Teaching Breastfeeding through Simple Analogies

We have to realize how vague our breastfeeding descriptions are to those who are unfamiliar with "normal breastfeeding behavior." Statements like, "babies breastfeed often" or "expect baby to wake frequently" can be misinterpreted based on the mom's expectations and definitions of the terms. The more specific lactation educators and consultants can be, the more successful moms will be. I try to use one of the "7 Laws of the Teacher": Teach from the Known to the Unknown.

Analogies can bring education to the forefront and help new parents relate to breastfeeding in a tangible way. I have shared these analogies or "advertisements" over the past year, but thought I would gather a few of them up and share them in one blog. I hope these analogies help others to educate on breastfeeding and convey the message that breastfeeding is the standard infant feeding practice.

I often describe breastfeeding anatomy and philology with house-hold items moms are familiar with. They may not have studied pictures of Dr. Coopers's Anatomy of the Breast, or read Dr. Hartman's research on the Mammary gland, but they have handled a bottle of glue.

Different posters convey the same message.  Having a variety of presentations can help reach the visual or auditory learner.  Some people like a quick, easy-to-read visual, while others prefer more detail. Advertisers state that a message must be seen at least ten times by an individual before it is "recognized." I think many educators can relate to this statistic.  I often feel like I am saying the same thing over and over again.

Unfortunately, some moms have been told that something is "wrong" with their breasts.  It is easy to blame a vulnerable, hormonal postpartum mom for difficult latch issues.  I like to remind moms that the baby doesn't come out of the womb, look at her breasts and announce, "those aren't like the ones I've seen in magazines." Babies have no basis for comparison.  There is a huge variation of nipples across the land and this could be a problem if babies were meant to "nipple" feed, fortunately for all the nipple challenged mommies out there, babies "breast" feed. I tell moms that nipples are like snowflakes--there are no two exactly alike. 

Anatomy concerns span from nipple formation to breast size. This is an easy description of "cup" size that everyone can relate to. 

Once moms gain the confidence that they will have what it takes to breastfeed, the next obstacle is milk supply. If I had a nickle for every time I heard the statement, "your milk hasn't come in," I would be a millionaire. 

I remind mothers that even though their meals were withheld from them, the baby had a steady supply of nutrient.  I sometimes joke that if they had been at the Home Town Buffet all day, they wouldn't be hungry right away either.  I encourage them to practice skin-to-skin, nuzzling, cuddling and offering the breast; but not be be discouraged if the baby is not ferociously hungry or "crawling to the breast right away.  In fact, the Breast Crawl has been documented to take up to 90 minutes to spontaneously occur. 

I invented the Lactation Lanyards as teaching tools to help with bedside education.  Seeing a formula bottle gives the impression that the baby should consume the amount in the container.  It is empowering to show a mom an accurate size of the newborn's stomach capacity.  The Lactation Lanyards are available from the Birthing, Bonding and Breastfeeding Store. 

Once a mom understands that her body is not only capable of growing her baby, it is also capable of 

nurturing her baby, the next obstacle is often overcoming any difficulties.  Prevention is key.  The first preventative step is not giving into the recommendation to bottle feed, or offer "just one bottle."

What about the accurately diagnosed "insufficient mammary tissue" or complications from breast surgery. What are those moms to do?  We have set the options as "breast or bottle" rather than "breast AND bottle." Some is still better than none, and this analogy points to that truth. 

I have many other posters and reminders about breastfeeding and breast milk.  I am working on my 2014 analogies.  Feel free to share misconceptions that frustrate you in the lactation field.  I may be able to make a visual to correct the erroneous advice. I hope you will join me on my Facebook Page: Birthing, Bonding and Breastfeeding and share some of the evidence-based information we post with others. Some of the posters are available for framing from the BBB Store. 

Happy New Year and let's work together to tackle myths and fears in 2014!

Communicating & Counseling Skills

I cannot stress the importance of good communication.  Lactation Consultants must be able to effectively communicate and counsel moms, dads, couples, families, pediatricians, obstetricians, communities, neighbors, etc...We have an agenda, like so many other professionals do, and how we communicate it will often cause others to accept or reject our message.

