Lactation Consultant Journey, One Year In….

KeepCalmLatchOn

Well, it’s been a year since I started working in the Lactation Department of a very busy Mother/Baby unit… I passed the BIG EXAM last summer and officially became an IBCLC…

I have learned A LOT in the past 12 months, changing up my career and switching from NICU nurse to Lactation Consultant. My job is still stressful, but in a very different way. I still get to work with mothers and babies, just in a separate capacity. I still love what I do, which is a blessing in so many ways.

I came up with a list of items that I learned this inaugural year as a Lactation Consultant…(these are just my humble observations so please take them with a grain of salt.)

1.) Think of healthy, term newborns as primarily what they are…mammals that are born to survive. And to survive, they must eat. Newborns have an incredible innate need and ability to suckle and, along with a sequence of reflexes they are born with, they can find their mother’s breast to nurse. In a most natural setting (read: natural childbirth), they don’t need much assistance at all. Check out The Breast Crawl video and be amazed! However, I must confess…in the past year I’ve not witnessed a natural childbirth. But the good news is, most newborns, even if the mother had an epidural or some kind of painkillers, or a cesarean section, will easily find a way to nurse within the first hour of birth.

2.) New moms are very emotional, especially first time moms. This is a no-brainer, right? Understandably so-their hormones are all over the place, they are tired, most are in pain, some didn’t have the birth experience they wanted or expected. Their lives have just been drastically changed. Depending on the day or the course of the moon, I’ll have a whole section of moms bursting into tears at the drop of a hat. They’re sometimes overwhelmed, overjoyed, over-tired, over-doing it…Sometimes I get teary because I remember how hard it was to be a new mom and trying to breastfeed and I understand what they are feeling.    ~Hugs.~    Hugs help a lot in this situation. And the permission to feel what they are feeling.

3.) Speaking of the birth experience, forceps, a vacuum delivery and/or Nubain are NOT my friends. Again, my own humble observations-but most babies that have experienced any of these things during birth seem to have a  hard time latching onto the breast, maintaining that latch, and nutritively suckling. Most of the time they won’t open their mouths wide enough (are their little heads aching?) and the mother ends up sore. (Think smashed nipples). Or their suck is a bit dysfunctional, they cry intermittently and can’t settle, and generally have a hard time in the first few days. Now I don’t mean they won’t breastfeed well eventually, it just might take a little more time and work.

4.)The most successful mothers at breastfeeding are those that made up their minds to breastfeed before they got pregnant or early in their pregnancy, or have breastfed before. These moms have usually taken some prenatal classes on breastfeeding, read some books about breastfeeding, are educated on the benefits of breastfeeding. They drink in every word you say, will call with any questions, are very thankful for all the help given to them.

5.)Some moms want to give breastfeeding a try. It can be very rewarding when the baby latches on successfully, the mom doesn’t have pain with feedings, she decides to exclusively breastfeed and everything works out well. On the other hand, some women are really ambivalent about breastfeeding and will try because they think that’s what they are supposed to do. Maybe a family member or husband is pressuring them and their hearts aren’t really into it. In this case, I have learned to look the mother in the eye and ask her what SHE really wants, deep in her heart. I’ll try to educate her on all the benefits of breastfeeding, for her baby and for her.  And I’ll be supportive either way.

6.) Female relatives are EXTREMELY influential regarding a mother’s breastfeeding decisions. Grandmothers, mothers, aunts, sisters, friends…they all have a part in the breastfeeding mother’s psyche. Especially influential is the new baby’s maternal grandmother. Surprisingly, sometimes more than the father of the baby. If a mother’s mother breastfed, it definitely seems like breastfeeding is on the agenda for a new mom. Conversely, many times I have had the baby’s maternal grandmother sabotage the new mother’s breastfeeding dreams. So listen up all you Grannies out there! Be supportive!

