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Subject:
From:
"Kermaline J. Cotterman" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 13 Dec 2000 18:49:46 -0500
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Esther Grunis, in Israel, must be currently off LN, as she has posted
about having to do nearly ALL her instruction by getting 30 mothers
together each day she is there.

While I don't have the kind of evidence Heather would like to see, I can
add my experience from 30 years ago when physicians asked the powers that
be (were!) to assign someone to help educate the OB staff nurses. At the
time, I was a staff nurse who also did the large-group CBE for the
hospital.

They wanted us to move from traditional OB care into the then-emerging
trend of perinatal medicine. (At the "dawn" when they were researching
about cold stress, hypoglycemia, brown fat, SGA, LGA, etc. This was just
before they purchased the hospital's first labor monitors, bilirubin
lights, etc.)

I was given a new title, treated to a 3 week course at the University of
Colorado, and set loose on the unit, but without a specific job
description. In other words, I was given carte blanch as to when, how and
whom I wanted to teach as long as I gave OB staff inservices.

I took the ball and ran with it! In the 7 years I kept the job, besides
doing all the CBE and much inpatient education, I eventually accomplished
training all L&D nurses to scrub for emergency CS in DR, orientation for
new maternity personnel, and 6 general inservices each year, round the
clock, on all sorts of things, and lots more.

Mothers stayed 2-4 days or more at that time. I set aside mornings for
mothers, and did all my staff education at other times.

I started with baby bath classes 2 days a week, (Tuesday and Thursday)
because at that point in history, though bathing was supposed to be
taught individually at the bedside, it wasn't getting done for many
mothers.

The maternity staff welcomed it, as they perceived that it lightened
their load, since all they had to do was inform the mothers of the time
and help them wheel the cribs to the mothers lounge. I think that got the
staff on my side and hid my ulterior motive.

I started out making rounds on the breastfeeding mothers. Pretty soon, in
order to see the most mothers, I began adding a "Nursing Mother's Circle"
at the same time slot on alternate days. (Sneaky. . Monday, Wednesday and
Friday gave that class an extra day!)

I especially encouraged multiparas to come, assuring them they could be
of great help with the first time nursing mothers, and of course, babies
too.

Often, there was breastfeeding going on, but feelings and individual
mother's comfort levels set the tone. The groups of course varied in
size, sometimes up to a dozen, but usually 6-8.

I played it by ear, finding out who the experienced mothers were, drawing
out questions, observations, experiences etc. and worked in topics
centered on what that particular group wanted to know.

Many times, I had to deflect advice, old wive's tales, etc. on which we
had since gained better insights, but even the experienced mothers seemed
to welcome new info. This was a voluntary gathering, but nearly always
well-attended.

The general time frame was to have the mothers there by 10 a. m. and out
by 11, unless one or more wanted to linger. Occasionally, one or two had
to leave early, due to a doctor making rounds.

It proved to be very workable, at least for me, in that I was able to
contact so many more mothers that way, saving time at the bedside for
more individualized instruction where needed.

This gave a chance for much reassurance, providing info on contacting
support groups after discharge, plus imparting some of what I personally
felt were helpful things to know. That was back before the semantics of
"latch". My words for it were "a good grasp."

Small potatoes next to Esther's experiences. I'll see if I can get her to
chime in on this thread.

Jean
****************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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