Who is calling whom? Does this mother call you or do you call her? If she is an adult, owns the problem and is interested in help, I assume she's (and believe she should be) making the contact with you almost always at this point in your LC-client relationship. If you are doing most of the calling, that is a very telling point. When adult clients are "high need," Karen Q has an important point re: getting "sucked" into the mother's issues. Some of these clients may have psych dx, such as personality disorders that feed on our wanting to help but can suck one dry.
Hope no one minds if I step on what is a big soapbox for me. What healthcare provider/agency ever came up with the words "compliant/noncompliant" in terms of clients following through or not with recommended care strategies? I wish we could get rid of these words in healthcare! They are abhorrent words to use if one has the objective of empowering clients, for these words are the antithesis of that concept! The thesaurus lists synonyms for "compliant" as: acquiescent, obedient, biddable, submissive, amenable, accommodating, conforming. Do we really want mothers who "fit" this passive, patronizing term? Yuck!
People use strategies, interventions, etc. that "fit" their current reality. When something doesn't fit, for whatever reason, they will be "noncompliant." (Yuck again.) I don't think we should wonder why if they don't go along with the wonderful breastfeeding care plan developed. Rather we should ask questions to find out what barriers are interfering with making it work, share possible adaptations and then ask the client for ideas to help make a realistic plan work. We won't always agree with those adaptaptations, and we should share info so mothers can make informed decisions, but often limited plan fulfillment is better than none.
Hope that makes sense. I just think we tie ourselves in knots when the mother is the gatekeeper of breastfeeding so it is out of our hands, anyway.
Karen (but a different one)
In a message dated 12/15/2003 2:44:22 PM Eastern Standard Time, [log in to unmask] writes:
> Thank you for your input, Karen. I don't think I am ready to do that yet.
> She is still trying, is not belligerent or abusive, and I do not want to
> abandon her. I know she "owns" the breastfeeding, but she is willing to
> comply to a certain extent. I am not anxious, just a bit frustrated.
> Often "high need" clients need more attention.
>
> I am going to help her a little more.
>
> Mary Jozwiak IBCLC, RLC, LLLL, AAPL
> Private Practice
>
>
> On Mon, 15 Dec 2003 08:26:34 -0800, Karen Querna <[log in to unmask]>
> wrote:
>
> >Dear Mary,
> >You have one other option - stop seeing her- You have given her lots of
> help
> >and options , she is an adult. She needs to own the
> breastfeeding, not you.
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