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Posts Tagged ‘birth trauma’

We met on a quiet, dark, rainy morning, as her baby slept the entire time I was there.  Were it not for her having had a baby 10 days prior and being exhausted, it would have felt like a few friends chatting over coffee on a gloomy morning.  It was still, quiet, and dark, and she shared with me the amazing story of her birth, which was unique, and of her first days as a mother, as all postpartum periods, beautiful but a little sad, as her challenges would pull at the heartstrings of any mom, remembering the challenges of the first weeks with a baby, and thinking of the things she is going through.

Many LLL Leaders don’t do many home visits compared to the meetings we run and phone calls we do, and I’ve done only a few, when I really felt I could sacrifice the time away from my home and work and family.  We ARE volunteers, after all.  Paid lactation consultants probably do more home visits, I’d wager.

I will have been a La Leche League leader for five years this August.  To become one, a mother must have nursed at least one child for a year before applying and then completed coursework in lactation support.

We run our LLL Meetings—support groups for women who are pregnant, nursing, pumping, have nursed—in which they can share what worked for them and get support and information for whatever they may be going through.  I’ve always run the Working Mother’s group, since becoming a part of LLL.

The vast, vast majority of the issues women face can be worked through with the correct information about how to latch a baby, how to maintain milk supply, how to nurse while working, what a certain type of discomfort or pain is indicative of, and etc.  So many problems moms face—while you might not call them myths—are problems that are fixed with correct information and not accepting that breastfeeding just isn’t in the cards.

Working with a mom that so wants to feed her baby this way, and seeing how empowered she is when she gets the right information she needed to attain her goal when she may have thought it impossible—it’s rewarding, it’s heartwarming, it’s fulfilling.  It’s drawing upon the ages old model of women lovingly supporting women through pregnancy, birth and motherhood—a model that is somewhat lost upon a large population in our modern day culture. 

While the meetings I’ve run are one part social gathering, one part support group and one part information session from a trained lactation professional, and are incredibly rewarding and helpful to mothers all by themselves—the much more rare “home visit” as a volunteer is…. sacred.

Recently this friend and kindred spirit and 10 day old new mother—whom I hadn’t seen in… oh, 13 years probably, (ah social networking does do a few good things!) very much needed some contact from a friend, a fellow mom and a lactation professional all at the same time.  Interestingly enough, I recently moved to be only 15 minutes away from where she lives.

This little baby was stuck, head up, somewhere in the mother’s abdomen or rib cage (I’m not a doctor and am retelling a story that isn’t mine, so won’t attempt serious details).  She hadn’t been moving much, the pregnant belly seemed to not look perfectly round and things just didn’t feel as they should.  The first induction wasn’t doing anything at all—no contractions, no water breaking, no dilation.  Luckily, she was sent home to rest.  She went to a chiropractor who adjusted her pelvis (and said it was very needed) and I believe she said she felt immediate relief and by that night her stomach looked normal and she was free of some of the odd pains that had plagued her last weeks of pregnancy.  She went back to the hospital and was induced, resulting in a successful vaginal delivery but some tough pushing.  The baby was visibly bruised, had broken blood vessels and some birth trauma.

What does this have to do with breastfeeding?  Or my work as a lactation professional?  I already knew there was more to the story than just baby wasn’t latching well, or gaining well, or mother was in pain, or the many common issues dealt with.  When a mom says her baby is adamantly *refusing* to breastfeed, you have to get the details.

I told her to start at the beginning, with the birth, before we even discussed breastfeeding.

Not only did the child have some birth trauma—she rejected the breast from day one, from feeding one.  This isn’t usually the case, by a long shot.  Even a baby having a hard time latching is typically pretty excited about being fed.

This already puts this story as one I must really listen to to understand what this baby is telling her mother, and not just give the usual advice about how to latch a baby onto a breast.  Not only was the baby not wanting to feed—which I personally feel was probably due to shoulder and neck pain from the position she was stuck in in utero or the birth—but a nurse, probably using a method that may have worked just fine with another baby—was pushing the baby to the breast.  I wasn’t there, and so I’m not criticizing what may or may not happened—but according to the mother, the baby was being forcefully pushed towards her breast and it was decidedly NOT working, making the baby more and more upset.

