Hi, all -
Guess I'd better re-introduce myself, since I've been off Lactnet for a year
or so and I'm seeing lots of new (to me) names here. Yay to that! And
congrats to all "new" (I know, it's not so new any more) IBCLCs. I'm an RN
and an IBCLC, currently in private practice in Ithaca, NY (in a kind of
loose sort-of affiliation with Diane Wiessinger). I have 3 mostly-grown
kids - a 24 yr. old son, living and working in Boston, and 19 yr. old twin
daughters, currently in college. (And yes, I nursed the twins for about 14
months, my son for only about 6 months.) I've worked in hospital OB as both
a nurse and an educator, and for WIC as the county's Breastfeeding
Coordinator.
Enough about me. In response to Barbie's worries about her young mom whose
baby fights & refuses at breast, but will take breast from others, and Mom's
with Barbie's help:
Seems to me that I see an awful lot of baby/mom dyads where this happens -
baby gets a gripe of some kind in an early nursing session (who knows why? -
something "not quite right" from baby's point of view, not necessarily
anything done "wrong" by mother or others), resists going to breast as a
result of the unpleasant experience (whatever it was), and is met by
determination from mom to "make" the baby take the breast. Babies are SO, SO
smart, and they very quickly learn this pattern of mom trying to make baby
nurse and baby fighting to avoid what it sees as uncomfortable or scary in
some way. The whole thing quickly escalates into this breast-refusal pattern
of struggle and tension. It's a healthy defense mode, for the baby; gotta
respect the baby's position in this! Mom gets tense even before she puts
baby to breast, baby knows what's up and fights as soon as there's a hint of
"assuming the position", and mom "tries harder", and on and on it goes, with
everybody's stress level going through the roof. Other people can usually
manage the baby just fine, because they haven't built up this whole gestalt
around the nursing experience. The babies are almost always calm & happy
with us, because they don't give a hoot about us or our agenda, and we don't
carry the same whiff of tension & struggle as the poor stressed-out mom
does.
I'm coming to believe that the best way to manage this sort of thing is to
STOP TRYING, for however long it takes. To break the cycle, to let the baby
regain trust and comfort, to give the family some struggle-free times. There
are other ways to feed the baby in the meantime, since feeding the baby is
the one absolute that has to be tended to no matter what. Honestly (she
says, cowering under an asbestos flame-proof cover), I have moms use the
bottle to feed temporarily, if they are willing. And of course we also work
on helping the baby see the breast as a place of comfort and pleasure -
skin-to-skin as much as possible, *without* trying to get babe back on
breast, nuzzling, co-sleeping, co-bathing, all that good stuff that we know
how to do so well. Mom needs to keep her supply up in the meantime, by
whatever means is least stressful to her. And bottle feedings need to be
fairly efficient and to-the-point rather than long drawn-out love feasts -
you want all that loving and gentle nuzzling stuff to be associated with the
breast, not the artifial teat. And, of course, baby and bare breast have to
be in the same place together, often enough that the baby will get back to
it & see that it's not so bad after all.
Sometimes it only takes a feeding or two away from the breast for the baby
(and mom) to regain equilibrium. Sometimes it takes a couple of weeks. But
the key is to NOT have nursing be a stressful time for mom or babe.
I think we could do a whole lot of good in this world if moms could hear
this "Don't fight at the breast" message from a lot of different sources -
starting with the peds & hospital nurses, and right on throuh family and
friends, and certainly from us. I find that people really have "got it" that
using a bottle to feed a baby can be a dangerous thing to BFing, that in
general it's something to *avoid* doing, and so I've seen a lot of
inadequately-fed babies who are refusing the breast but not getting fed any
other way, and a lot of crying moms who take up this "fight" to "make" the
baby take the breast as if it were like winning a soccer match or something.
I'm starting to put "Don't fight at the breast" as Rule #2, right up there
with "Feed the Baby". But I wish this concept could become more widely
spread - too often it seems that a breast-refusal stage is viewed as an
occasion for armed combat. I'm not here to "make" anybody do anything -
*including* the baby!
OK, off my soapbox. I see I haven't polished my ability to write
short-but-sweet any since I was last here!
Cathy Bargar, RN, IBCLC (with a big hug to all my old Lactnet friends)
Ithaca NY
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