World Breastfeeding Week – Day in the Life

Four years ago, I began working exclusively as a nurse lactation consultant.  I will always be grateful to Judi (my manager)  for recognizing my potential for helping moms in the early days of breastfeeding.

What do our Ladies of Lactation do?  Teach, support, assist, support, reassure, support.  Support.

After the baby is born, the learning begins. Parents begin to learn about who their child is.  A baby’s behavior is very often confusing, scary, demanding, and oh yes – there is crying.  Sometimes it’s the baby who is crying, sometimes it’s the mom – and at times the dad may be getting teary.

Since I work part-time, I do not always see the day to day progress as parents and baby figure each other out.  I see the beginnings, the middles, and the discharge days – but on different moms and babies.  This past week, I worked a series of days in a row.  I was able to see a couple of babies get better and better at breastfeeding,  and a couple of moms grow in their confidence that things were starting to come together.  I saw a NICU mom  continue pumping in faith – and then there was the sudden increase in her milk supply overnight – and she looked at me and said with a big smile “It was like Christmas morning!”

Sometimes there is little to no struggle – and yet a mom may still wonder “is this working right?” We encourage, we reassure.

Sometimes there are significant struggles – and we support and help and adjust positions and get deeper latches and give out lanolin and gel pads and set up pumps and explain when a supplement might be necessary.  We explain the possible impact of their baby’s early arrival, or difficult arrival, or circumcision, or bruised head.  We explain the potential impact of too much supplement too soon or too frequently – and sometimes we have to suggest a supplement because baby is.not.latching. No latching = no nursing. We talk about jaundice.

We point out signs of readiness to feed and why their baby’s eagerness to feed moments after delivery is not hunger but instinct.  We warn that there will be sleepy times and when this may become a problem – and that next there are wakeful times and that these will likely occur at night.   Feed, feed, and feed again?  Is this normal?  (Yes, today – not so normal in a few days.)

With earlier discharges becoming more common, teaching about how to verify sufficient intake in the early days post-discharge is crucial.  Watching a feed for a few minutes gives us a good idea how things are going … or not going.  Getting a good latch is important and hearing a mom say – wow, it never felt THAT strong before – is a scary thing to hear as they’re about to head out the door.   Teaching moms to know what a good latch feels like or looks like – is a very important part of breastfeeding success in the early week or two – and minimizes pain!  We can often help.

Sometimes we can support a mom towards the decision that she cannot continue.  Support without judgment.  This may be on Day 2 or Week 2 or Month 2 or beyond.  We listen and  often “hear” what may be hard for a mom to verbalize.

Sometimes a mom has a few questions soon after her child arrives as she wonders…do I want to try?  We answer questions and try to hear what she is saying and give her options.  We support her in her decision – whatever it is.  She is the one who will need to do the breastfeeding so she is the one who needs to decide.  (Not the government, not the husband, not the grandmother…)

Does she want to exclusively pump?  We can give a plan for better potential success if this is her choice.

Sometimes (and NOT rarely) there is the heartbreak of insufficient milk or the baby who won’t (or can’t) latch or too much pain or employment that needs to be resumed far too quickly.  Sometimes maternal anatomy is …. challenging.

Sometimes there is the too early baby and all plans are suddenly changed and there is a pump to hold rather than a baby.  All challenges in attaining one’s expectations and hopes in breastfeeding.

And we see successes!  Yes,  breastfeeding works for many moms and babies! 🙂

The ability to get help from a lactation consultant – both in the hospital – and post-discharge – is often a huge part of success in the first week or two of breastfeeding.   And mother to mother support groups help, too. Without offering any political opinion – I am happy that insurance companies will now be required to reimburse for breastfeeding support when moms see an IBCLC.  When looking for increased success rates for breastfeeding moms, it has everything to do with available – affordable – support for those who desire it – and IMHO – very little to do with hiding formula bags in hospitals.

Tired of the breastfeeding wars on the Interwebs – but so happy to help moms and babies – two by two.

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