to get to Puerto Rico from Chicago
- if >anyone had told me that in order to breastfeed I would need to relax,
I would >have quit nursing!  I KNEW I couldn't relax!!!

Dear Jeanette, I felt total horror for your situation as described above,
such a sad and difficult time. Good on you for managing to breastfeed and
cope with it all.  I felt sad that my words were taken to mean that I would
have "told" you you "needed to relax",  I see that sort of prescriptive
comment as abusive and damaging...just goes to show how careful 'me' as the
messenger needs to be and how easy it is for me to be misunderstood, a
useful and welcome lesson.  Thank you for that.

>When moms are in this situation at our hospital I use warm compresses,  put the
>breast pump on and I NEVER say she needs to relax in order to pump

right on!

>I show her
>HOW to relax and pump.  We do deep breathing exercises, massage,
>visualizations,
>talk, cry, and make plans for when baby is out of danger.

This is wonderful stuff that you do.  What is also great is to ask her how
it all is for her, help her to express her ambivalences and her fears. This
is also when parent support groups can be so good, when they are facilitated
by someone who doesn't mind people talking about the difficulties and the
emotional swings that premature baby or sick baby parents go through.
Validating the emotions and providing a non judgemental forum supports the
mother and lets them know that feeling ambivalent does not mean that she is
a bad mother..it is a normal response to (dis) stressfull situations.  It is
interesting to me, how often mothers will say they 'feel lighter' like a
'burden has been lifted', when they are 'given permission' to say the
unspeakable.

sincerely, Carolyn