Wednesday, August 26, 2009

When should you call in the breastfeeding cavalry?

When I worked in a store fitting nursing bras, a lot of women came in at their 8th or 9th month to get a few bras to start with. It was a boutique-type place, so I'd spend time with them fitting numerous bras, helping them find nursing clothing they might like, and setting them up with pumps or other needs they wanted to take care of.

As I spent time with each woman, I would try to start a conversation with her about breastfeeding. And I can't tell you how many women said "I'll give it a try" or didn't want to buy too much "In case it doesn't work".

I will readily admit that breastfeeding does not work out 100% of the time. There are women who are physiologically unable to produce enough milk. There are babies who have physical or birth trauma-related issues that make it difficult or impossible to nurse. It's times like this that everyone is grateful for alternate feeding methods and the substitute foods of donated breast milk and/or formula. But I tried to emphasize to these women how rarely these situations ACTUALLY happen. I read a study a while back in which only 5% of women referred to a lactation clinic for insufficient milk supply turned out to be physiologically incapable of producing enough milk. The stories they've heard about insufficient milk supply or babies who refuse to latch are probably, 95% of the time, due to poor management and lack of support.

And that's why the store pushed a piece of paper into everyone's hands with the times and locations of support groups, and contact info for IBCLCs the owner knew and liked. I would hand this paper over telling them to call if they had a problem and repeating a mantra of "Call early, call early, call early". When a newly postpartum woman came in, and made that little grimace when I asked how breastfeeding was going, I put the piece of paper in her hands saying "Call today, call today, call today". Why? Because the longer you let things go on, the worse they get. The sore nipples become cracked, the baby who won't come off the breast starts to lose weight, the occasional bottle becomes regular. I drew the analogy of a road branching off to the side - the farther you travel down the wrong road, the harder it will be to get back on the right one. And newborns travel fast - so your baby is four days old and things have been going badly for the past day? That's a fourth of their life! Not to mention that those early days are when women's bodies are establishing their milk supply.

Here's a story about initial low milk supply where an LC, supportive pediatrician, and determined mom caught a problem fairly early and dealt with it. This is a story that could so easily have spiraled down into lower milk supply, panic, supplementation and the declaration that "some women just can't make enough milk". But it didn't - so call early, call early, call early!