I think you have to start by creating the right environment so the women
gets as much rest and downtime as possible. Birthing is an exhilirating
experience! When the couple fists arrives in the postpartum unit I explain
that mom is probably very "high" and could also be sleep deprived. I ask the
partner to be the "the keeper of the gate" ie ensure she is not swamped with
visitors and the phone going. I know its an exciting time but to keep things
low key and nuturing. Unit had unrestricted visiting hours except straight
after lunch. The lights were turned low phones off, visitors out and the
women had about 1 1/2 hours to sleep or just relax. Midwives talked in
whispers and did nothing expect give mother time out. If that meant
cuddeling a babe all the better.(no doctors, maintanence folk, nobody
allowed in)

 From early evening if there was a an appropriate time for mother to nap and
babe needed a love the midwife would oblige. If you knew the mother was
frazzeled you made the time.

I also think that its very important to explain to mothers about cluster
feeding. I found that often when mothers milk was about to "come in" the
baby would start feeding frantically. This can be quiet a shock for the
already very tired mother whose baby has been quiet placid and relatively
undemanding. I explain that is normal babies often do this when the milk is
about to come in and encourage her to put baby in bed and just feed feed
feed!

If all else fails express some ebm and cup feed and cuddle while mom gets a
couple of hours sleep. Explore every option with mother other than formula.

Also remember there is father - with a little bit of gentle encouragement he
can be used to give mother time out so she does not end up in an exhausted
heap screaming for formula at 2am.

Probably as importantly as the above. The nurses must be committed to
breastfeeding. It only takes one flea in the woodplie they say!

Regards

Mandy O'Reilly RNRM

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