Becky,

I feel your pain :-)  At Miami-Dade WIC we call this the "no se llena
story".  "No se llena" (pronounced 'yenuh') is Spanish for "he's never
full" or more literally "he doesn't fill up".  Basically it's the
Hispanic variation on perceived milk insufficiency.  

I can't think of a specific handout in Spanish at the moment, but I can
offer a few suggestions:

1) Newborn stomach size.  Many believe their newborn's stomach to be
much larger than it actually is.  When they realize that the baby can't
handle that much food at one time, the frequent feedings make more
sense; use some sort of visual to convey this graphically.  And REPEAT
yourself on this one.  Say the same thing 3 different ways.  Then make
the connection for them between colic and overfeeding.  "When will
baby's stomach be bigger?" she'll ask you.  "HE will know," you reply.
"Watch him and he'll tell you. It's not a sudden change but rather a
gradual one."

A corollary to sharing the concept of newborn stomach size is how
quickly breastmilk is emptied from the stomach.  "Baby is hungry sooner
because your milk is twice as easy to digest.  Better for him, but yes
it does mean you'll be nursing frequently."  (Point #7 fits in nicely
here.)

2) Culture: where did they come from?  Was breastfeeding the norm in
their family, their town, their community?  Were they themselves
breastfed? If so, for how long?  Did they breastfeed their other
children in their home country (and how long)?  Did their mother or
sister or cousins, etc?  If so, which is often the case, then simply
REINFORCE WHAT THEY ALREADY KNOW.  I guarantee you that if they
breastfed in their home country, and did so for an extended length of
time, that they breastfed on demand and very frequently, around the
clock.  One told me she didn't even HAVE a clock back home.  Whenever
the child whimpered, she popped a breast in his mouth.  

It's this abandonment of what they already know about breastfeeding that
personally makes me the most nuts, as an LC.  I often tell my clients
that I was born and raised here (to Cuban parents), and I love this
country, but there are things that we don't do quite as well as other
countries, and infant feeding is one of those things.  "Your country
knows more about how to breastfeed than mine does."  The problem here is
that OUR way of life is something to which they aspire.  They want and
expect to change their lifestyles.  I'll point out something about how
they parented in their home country and some will admit, "Oh yes but
things are different here."

3) Get "abuela" (grandma) on your team.  Their mothers are a huge
influence on them.  If their mother is here in the US with them, then
HER desire as to how her grandchild will be fed is hugely influential.
She will push for what SHE thinks is best - breastfeeding or formula
feeding.

4) Remind them that babies need holding, and that they ask to nurse not
just for food, but for love and comfort as well.  Point out that often
when a baby wakes up looking for a breast soon after being laid down (a
common complaint), it's BECAUSE he was laid down, not necessarily
because he's still hungry.  Perhaps he is, and if so no problem; just
nurse some more.  But either way, nursing is how baby wants to go back
to sleep again.  Hold him longer before laying him down or nurse him for
a few more minutes then lay him down.  Advise them not to mistake a need
for MOTHERING-by-breastfeeding with a lack of breastmilk.

5) If they want to "count" something (like ounces in a bottle) tell them
to count diapers instead.  It reassures them.

6) Deal with the work issue.  They may be anticipating going back to
work and not know how to continue breastfeeding once they do.  If they
have hope of being able to work & breastfeed they may not give up on
breastfeeding so easily.

7) Lastly, the concept of sacrifice.  This has to be brought up
carefully but many Hispanic moms see sacrifice as a normal and expected
part of mothering. They expect to have to go beyond their comfort zone
for their kids. Remind them of this (if you are comfortable doing so).

That's all I have the time for now, but I hope it helps!



Regina Roig-Lane, BS IBCLC
Miami-Dade County Health Dept
WIC & Nutrition Breastfeeding Program
7785 NW 48 St., Suite 300
Miami FL 33166
(786) 336-1333 x162

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