Dear all:

 I have to say that Diane's experience of moms organizing themselves is consistent with my experience with larger groups.  If it is in a phase where lots of moms are coming to the group, there may even be a couple of clusters of moms coalescing around a particular issue (not always breastfeeding related).  The only time I give a slight nudge is if I know two moms on opposite of the room in a bigger group have very very similar and not very common issues where they might benefit from talking to each other or when a mom is professing she has the answer for other mothers that have very different problems or different parenting styles. When there are moms with different parenting styles I always point out that there are different ways to solve problems so they don't feel they have to copy each other if they are comfortable with their own approaches (and of course the baby is doing well!)

My groups have ranged in size from a few moms to up to 25 mothers.  I find 6-10 to be the best range for moms to be able to self organize their own discussion groups and doable in terms of inserting the little snippets of professional advice that moms request.   Groups of 12-15 require a great deal of focus on my part.  Groups larger than 15 are not good for shy moms -- so I try to follow up on those moms that didn't really talk much or slide out the door in those groups. 

And absolutely these groups drop the need for lots of home visits.  I've found that I can then use the home visits for the really challenging situations and find that the gradual fix situations work out much better in the group setting.  In the group setting, the ability to come and meet others a bunch of times and try out different approaches over time really works well for mothers.  If something doesn't work for them, then they can modify and try something else.  Its more difficult to do that when you have to fork over a lot of money for a home visit.  And in Manhattan, you pay a lot more for home visits than group visits. 

Best regards, 

Susan E Burger, MHS, PhD, IBCLC

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