Saturday, October 27, 2007

Trouble

Went for an all time record the other day. Nurtured this gal along all night and half the morning. Got her to complete with only a few grey hairs. First real push dropped the FHR to 60 where it sat until I pushed the kid back up and then FHR recovered. Tried Mom pushing again, needless to say the deceleration repeated - imagine that. I called my consulting and we delivered by cesarean section. Baby had an OP presentation with a double nuchal cord, and a true knot. Hummmm. Not planning on a vaginal delivery with that mess was he. Cute little boy. More grey hairs for the midwife.

Friday, October 26, 2007

Breastfeeding frustrations

Alas, one of the services I offer in my practice is help with lactation. If a Mom plans to breastfeed I do a nipple assessment prior to delivery (actually early in the pregnancy) and we talk about what it takes to get nipples that stand up so the newborn can latch. After the delivery, I don't leave the room until the baby is well latched and suckling like a champ. This sometimes takes a while, especially if Mom has had medication and the baby is sleepy. My frustration arises when I see these Moms back in the office from 3-5 days after delivery and I am told: "I got a pump from WIC and I'm just pumping and giving my baby breast milk in a bottle, the baby really likes it." or "It is really hard to breastfeed at night so I have my boyfriend give the baby a bottle of formula so I can sleep." or "I don't have the time to breastfeed my baby, all the baby wants is to be held and suck on my boobies." I explain that pumping will not keep the supply of milk up and that every bottle of formula given works to decrease the supply of breast milk because breastfeeding is supply and demand - the more demand (nursing/suckling) there is, the more supply (milk) there will be. My clients all reply "Oh, I have plenty of milk, that is not a problem for me. The when I see them back at 4-6 weeks and sometimes sooner, they are whining and crying that they don't have enough milk and they don't know what to do, or they don't have enough milk and the baby really likes bottles better then breastfeeding and so they are going to stop pumping/nursing and just use formula. I am so very frustrated by this. My population is poor, young, ignorant and for the most part selfish. They find having to spend time with their babies a pain in the ass and are happy to pass the baby and the bottle off to someone else so they can go about their lives unencumbered by baby feeding. They all espouse the breastfeeding is best ideal, but when it comes to making it happen, they are not motivated, or unselfish enough to offer their baby their time or their breast milk from the source. Bah!