7.) Cultural norms are hard to break. Example-some moms insist colostrum doesn’t have enough volume or nutrients to satisfy a newborn’s need and they must supplement with formula. This mind-set has been in play for generations of certain cultures. No matter what information I give them, no matter how I try to convince them there in no formula that can touch the nutrients of colostrum, they will not trust me or believe me. (Again, there is usually a family member influencing them.) We definitely need more education out there-in my opinion, it should start in health classes in schools! So I have to sit by and know all those antibodies and nutrients and good bacteria forming in the baby’s gut from the colostrum will get wiped away with a supplement of formula. Ugh.

8.) Which brings me to my next point…Sometimes formula is necessary and it’s OK! Occasionally there really is a problem with milk supply and the baby is losing too much weight. First rule is to Feed the Baby. Sometimes it really is too stressful for the mom to breastfeed and it’s causing her way too much tension and angst. Maybe I am a dysfunctional Lactation Consultant but give that mom a bottle and some formula! Is it really worth her getting so upset and feeling so bad about herself as a mother?  NO! There are so many ways to mother and love a child and breastfeeding is not the only way.

9.) This was surprising to me-Pacifiers and artificial nipples really can mess up breastfeeding success. As a former NICU nurse, I believe pacifiers are necessary in the NICU. It helps the babies calm and decreases their stress and pain. With a healthy newborn, I hate to say this, but be careful. Some babies can go back and forth with no problem. (My first child.) Some develop a preference. (My second child.) I originally thought the term “Nipple Police” was a funny way to describe a lactation consultant, but now I understand. It’s true, a baby can get confused by artificial nipples.

10.) This might sound bad, but I find it more and more to be true- Dads are on their phones A LOT! Ok, ok-I don’t want dads to seem like they are not interested in their new babies or supportive of their wives, because that is simply not true. But It seems like in today’s society with cell phones and texting and social media, extended family and friends want to know what is going on with the new family every minute. It seems like dads are handling most of the social media and they are on their phones a lot. Meanwhile, I am trying to help the mom get their baby latched correctly. And all I want to say is, “Please, get off your phone and listen to what we are discussing because YOU are going to be home alone with your wife in the middle of the night when you three go home, not me.” In our social media rich society, I don’t even think parents realize how much time is being taken away from bonding with their child by their cell phones. But it seems like a lot…

11.) If a mom comes in with a plan to exclusively pump and give expressed breast milk with a bottle, there’s a reason for it. I don’t ask questions or try to persuade the mom to put the baby to breast. She has her reasons and I am just there to support her. Furthermore, if a mom comes in and her plan is to exclusively give formula, I support her in that too. Motherhood can be a rough journey and no one should judge anyone else.

12.)Visitors, as well meaning as they are, can make breastfeeding more difficult. Babies put out early feeding cues-signs they are getting ready to eat. They lick their lips and put their hands to their mouths and root around.  It’s the best time to try to get baby to latch on. Well, chances are if countless friends, fraternity brothers, extended family and so on are visiting, the mom doesn’t want to pull out her breasts to feed the baby in front of them. (And the dad doesn’t want it either.) And some time goes by. And baby gets hungrier. And then cranky. And then Snickers Hungry. So hungry they change personalities right in front of your face. Yeah, not an easy time to try to latch onto the breast. Downright impossible to get a frantic newborn to latch on. Not to mention the new parents are exhausted from perhaps not a lot of sleep the day or night before. You know, what with the labor and birth and all. So you get the picture.

13.) I am very, very busy during my work day. Most days, the lactation consultant is the most popular person on the unit. Where I work, almost all the moms want to breastfeed and there are usually two lactation consultants on the unit. We carry a phone so the moms and dads can call when they need help. This means our phones are ringing frequently. Some days, it’s constant. Sometimes I’ll have a line of moms waiting for me to see them. There are moms who went home who need help whose phone calls we have to return. Moms that need an outpatient visit to solve a breastfeeding problem they might have. There are breast pumps that need to be rented. Medical-Surgical Units calling about drug compatibility and breastfeeding. Breastfeeding Support Group that needs to be moderated. Breastfeeding classes that need to be taught. Supplies that needs to be reordered…it can get overwhelming. So rest assured, if your lactation consultant takes a little time to get back to you, it’s not because she is having coffee at the nurse’s station—she’s most likely running around like a chicken with her head cut off.

