28 October 2008

Becoming a Lactation Counselor

I decided that since I already had so many roles (pun intended) on my plate that another couldn't hurt.

I first got interested in birth work after the difficult time I had breastfeeding my first baby. I realized that there was no one available to come at my call to help me. There is only one fully trained lacation consultant (LC) in the whole country, Meena. (I didn't know about her at the time). She is so busy working at the only baby-friendly hospital and doing lactation work with other hospitals while also helping to enforce the WHO standards of forumla marketing.

Meena really encouraged me to consider going into lactation work as there was a great need for it and I had come to love working with breastfeeding women while working as a doula and childbirth educator. I enjoyed my training with Childbirth Int'l and was so excited to hear they were about to begin a certified lactation counselor course in October. I enrolled quickly to get an "early bird" discount on top of a graduate discount. I knew that my doula/CBE training was good for breastfeeding education and wanted something way more in depth. While the training will not be as in depth as a LC that is IBCLE trained, this is a close second I believe. This will focus some on education and a lot more on solving breastfeeding problems.

I began the course two weeks ago and I am so impressed. Right now I'm working through anatomy and physiology of breastfeeding. The breastfeeding COUNSELOR part is fascinating, and just by browsing what I will be studying, I know that the counseling skills will be a huge asset to my midwifery and doula services. A lot of what I do with women now is counseling. Sometimes it's just listening to birth stories. Other times it's helping to build a birth plan, explain information to a worried father, debunk baby-sleep myths, and more. What I also already like about the course is that all of the books I need to read and about 75% of the assignments can also be used for my midwifery education so I'm not having to do double the work!

Of course I can't know everything about every topic, though I wish I did. I now have a growing list of people that I can refer to when I know it's a situation that I can't handle. Breastfeeding problems that I can't solve go to Meena. If it's someone in need of major psychological help, depression, marital, etc problems, I have a Christian counseling group that I can refer to. (They're actually the parents of two of my former students!) The BAMBI group here also has support groups for everything from PPD to breast cancer to SIDS.

One of the requirements for certification is to support a minimum of eight women for a minimum of 3 hours each. Since enrolling, I got my first phonecall needing help with breastfeeding just this week. The baby was born 5 weeks early and I had JUST read the section on breastfeeding preemies which was so helpful! Breastfeeding counseling is going to be great for my family because it will be hours that I can schedule more easily than births that just happen when they happen. Will I earn money from this? Not very much, but I just love the satisfaction of helping a mother work through her breastfeeding problems or to establish breastfeeding with a newborn.

So how did I work through my problems of breastfeeding my firstborn? Well I suffered horribly for seven weeks. I suspected it was a latch problem as I heard "clicking" when she nursed. The nurse at the hospital had said she was doing fine before we were discharged. At the 4 week checkup, our pediatrician (supposedly trained in lactation) said, "oh she's just a noisy eater." Never mind that the baby was puking up her whole entire meal three times a day, my nipples were raw, and every second of nursing hurt. I went to a BAMBI meeting (similar to La Leche League) and that day, a woman from Canada was visiting. She just happend to be a LLL leader and said that maybe she could help. She took the time that no one else had bothered to do for me. She watched me breastfeed for over an hour, checked the positioning, the baby's mouth, and the latch. What I could not see over my engorged breasts was a baby that was sucking in her bottom lip! After correcting the latch and training the baby to open her mouth to latch and keep the lip down, breastfeeding was painless within 24 hours. No more puking because she wasn't swallowing in so much air.

I don't know the name of the woman who helped me, but she forever changed my views on breastfeeding. I learned that babies need to learn how to breastfeed as much as the mother does. I learned that women need the support immediately and not weeks later, as that's when most women give up. I was ready to quit a week later if breastfeeding was still not working. 6 to 8 weeks had been my goal anyway at the time. Wow so much has changed in my breastfeeding goals! My daughter was breastfed to 19 months. My son was breastfed to 19 months, weaned during the rest of my twin pregnancy, and unweaned shortly after their birth. He is still breastfed at over 3 years old. My twins are 15 months old and have never had a drop of formula or even a bottle! Nursing them has been a huge challenge and reward.

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13 October 2008

On to Orientation

I finished all of the prerequisite work before my October 1st deadline. On to Orientation, which for someone working on it full-time, is supposed to be finished in 3 to 4 months. So my goal is 4 months, due Feb. 1st. Thankfully a lot of those assignments were already completed when I did the Intro to Midwifery course last year.

This month I'm working on Gentle Birth, Gentle Mothering by Sarah J. Buckley, an Australian GP who researches on unhindered birth and such. Very interesting and a must-read for all moms, and especially for my readers in New Zealand and Australia!

I'm also working on getting my bedroom more "office ready" as I have more women coming through needing checks, counseling, etc. Working with one mother due in two weeks and having fun palpating on her ever-growing tummy and baby. That baby stayed in one position for weeks and weeks and decided that was just too easy for me. Decided to go in a very awkward position that really made me wonder if the baby was breech posterior (RSA) or vertex posterior (ROP)... either position puts hands and feets poking out with bum and head hiding. Listening with fetoscope was difficult because with the back so far away and moving limbs I couldn't catch fetal heart tones (FHT for those learning my abbreviations) for more than 5 to 10 sec at a time. And the location of the FHT lended itself to again being one of those two postions. But this week, back to its favorite spot!

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03 October 2008

Phase 2 is done

I just finished Phase 2 and requested the rest of the curriculum! The huge step only took 2 months to complete. Orientation is next and I'm giving myself a goal of 4 months to complete.

So what have I done in the last month?
Completed my inventory and documentation codes. Made a ton of charts. Set up my filing system. Started filing my piles of notes, clips, articles, handouts, etc. Read 3 books. Critiqued 9 articles on a variety of subjects. Wrote a few philosophy and formula papers.

This month I'm working on reading another book, commenting on 20 articles, creating client handouts, finishing some quizzes.


I did prenatal care for friend again yesterday. She's now 36 weeks. The baby had been in the same position the last few checks but yesterday decided that was too easy for me so switched it around some! Took me about 5 minutes (and with a very patient friend) to work around the wiggly parts to figure out the position. And when I went to check the heart rate couldn't count for long enough before the baby wiggled on away. I am just secretly wishing her labor goes so fast that she can't get across town and come to my house instead. In 15 minutes I'd have that bed pushed over to the side of the room, birth pool out and filling, supplies set up. I can dream can't I???

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