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

 

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

To Be a Nurse…

 

I am a Nurse…

 

I don’t think I ever mentioned that here before.

Today seems like a fitting day because it’s the anniversary of my grandfather’s death and he assisted me tremendously by helping to finance my education. I wouldn’t have been able to do it without his help.  I am so very thankful for that. 

And for him.  And I miss him.  And I know he was very proud of me.

dzia

 

I graduated from Loyola University in 1994, so that means this May I will have been a nurse for 20 years…

20 years…

My first year out of college I worked on a Medical-Surgical unit.

The past 18 years have been spent in the NICU.  I’ve been blessed in loving what I do.

nicu photo

In 1997, I wrote an essay for Nurse’s Day.  The theme was “Nurses Have the Courage to Care”.  I was a young, ideological nurse.  But what I wrote, still holds true today.

The Courage to Care

When I was in nursing school, nobody said anything about how hard it would be physically, mentally, and emotionally to be a nurse. No one said anything about the aching back or the sore feet I would have. Nobody told me about how mentally challenged I would be every day and that nothing about my job would ever be routine and, most importantly, they forgot to mention how courageous I would have to be.

Many people ask, “Why would anyone want to be a nurse?” Nurses are, by nature, a caring group of individuals…it is what calls us to this profession. That is the easy part. The hard part is that it
takes a tremendous amount of courage to care for others and give of your self unselfishly and to do what nurses do day after day.

It takes courage to take care of people at their most vulnerable, most human states. It takes courage to face the realities of life, realities that nurses know better than anyone else: that sometimes the world is incredibly unfair, that the human spirit is strong, but sometimes it breaks, and that sometimes, no matter how much high technologic equipment is available, sometimes even babies die.

Nurses are the soldiers at the forefront of it all. We are there when life begins and we are there when it ends. We open our hearts to our patients and their families and they forever become a part of us. We see miracles and heartbreak every day, we are in the middle of it, we are real, we are involved. For our patients, we hear their fears, we feel the struggles, and we can taste their pain. We see the best of human nature and the worst. We save lives every day; we grieve over the losses and triumph over the victories. Sometimes we leave our job in tears yet we still keep coming back. No other profession could ask so much of its participants, but nurses, they give of themselves courageously.

I wish to celebrate all nurses for all their strength to care and the courage to keep giving of themselves to their patients and their profession. And when people ask, “How could nurses do what they do?” The answer is simple: they have the courage to care.  Copyright 1997

 

Thank you Dzia Dzia!  See you on the other side!

 

Peace,

K