14.) Patience, Patience, Patience!!! Practice, Practice, Practice!!! When you learn something new with someone you’ve never met before, it can be a little awkward. Perplexing. Frustrating at times. Same is true for breast feeding. Yes, it’s natural. Yes, it’s what mammaries are made for. But that doesn’t mean it doesn’t take a little work and a little problem solving. After all, I wouldn’t have a job if it was that easy. So I’ve learned to counsel my moms on giving themselves a break. Whenever doing something new, it takes a little time, some energy and bit of fortitude. I would like to teach them to trust their bodies and themselves but that is something we learn on our own. And in the end, the rewards for all that patience and practice is priceless.

15.) Which brings me to the next lesson, It’s such a beautiful experience when you witness a new baby breastfeeding.  The mom and dad smiling down on him or her. It’s like the stars have all aligned and all is right in the world. It’s peaceful and gentle and hopeful. It’s how we as humans have survived for thousands of years. The truth is, breastfeeding is so much more than just delivering nutrition to a baby. It’s about bonding, learning about each other, recognizing smells and voices and different cries. It always amazes me how content a newborn is at his or her mother’s breast.

And finally…

16.) For me to do my best at my job, I need support as well. This comes from hospital administration, managers, doctors and nurses. Everyone needs to be on the same page—to support breastfeeding and breastfeeding moms. I learned I am very lucky to have this support from the hospital and management where I work. In fact, the hospital I work at was recently designated as Baby Friendly, which is HUGE! You know the saying—“It takes a village…” and it couldn’t be more true in this case.

So as I look back, I smile. I have had some rough patches in the past year but I learned and grew as a person. But truthfully, I am looking forward to many more years of learning about this amazing profession and how I can make myself a better advocate for breastfeeding and breastfeeding families.

bf

Peace,

K

 

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Coming out of my Test-Taking Fog…

 

So the IBCLC exam is over…hopefully.

 

July 27th, 2015-the date that I had been dreading since I decided to try to take my career on a new course. All over the world, thousands of candidates were sitting for the IBCLC exam in hopes of a passing score.

I’d like to say I didn’t study that much for the exam, you know, in case I fail.

But the truth is, I worked harder than I had for something than I had since college. I studied very hard for many hours, read textbooks and made notes and then studied those. I looked up current research, used flashcards and even made my own quizzes on Quizlet. I poured over clinical pictures, protocols and case studies and probably did over 1,000 practice questions.

And with all that, I was trying to learn a new job in a new hospital with new co-workers and working more hours than I had since my first child was born…

My social life suffered-I turned down invitations to breakfasts, lunches, drinks, concerts, girls’ night outs…

My hobby life suffered-there was no sewing, crafting, embroidering, blogging, link parties, garage sales, furniture painting, estates sales or flea markets…Heck! I even put away Pinterest-very hard for me to do…

Most importantly, my family life was upended…my house was constantly disorganized, laundry was done in between study sessions, dinners made on the fly…

I constantly felt guilty that when I was studying, I should have been spending more time with my boys and my husband. I was stressed and cranky and not very patient at times. Many times.

With all this studying and preparing, I still walked into that exam very nervous because I had heard from previous test-takers that it was the hardest exam they had ever took. I’m not allowed to discuss test content, but I can say-They were right!

It’s not enough to just know the facts-you have to be able to apply them.  And because it is an international exam, it can become tricky. For instance, we have a tendency in the U.S. to think that our way of doing things is the only way-not the case.

With a nervous stomach, my heart pounding and sweaty palms that could’ve used some Botox injections, I took the train into the city and checked into my exam site.

