A good story for a change.  Last week I saw a mom and newborn baby boy for 2
- 3 days in hospital and after discharge for very severely abraded nipples
*and* engorgement.  The whole snowball train-smash scenario.  Finally mom
was in so much pain and was so overwhelmed that she was on the point of
giving the whole thing up.

It so happened that mom's sister, who lives in Botswana, had also given
birth to a baby boy exactly one week before, and the grandmother had spent
the first week with the first daughter, then hopped on a plane to come and
help her second daughter just as she was discharged home on Day 3.  To my
mounting horror, Grandma told us how Daughter # 1 had suffered in *exactly*
the same way as Daughter # 2 (my client), and proudly related how they had
solved the problem by feeding EBM in a bottle, topping up with formula
because "she didn't have enough milk", and giving the baby a dummy between
"feeds".   Granny also described how she herself had not ever breastfed any
of her three daughters, and pulled her shirt tight across her flat chest as
she told me of the mastectomies she had had, the first when her youngest
daughter was 2, and the second when she was 4. I could have wept.

Just as I thought it couldn't get any worse, Daughter # 1 was on the phone
from Botswana again to say she had stopped pumping, the baby was completely
formula-fed now, and she was very relieved not to be doing "that"
(breastfeeding) any more.   While I mentally raged about different degrees
of baby-friendliness in different countries and different times, I got very
specific about the need to drain the breasts promptly, why and how, and went
through the positioning (again!) with the mom. The baby drank like a little
champ but I went home with a heavy heart.

Today I phoned them to follow up, expecting the worst.  Wrong!  Mom was
bright and cheery, described the baby as feeding "like a little pig", but
"so good", engorgement all gone, nipples healing - everything hunky-dory,
she loves breastfeeding!  But the *best* part - mom has coached the sister
in Botswana over the phone and now she is *breastfeeding again* !!!

Pamela Morrison IBCLC, Zimbabwe
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