Jeanette,
I do not in general disagree with most of your post, but I think 
posting it in response to what I said was odd. If you read my words--I 
think it is clear that what I am addressing is the confusion mothers 
feel when presented with conflicting information and how this places me 
or whoever else is seeing the mom in a difficult position that may 
compromise her success.

I always tell moms that I am not in a position to know exactly what 
another person saw, nor how the baby might have appeared at the time, 
etc. This is, after all, completely true. I think it is terribly 
disrespectful to parents, though, to mislead them into thinking the 
error is theirs, they did not understand, their breasts have changed, 
etc, when they were simply badly cared for. This does not mean I will 
make disparaging comments about a particular practitioner, but I will 
not mislead the parents deliberately, either. While breastfeeding is 
very much an art, there are some fundamental basics that anyone who 
opens his/her mouth to give info to a mother ought to know--or s/he 
should say "I do not know".

People are not stupid and when they are given blatantly wrong info, 
they can usually figure it out. It does not take a rocket scientist to 
figure out that when her latch finally stops hurting and she can hear 
swallowing for the first time, that all of the other "your latch looks 
fine" comments must have been wrong! I did not, in my post refer to 
differences in approach, different styles, or the like. I refered to 
those situations that are obvious--we all know them--the mom is certain 
the problem is anything but latch and lo and behold, a tongue-tie, a 
baby latched onto the nipple (and the mom says this is how the baby has 
always latched on), etc. Many times, these moms were certain something 
was wrong, and they feel they were dismissed. I wish I had one yuan (I 
really want to go back to China) for every time a mom or dad stood in 
front of me and said, "It's not that we don't appreciate your 
knowledge, but you have to understand that what you are telling us is 
completely different from anything else we have heard before. Everyone 
has told us something different, but no one said xyz".

My point, of course, is that all of this conflicting information is 
highly problematic for everyone. I will not, however, show such 
disregard for a mother's intelligence that I will lie to her about her 
feelings or conclusions. We say we want parents to demand better care, 
to advocate for themselves, yet, if I interpret your post in one way 
(perhaps incorrectly), you suggest we deflect them away from the poor 
quality care they received (and, to a degree, I do this in the heat of 
the moment, b/c I want to focus on problem-solving). But, in the final 
outcome, this makes no sense to me at all.
Jennifer Tow, IBCLC, CT, USA




    Jennifer said:
"Then there is the issue that the mom doesn't know if she can believe me
when I tell her that the problem is latch--because this may mean that 
other
things she was told by the nurses, doctors or LC's was also wrong."

I know I've posted this before, ...but I will again because I think it 
is so
very important, not only for our own professionalism, but also for the
sanity of our moms...:

We CAN change/correct/improve on/add new information to the mothers we 
see
after others WITHOUT cutting down/criticizing/implying incompetence of 
those
who saw the mother before!

All we have to say is:
...well, it seems that things have now changed
Or
...your baby's mouth has changed/grown
Or
...your breast changes now seem to require that we try...

MOST of the time - this is true!  We are seeing DIFFERENT mothers and 
babies
from the mother seen at 24, 30, 36, 48, 72 hours...there are a lot of
changes occurring in that time - from mother's capacity to comprehend, 
mom's
ability to SIT, baby's ability to suck, swallow, breathe as well as the
breast glandular tissue changes.

I've seen a mother 2 hours after another LC - and compared notes - you'd
think we were talking about totally different children!

...and even if it isn't true that there have been changes - we can still
imply that there are different recommendations now, because she already
tried the set of #1 recommendations and now we go to set #2....

If you find that, in FACT (not because mother didn't 
hear/understand/clearly
state her problem) the previous person who saw her DID make a mistake - 
you
don't have to communicate that to the mother.  You can complete YOUR
evaluation, provide YOUR recommendations with rationale, and let HER 
decide
what recommendations work for her - without "cutting down" the previous
person.

Hopefully, you also develop a way, through a quick, informal phone call:
"you know, I just saw ____ and found that NOW I found ____." (after 
getting
a signed release from her, of course)

Again, with a release, you can also communicate by a letter - but 
written in
such a way that it is sharing NEW information rather than implying
incompetence.

Remember for ALL situations - our criticism of others often reflects 
more
poorly on us than on those we criticize (how does she know you won't 
speak
badly of HER once she leaves?).

Having lived in many different locations and had to prove myself 
competent
upon arrival AGAIN AND AGAIN I've learned that honey works better than
vinegar - and makes ME "smell" better too!

Jeanette Panchula, BSW, RN, PHN, IBCLC
California



    

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

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