When I read the first few questions, I felt like this-

surprise

As the test went on, I gained a little more confidence. It took me about 3 1/2 hours to finish…and when I did, I felt a lot of relief. It was over.

OVER.

I walked out into the late afternoon sunshine on a busy city street and felt very discombobulated. I couldn’t figure out which direction to head toward. I actually shook my head back and forth to try to focus! I started walking west, I think, and heard all these footsteps running behind me. Confused even more (and a little worried there was something weird going on), I turned around to see my husband and children running toward me!

Best feeling because all I wanted to do was hug them!

Turns out my mom and sister and niece and uncle, my husband and kids, all planned to surprise me after the exam and take me out to dinner in the city.

How awesome is that!

 

 

I had an adult beverage to start with…

mojito

Can you blame me? (Truthfully, I really wanted about 10 of these but I do try to set a good example.)

After a great dinner with lots of laughs and pasta, I went home with a full belly and felt both mentally and emotionally exhausted, like I had spent the whole day crying. I couldn’t wait to go to sleep and just sleep peacefully without this exam hanging over my head like a big, black cloud.

I think I was asleep before my head hit the pillow.

But then it happened—I woke up at 4 a.m. in an absolute panic, dreaming about the questions and how I answered them wrong. Trying to remember the wording and if I picked the right answer, trying to remember all the facts and data and wondering if I applied them correctly, thinking about all the sacrifices of time and money and energy that went into this and wondering if I just really  f*#%ed it all up.

Not  good feelings at all. Yucky, icky, stinky feelings of fear and dread.

I’ve been wandering around looking like this

upper lip baby

I won’t find out if I passed till late October/early November. That’s a long time to feel like s*!t.

So I’ve finally started to put on my big girl panties. It is what it is, there’s no changing anything now. I do know that I put a lot of work into studying for this exam and did the best I could. If I fail, it’s because my test taking skills were lacking, not because I didn’t have a head full of knowledge.

did-someone-forget-their-big-girl-panties-funny-plastic-sign

I learned so much in the past five months! You can’t take that away from me…and, I’m still helping mommas and their babies and I love it! That’s not going to change. So for now I just have to sit back and try not to focus on it.

Wish me luck!?!?

Peace,

K

Saying Good-bye to the NICU after 20 Years…

 

Every new beginning comes from some other beginning’s end.

                                                                            “Closing Time” –Semi Sonic

 

Yesterday was my last scheduled shift as a NICU nurse.

For the past twenty years, the NICU was my professional “home”.  I never intended it to be…when I was in college, I wanted to be a Labor and Delivery nurse. That, I believed, was where I was meant to be. My clinical rotation in L&D was so exciting and wonderful and adrenaline-filled. New life coming into this world-it was a mostly joyous occasion filled with celebrations. It was hard to comprehend in those moments just before the birth that there was going to be another person entering the world who was created from just two separate cells 9 months before. One minute they are not there, and then one minute later~Boom! There’s another person on this planet.

Incredible!

But I couldn’t find a job in L&D after graduation in the mid 1990s. Everyone wanted “experience” and I didn’t have that yet. I was just a brand-spanking-new- idealistic nurse.

I was offered a job on a Medical-Surgical floor, so I took it. I had to gain nursing experience while waiting for that L&D opportunity to open up.

Yeah, needless to say, that wasn’t my cup of tea. Back in those days, we had nine patients each with one nurse’s aid for the whole floor to help out. I felt like all I did was hand out medications and change bed linens. I didn’t feel like I was ever making a difference in their lives. I never felt like I was making their lives a little easier, a little less scarier, a little more comfortable…who had the time to do that when there was blood to be hung, peritoneal dialysis to do on four different patients, medications to be handed out, charting to complete? I often left in tears because this career that I had worked and studied so hard to join was not what I had envisioned AT ALL.

