Cheryl, I am not surprised to see the talk about abm
supplementation. This talk varies tremendously as
mother/baby situations vary -- from simple concern to
slow weight gain to FTT cases of varying severity.
That said, I proceed!
Blame it on my mother-support background, I do not
like to see a mother use abm as a crutch. My reliance
on it will no doubt be seen as the ultimate strike
against her own bountiful milk supply. Imagine
calling your LC/LLLL/etc & being "told" by her you
don't have enough milk! (That is what we're "saying"
... & sometimes it's true.)
Sometimes a mother contacts me when her baby is
primarily supported artificially. I am cautious in my
language because it is important that she trust the
team of health care providers helping her baby. I
don't wish to be the first suspicious player she
encounters!
Sometimes I think the biggest gift I can give a woman
is the pep talk I lace through our consult. Milk is
an emotional secretion. I make sure the woman knows
that I absolutely believe in her breasts, her power as
a woman and a mother to make this thing happen. Many
women report a change in 24 hrs! I love to hear
followup reports of leaking milk at 3am & gulping
babies. I do not mean to simplify the myriad problems
women encounter with supply, weight gain, or sobering
physical challenges to mom/baby. But if there is a
mountain to climb, I want to hear the woman announce
she is taking her own first step. The abm is tied to
her ankles like so many weights.
This is not to discount the fact that some mothers &
babies present too late to cut the abm as quickly as
I'd like, but cutting the abm is itself an act of
defiance by the mother.
When we discuss our action plan for future bf
management I point out details in the baby's feeding
history that relate to the new change. I give a short
"why" for each step. Light bulbs are forever going
off over mothers' heads. Frequently mothers interrupt
me to finish explaining why we are doing this or that.
That's when I know I have her! I get a lot of "So
that's why ..." & "I kept thinking I should _____ but
everyone said _____." I particularly enjoy it when a
mother looks straight into the baby's eyes & explains
the plan to the baby! Sometimes she apologizes to the
baby for not trusting her own instincts -- or the
baby's.
Of course, you can't just be whistling Dixie when you
say this stuff to a new mom! You've got to believe.
Cheryl, I hope you've opened a new dialogue on the
ramifications of abm use & our attitude toward abm.
And Ellen, I suspect I've expanded on your well-taken
comment re concern for Mom's confidence. If I'm off
track or haven't gone far enough, please post!
Diane W., is this perhaps another issue for your next
edition of "Watch Your Language?" (That is, the LC's
attitude toward abm.) I will post later on the
never-ending issue of semantics.
I find it a challenge to communicate through this
format. There are endless details to a given case we
cannot give, endless questions if we were all in a
room w/ a mom, & when we generalize about a practice
(as I have attempted here) we may all be thinking
about a different interpretation of that practice.
Hopefully, we keep an open mind about the format --
the limitations of on-line discussion and the highest
intentions of those who attend this discussion.
Susan Johnson MFA, IBCLC, LLLL
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