Hi Mary Kay -
You posted that you were having a bad day working with moms who were not
doing what was needed to make milk and coming to you for the magic pill.
You were "Looking for some tactful and productive ways to pull these
situations out of the dumper."

I work with a group of awesomely supportive physicians and went to them many
moons ago with this problem, figuring they must see same (e.g. give my kid a
pill to make her thin while I feed her the worst of fast food).  Indeed they
do.  But they are taught early in medical school that "it's the patient who
has the problem".  In other words, their job is to provide the info and it's
up to the patient to do something (or not).  

Our Code of Ethics states we "will strive to remain objective...attempt to
resolve the problem to the satisfaction of the client, regardless of whether
that outcome is what the IBCLC would have chose for himself or herself."
sometimes this means helping the mom understand the results of her choices
and leaving her to decide if a change is needed, e.g. a mom following one of
those scheduling programs (eat, play, sleep etc - you know the ones) is
seeing a decline in her milk.  But she likes the schedule.  But she wants
more milk.  Well, we can explain the physiology, suggest corrective action -
but then mom has to decide if she prefers schedule over milk.  Again from
the code of ethics "It is the mother's decision how she will breastfeed."

When a mother puts the load on us by asking "what should I do?" (translate
"where's the magic pill") it works well to respond with a number of choices
giving possible outcomes for each, state will support mom in any choice.  As
another Wise Doctor advised - "let the problem reveal itself".  In other
words, mom may need to discover for herself that pumping 4/day and taking
Reglan doesn't work - exactly what we gently said!

By the way - my experience is it's not always possible to correct supply if
damage has continued too long, even if mom becomes determined and does every
last thing possible.  Am sure there are many variables.

Joanna Koch MBA IBCLC, No Ca  

            

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html