And then a new couple moved into the apartment below me. The girl was a NICU nurse at a different hospital and said they had a few positions open and that I should apply. I had spent a day or two in the NICU in college during my Mother/Baby rotation, but it hadn’t interested me at the time because it looked so scary.  Truthfully, I was so unhappy at the current job that I did apply and got the job. I thought it would be another stepping stone to finding a job in L&D.

God works in mysterious ways, doesn’t He?

This “stepping stone” job became my passion, my love, my vocation, my “calling”. I remember walking into that NICU on my first day so full of nervousness, excitement, apprehension and fear. I had never even really changed a baby’s diaper before and now I was going to learn how to help a 500 gram, 24 week gestation infant live?

But I had wonderful nurses there to show me the way. They became my second family, my mentors, the nurses I wanted to imitate, to be like. They shared their knowledge, skills and “tricks of the trade.” After months of orientation, I was on my own.

But not really. If you work in a good environment, you are never really “on your own”.  There is always someone to refer to, to ask questions, to offer nursing advice, to save you from drowning during your shift. Everyone is there with one goal~to take care of the babies and their families as they go through such a difficult time.

And as time went on, I gained confidence and started loving it.

Every part of it.

The adrenaline pumping high-risk deliveries we were needed to be present for if the baby was preterm or distressed in utero…

The first stunning moments a parent sees their child for the first time, and he or she is connected to wires, IV’s, tubes and machines.. or gets to hold their child for the first time…sometimes they had to wait WEEKS for that moment…

The hard times when a sick infant gets even sicker and there is nothing you could do to help…

The good times when a baby who has been in the NICU for months gets to finally go home with his parents…

Seeing a family develop right before your very eyes, tentative at first because of all the uncertainty, but with time becoming more confident…

Developing relationships with the babies who are entrusted in your care…taking care of them like you would like your OWN child cared for if he or she were in the NICU…

Developing relationships with the parents who entrust that care to you…who have to leave their babies in the hospital while all they want is for their child to be healthy and home with them…

Having a part in something greater than anything I could explain…

I loved all of it.

But in the past two years, I have felt a new calling, a new passion, a new love that I would like to pursue.

I have taken a much greater interest in helping new moms and babies learn how to breastfeed. Again, this was not something I ever envisioned of myself doing as a career in the beginning, but now I do. Funny how things change and evolve, isn’t it? At first I tried to ignore it because I felt “safe” being a NICU nurse. It’s what I have always known.

But more and more I found myself enjoying this aspect of NICU nursing the most. I started reading more about becoming a Lactation Consultant. I took a week long course that earned me the title of  “Certified Lactation Specialist”.  I prayed long and hard over what to do, where my next step should be.

Am I scared?

Yes! This is a big change for me. Sometimes I feel like I am standing on the edge of a cliff about to jump off and I don’t know if there’s a safety net there.

But I’m more afraid NOT to try.

A few weeks ago, I found this guy sitting on my couch…

butterfly

It was exactly –17 degrees outside that day in the middle of February, but this guy was on my couch. How he got there, I have no idea.

But he symbolizes change to me. Beautiful change.

I had gotten an email from a recruiter on Linked-in. Out of the blue. He had seen my qualifications on the site and referred me to a position that was opening up. I forwarded my email to his contact. They called me in for an interview and I went and did my best. I was very impressed with the leadership team and really wanted the job! They called me for a second interview, a peer interview.  I was really nervous, but was myself and tried to let my passion show through.

In the end, they are awesome enough to give me a shot at working in the Lactation Department. I truly can’t wait to start.

When I was leaving the new hospital after getting my new I.D. badge picture taken, I passed by their outdoor atrium and spotted this…

metal butterfly

I had to take a picture of it.

I am excited to take on this new adventure, I am sad to leave the old one behind. I am thrilled I will still be able to work with mothers and babies, just in a different capacity. I will never forget how truly blessed I am.

butterfly quote

Peace,

Kathy