A calm baby with no stress, no pain from birth trauma, can be encouraged to latch quickly and firmly, probably without it harming her feelings toward breastfeeding.  Babies can be pretty adamant and voracious in trying to find the nipple, actually.  And thus, I think that if a baby is crying and refusing the breast from day 1, before so much as a bottle has even been introduced, we absolutely must listen to what the baby is telling us, and listen to the mother’s intuition.

This mother may get all types of advice from well-meaning friends, some encouraging breastfeeding, some not—but few understanding what this motherbaby pair is dealing with.  I spent my time listening to her, rather than the usual observing nursing and giving pointers.

I reassured her that any and all of the things she has or is beginning to deal with—engorgement, pumping, a little nipple confusion, possible reflux or food intolerance—each and every one of those things are difficult for a mom without her unique story. 

I told her that were this to be my fourth child– three times I’ve nursed a baby—and with all that experience, this would be hard, and challenging, and would take all my strength to stay calm and continue to work for the breastfeeding relationship I thought I would have, but that is just not working at this time.

The baby still refuses the breast, but is eating by bottle and is sleeping well.  This is not a baby that one can just give a few tips to the mother and will get over a bit of latch issue or nipple confusion in a week.

The look of gratitude on her face when I told her the number one rule, above all this stuff to try to make breastfeeding work, is FEED the BABY.  A tired, hungry, spent baby cannot learn to breastfeed.  So whether it is with SNS, cup, syringe, bottle or breast, FEED the baby.  The nipple confusion and latch issues from bottle feeding can be dealt with— the baby will get older, stronger and bigger.  My friend feels that “breast is best” but that no one can understand her baby’s outright refusal, often with screaming, to breastfeed. 

She must simply get her little girl comfortable with being around the breast, not even feeding from it at first, and must address any shoulder or neck pain that there may be.  Her plan may be to take the baby to a chiropractor or cranio-sacral therapist.  I have heard story after story, since becoming a mother, of colicky, unhappy little ones that are like night and day after some neck/spinal adjustment, probably because they are feeling some type of pain from the birth that they cannot tell us about in words.

If she addresses any underlying causes, gets the baby comfortable with that area of her body again, THEN she can begin seeing if she baby will latch well and deal with any nipple preference to the bottle.

A mother in this situation may look into skin-to-skin contact, rebirthing, and babywearing.  She may attempt breastfeeding in the tub, or when the baby is night feeding or waking up and its instincts are at its strongest. 

The look on her face when I told her a baby with this history may be looking at weeks, not days…. A few months, maybe not weeks… before breastfeeding happily was not one of worry over the time frame, but relief that she didn’t have to have this all figured out and fixed RIGHT now.

Usually, the earlier the baby gets to breast the better to set the nursing relationship off.  But this is not the usual case, at all.  Anything else can be dealt with, but this baby needs to heal, and her mother needs to know that she was thrown a tough deal and not to judge herself on the standards of other births, other babies and other mothers.  Of course, this *should* be our society’s standard attitude toward any mother, but we all know that isn’t the case.  Even among breastfeeding advocates such as myself, I think the extremity of this little one’s situation might be met with some skepticism.

We have lost the art of storytelling, of listening to another’s story and putting ourselves in their shoes, and then of sitting back without judgment to reflect. 

I don’t know if this baby will breastfeed.  I don’t know if the mom will pump for a year, quit pumping, get the baby to breast.  I can’t tell.  I think it is entirely possible she gets the baby to breast, but the baby will need a lot of support along the way.  It will be one amazing crash course is perseverance, to say the least.  But most importantly, the mom and baby (and dad) should feel good about their experience and their choices.  They are all doing their best.  I think that with quiet little steps, over time, little by little, she may be able to reach some of her goals.

In my official role as a lactation professional, I want this mom to succeed in her goals that she originally had, which were something like breastfeeding for a year or so—pretty normal.  But it is also completely a part of my role to know when to tell her that her situation was unique and hard and remind her that her and her baby are making up their own story, and it’s not going to be the same as some of the other stories we might have wanted it to be.  We all want uncomplicated births and easy first years with our babies, and we all know life hardly ever works that way.

The baby is loved and the mom is balancing what she wants to happen with what she can make happen and making peace with the rest.  Which is basically all parenting really is anyhow.  

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