I recently listened to the speech "Love Wins" at the CAPPA Conference and agree with the philosophy in all areas of life...raising children, maintaining a good marriage, sharing faith, promoting lactation...  My husband always says, "the one who gets angry loses--the argument and their reputation."  There is never a good reason to use fear or intimidation to manipulate individuals or convince them to breastfeed.  We must apply the "Love Wins" principle when giving breastfeeding advice.  Put yourself in the mom's shoes.  Often postpartum moms are exhausted, confused, sad, weepy, in pain and lonely.  Be compassionate.  Be gentle.  Be reassuring.  Be comforting.  Be kind.  Behave!  I have heard statements made by LC's that make me cringe.  Of course these statements come from LC's that also have terrible bed-side manners.  Let's decide now to improve the reputation of the profession by always being gracious.  Remember, "people to not care how much you know until they know how much you care."

Besides being kind and using common sense, there are some effective tools to use in communication.  I want to share the 3 Step Counseling Model because it is easy to remember and it works!

Climbing the steps to communication success

Three Steps to Communication Success: 

1. Ask OPEN-ENDED Questions (I don't necessarily like the connotation of the word, but because it rhymes with the other two steps, I remember this step by associating it with the word "interrogate").

Open-ended questions are questions that cannot be easily answered with a "yes" or "no" or other one-word answers.  My favorite open-ended question is "How do you feel about breastfeeding?"  That can really open communication up and help get to the root of the problem.  Remember, our goal is to meet the mother's needs and this is one way to pinpoint what direction you will need to go with your counseling.


While asking open-ended questions, help the dialogue by using the following four probing methods to confirm understanding:


1. Extending
Get the rest of the story; example: “Can you tell me a little more about how you feel about what your mother said?”
2. Clarifying
Make sure you understand what the client means; example: “When you say that breastfeeding may be embarrassing, are you saying you may be embarrassed, or those around you?"
3. Reflecting
Let the patient know you have heard what she has said; example: “So, you think your mother would disapprove?"
4. Re-directing

Move the patient to explore a different related subject; example: “Besides milk supply, what other concerns do you have about breastfeeding?”
Now that communication is flowing...remember to constantly use the second step
   

     2.  VALIDATE CONCERNS

This step encourages mom to continue opening up to you....it says, "you are not alone in your feelings." Get used to (genuinely) sharing that "a lot of moms feel the same way" or "I have heard several moms say this exact thing."  another way to validate is to share personal experience by stating, "I thought that very thing not too long ago..."  This step will become more comfortable with practice.  It is probably the most forgotten step, and the most necessary...never go on to the third step without first camping on this one!  A mom may confide that she doesn't feel like she is making enough milk for her child, and our first response may be to educate (the third and final step).  We may want to dive right in with "if baby is getting enough wet diapers..." if baby is gaining weight...baby looks health...etc.  By jumping right to educating, the mom is made to feel insignificant and shouts the message that her feelings are NOT valid.  It will kill a conversation and close doors to further counseling.  Take time to validate.

Okay, the step we are all so very good at...the last step in the sequence...
     

     3. EDUCATE

Here is where we get the opportunity to answer specific questions.  It is not the time to share everything we know about the topic.  We are not trying to overload the mom, but rather simplify her life by giving her specific advice.  Share in a loving-compassionate way the correct, accurate answer.  Once we have identified the real problem and have isolated the concern, we may address it and help the client get over this hurdle.  Also, a relationship has been established and the next time a problem arises, it will be much easier to get to the root of things since the client will feel comfortable sharing with you.  The client will know you really listened and she will feel like a person worthy of your time.  It is amazing the results that can come from being a good listener and by asking the right questions.  Counseling from the heart reaches the heart of the matter.

We also have to keep in mind when talking to adults to use methods that appeal to the adult learner.  The history and principles of teaching adult learners can be found on the web.  I have included a few to peruse at your convenience.

Principles of Adult Learners

On-line education for adult learners

Websites and books about Adult Learners

Communication is as much of our job as assessment and intervention; in fact, we may never get to the other aspects of our profession without proper communication.  This may not be a large portion of the IBCLC Exam, but it is a large portion of your vocation.  Practice.  Smile.  Be inviting in your personality.  Love others.  Be yourself. 

Looking forward to hearing about your successes,

Christy Jo Hendricks, IBCLC, Doula

For counseling the grieving mother, please be aware of local resources for your families

As you locate excellent resources, please advise so I can add them to my website under "resources"

Christy Jo's website, Birthing, Bonding & Breastfeeding