Ann,

        You are teaching way too much to the early postpartum moms.  I did
hospital postpartum lactation consulting for 5 years and have been a
postpartum nurse for almost 14 years.  The bottom line is that the early
postpartum mom is not teachable.  What she needs is support.  I remember my
old maternity nursing text which stated something like this: the new mother
needs to be mothered for at least 2 days postpartum.  I forget which culture
(Kathy D. may know), but there is one culture in which the new mother is
cared for for 21 days.  I've tried many different techniques to help mothers
retain info.  What I found to be the most effective was the following:  I
first tell mom she made a great choice for her baby.  If she has been having
a difficult time and is a primip, I tell her that many things in life that
are done for the first time can be difficult but once one learns the correct
techniques, things often go well.  Please forgive me if I offend anyone, but
depending on the mom (i.e. culture, etc.),  I will often say - "geez, I
would have given up sex if I passed judgement based on my first experience".
You may think I am crude, but this has made lots of sense to many of my
patients and they have stayed with breastfeeding.  Humor works really well
as these moms are totally overwhelmed with all that is going on around them
(especially the primips).  I give basic latch-on instruction, tell mom to
attempt nursing at least 8 times in a 24 hours period, give signs and
symptoms of  appropriate newborn intake, AND, most important, the phone
number to the lactation clinic.  I alway tried a latch-on.  This is where
the visual learning comes in.  They need to do this with their own baby --
not a doll. I tried dolls for awhile and it was useless.  Dolls are for
prenatal learning-- so my advice is to leave the doll in the box .  The
nursing staff were really helpful in letting me know when feedings were due.
I would then prioritize my list.  My rounds were always done in several
segments of time with each patient.  For example, I would go in one room and
teach about baby intake and output; then leave, and go in another room and
assist with a latch-on; go on to the next room and latch a baby, and go back
to the second room and listen for swallows, etc.   It was sometimes like a
15- ring circus!  The nurses would help out too.  The breast feeding rate
increased from 50% to over 80% within the first month that in-patient
lactation consulting was started.  I believe they have stayed at least over
75% since.  So, it makes a difference.
        Too much info is a big turnoff.  New moms need to know breastfeeding
is not a difficult thing to do.  The phone call within the first 72 hours of
discharge is very important. This is when mom is ready to learn more.  We
have our moms come to a mother/baby follow-up clinic within the first 72
hours.  Mother/baby couples are seen by an RN/LC.  If there is a problem,
they go directly to lactation clinic and continue being followed as needed.
So, in a nutshell, what I am saying, is postpartum in-patient rounds are a
PART of the big picture of breastfeeding learning and support.  They should
be kept short and simple, filled with lots of support and encouragment.  The
goal is for moms and dads to know they have a place and person to come to
with their breastfeeding questions and concerns -- that they are not alone
with this new experience.  Good luck with your work and feel free to
privately e-mail me if you have questions.

Donna Zitzelberger, RN BSN IBCLC