When a Leader Needs a Leader
Ypsilanti MI USA
From: LEAVEN, Vol. 40 No. 2, April-May 2004, pp. 27-29.
I went on a home visit today, the first since my son Elliot was born three months ago. My co-Leader and I went to help a new mother whose three-day-old baby was having trouble latching on to her engorged breasts. I watched my co-Leader talk calmly to this first-time mother. She was empathetic and comforting.
She explained how in the beginning nursing could be difficult, that it was a learning process. She reviewed comfort measures for the mother’s engorgement and sore nipples and assessed the baby’s latch-on and position at the breast. She was reassuring and supportive, telling the mother what a wonderful job she was doing, telling this mother many of the exact same things she told me more than once during the first few weeks after Elliot’s birth.
Our home visit reiterated for me just how vulnerable mothers are during the postpartum period. Between the fluctuating hormones, the physical discomfort, and the disturbed sleep, even the most committed breastfeeding mother can falter. It was also clear to me that even though I knew many things about breastfeeding and had already successfully established one nursing relationship. I wasn’t any less vulnerable after Elliot’s birth than the mother of the three-day-old baby in front of us.
Elliot seemed to start out okay. My labor was long but uncomplicated and without medication. Initially he latched on and appeared to nurse well. His suck did not seem as strong as my daughter’s had been and he fell off my breast very easily. The midwives who delivered him and the pediatrician who came later that day checked him for tongue-tie and palate abnormalities and he was fine on both counts. However, he was sleepy and never nursed for more than five minutes at a time, another big change from my older daughter. Fairly quickly, he started making a clicking noise whenever he nursed and his cheeks were dimpled. My milk was slow to come in, which seemed to frustrate him. A visitor, who had come to help, described his nursing as “desperate,” a decidedly unhelpful comment. I spoke with one of my co-Leaders on the phone, but I felt a little anxious and silly. She came for a visit and talking with her calmed me down and got me back on track. She reminded me of the cross-cradle position and doing breast compression in an effort to keep him nursing longer.
When my milk supply finally did “come in” on day five, Elliot checked out of the process completely and spent most of the day sleeping and occasionally latching on for a very lazy nurse. A friend from my Group visited and commented on his sleepiness. My co-Leader called and, during the course of the conversation, asked me whether Elliot’s bowel movements had transitioned from meconium. I realized his output was completely inadequate and my breasts were lumpy and slightly engorged. I was surprised at how easily I had forgotten the important process of keeping track. I put up a small white board next to the changing table to record day-by-day Elliot’s wet and dirty diapers.
Engorgement was another new experience for me. I used warm compresses and hand expression. I spent a lot of time reviewing the 2003 Breastfeeding Answer Book because Elliot’s latch-on was not improving. He had a difficult time maintaining suction and I could often see gaps at the corners of his mouth. I knew that he needed to open his mouth wider and take more of my breast into his mouth, but I couldn’t seem to make him do it. I started waking him up every two hours to nurse, and I began some of the exercises mentioned to help improve a weak suck. I also took Elliot to the chiropractor I had seen during my pregnancy.
On day seven, my nipples got sore and started to crack. I panicked again. It was a mystery to me why my baby wasn’t latching-on properly. Secretly I worried that I couldn’t nurse him and I wondered exactly how I could lead a meeting without nursing my infant because I certainly couldn’t be fumbling around so much at a meeting. I now totally understood the mother I knew who had stopped coming to meetings after her baby was born until their nursing problems were resolved because she couldn’t bear the thought of awkwardly latching on in front of so many mothers and babies who nursed so effortlessly. After this panic attack, another local Leader came to my house. She rearranged how I was sitting, added pillows for more support, and suggested that we may have thrush. I told her that was impossible; I knew what thrush felt like. My daughter and I had it for months. The soreness couldn’t possibly be yeast-related because neither Elliot nor I had been on antibiotics and I had been taking acidophilus prophylactically. She had to be wrong I thought to myself. The following Tuesday, the pediatrician diagnosed thrush.
By week three, Elliot had completely humbled me. He added projectile vomiting to his repertoire, and between the hours of colicky crying, and the occasional bloody stool followed by the lack of stooling, I suspected he was reacting to foods in my diet. This time, materials from a previous Area Conference session on allergies gave me some clues. One elimination diet later, I was off dairy, soy, eggs, and peanuts. Throw in a couple of chiropractors and a craniosacral therapist, and a whole lot more crying over the next few weeks and the transformation was complete. I stopped being a Leader and became the mother who most intimidated me when I encountered her on the local area phone line, a hormonal wreck with a fussy unhappy newborn who couldn’t stay on the breast.
After each visit from a Leader or trip to the pediatrician or chiropractor, I would always be frustrated by my inability to get at the root of our nursing problem. It’s not as if I didn’t have this information. I was a La Leche League Leader. Elliot should not only be a breastfed baby, he should be a perfectly breastfed baby. Sometimes I worried that I was creating problems where none existed. Knowing how much can go wrong with breastfeeding can become a self-fulfilling prophecy and suggest difficulties that aren’t actually there. Maybe I was turning normal newborn fussiness into colic and food sensitivities. Maybe the clicking and dimpling weren’t signs of a weak ineffective suck but just part of the learning process. Maybe I was just being whiney. After all, he was gaining weight really well. Then again, maybe my daughter interpreting his almost perpetual grimace as a smile wasn’t so normal and maybe the path we wore out walking around the neighborhood was an indicator of a newborn a little more fussy than normal. I had a hard time deciding.
I was too close to the situation to see it objectively and for that I needed a Leader. Even though the midwives, the pediatrician, and myself all assumed I would breastfeed, I suspect only I assumed I would need no assistance. Like many other mothers I found that I did need help and like many other mothers, La Leche League provided that support. I couldn’t distance myself from my role as the mother of a newborn to play the role of Leader and see the solutions that were plainly obvious to other Leaders.
In the foreword to Kathleen Kendall-Tackett’s The Hidden Feelings of Motherhood, the period immediately preceding and following birth is described as a biologically sensitive period. For the few weeks leading up to and following birth, the mother is in a “state of primary maternal preoccupation” during which she needs “nurturing support and a protected environment to develop and maintain this state....The more the mother is cared for in a humane manner, the more sensitive and caring she will be with her own infant.”
Contact with other Leaders during the postpartum period protected my environment and allowed the bumbling about that was necessary for Elliot and I to become a reasonably successful nursing dyad. I needed their objective opinions to help point out the obvious. I needed their ears to listen to my grumbling. I needed them to remind me about the tincture of time and how most latch-on problems work themselves out with a little care, patience, and persistence.
And somewhere in the last
month, we did hit that magic point. I’m not exactly sure what day
it was. I suspect it got better little by little, quietly improving,
just the way my co-Leader said it would and just as she described it
to the mother of the three-day-old baby. I’m almost ready to be
a Leader again.
The home visit was a good start. Seeing this newly born mother recovering from her birth and working hard on getting her infant to latch on made me realize that nursing Elliot has finally become easy. Elliot’s latch-on isn’t perfect but it works. I may even lead next month’s meeting.
Linda Irvin is a Leader and Assistant Area Professional Liaison in Ypsilanti, Michigan, USA, where she lives with her husband, James, and her children Sophia and Elliot. At 10 months, Elliot is taking his first steps and is very dedicated to breastfeeding and the sport of peek-a-boo. Thanks to all the loving support we both received after he was born from family, friends, and, of course, area Leaders. Special thanks to Nan Vollette, Contributing Editor, who originally received this article for the regular Leaven column, “Helping Mothers.”