New mother, Breastfeeding and Feeling Fragile

I just left a brand new mother in the hospital, going home today with her baby. She's doing fine, the baby's doing fine. So why did I spend 2 hours with her?

She had been reading a book about breastfeeding. It was very thorough and complete. Yet it didn't mention the issue she was having with painful engorgement on one side but not the other, and the problem she was having draining the engorged side. That wasn't the bad part. The bad part was the message the book conveyed that if it's not going according to the chronology in the book, then either you have incompetent breasts, an incompetent mother, or are doomed to failure.

Again and again when I see the beginnings of postpartum depression, it rears its ugly head in the camouflaged form of off-the-cuff comments by beloved relatives and friends. And book authors! Something is said along the lines of "...I did it this way and it worked beautifully" or "most women have no difficulty with...."

Though mammarily-challenged, I keep getting the impression that women have breasts their entire adult lives but never learn how to work them as a device until they have a baby. Imagine how difficult it would be to learn to walk, if even though you've had legs your entire life, you only now, suddenly, had the ability to use them. Books are helpful, and friends can be supportive. But, I told the mother today, they don't have your breasts and they don't have your baby. Both the baby and mother are still, at day 4 of life, trying to figure out a working system that keeps both happy. This is an iterative process, of course, so it's logical that an optimal outcome can come about only after many trials and many errors. She expressed her frustration with the baby failing to latch after 3 tries. I think it was Mark Antony who said, "I thrice presented him a kingly crown which he did thrice refuse." So maybe Julius Ceaser only got 3 chances, but not the baby! I told her that the baby might be hungry, but he wasn't going to starve in the next hour or so. So maybe he'll nurse on the 5th try or the 25th. The baby was just figuring it out much like mom was. I told her that the baby would be OK and she shouldn't be so hard on herself.

There is no one right path to parenthood, or motherhood, or successful breastfeeding.

She felt better having voiced her insecurities, and I didn't wave them away. I did, however, give her permission to use her own creativity with her baby. I gave her permission to give herself a break and then try again. It was 2 hours well spent.

Sometimes, with mothers in whom I see a risk for postpartum depression, I'll see them once a day, every day, in the office and then phone them every evening. I've had good feedback about this method. I also use the Edinburgh Postnatal Depression Scale.

But sometimes, what works best is my home phone number. And that one time when they're really upset when I show up at their house. It's only me, but they're not alone.