Difficulties in Breastfeeding - Term Paper Example

Difficulties in Breastfeeding Introduction Breast feeding is an important nutritional aspect that enhances the overall wellbeing of the mother and baby. Mothers particularly derive great satisfaction from being able to breastfeed their children accordingly. Seemingly, those that are unable to breastfeed suffer significant social and emotional problems. Breastfeeding support within the community settings has taken a positive step forward since the launch of the Baby friendly initiative (BFI). For this reason, I was able to gain much needed hands on experience with teaching the required skills needed to empower mothers to breastfeed their babies successfully. This essay will focus on a particular challenging breastfeeding experience with a lady within the community, discharged from hospital following an emergency caesarean section. Using the Gibbs reflective cycle in an attempt to stimulate personal and professional growth, I will explore the emotional and physical difficulties faced by these women in regards to breastfeeding and the care and support I gave. This lady will be referred to as Kelly throughout this essay to ensure confidentiality guidelines are met. The essay is reflected on the evaluation of critical incident, natural breastfeeding intuition of mothers, importance of skin to skin contact, latching the baby on, co-sleeping, usage of hands off technique and moral, legal and proficiency aspects of the incident. Understanding Kelly Kelly was an educated lady who had expressed her eagerness to breastfeed her first born child. However, on return from the hospital, she experienced difficulties with getting the baby to latch on and resorted to using a mixture of breast and artificial feeding. She was very emotional about this and had concerns about her breast milk diminishing because of problems in lactation even whilst expressing. It was both emotional and frustrating for me to see Kelly go through such an emotional cycle of responses, to not being able to provide her baby with what she felt was the best choice of infant feeding. She questioned her abilities as a mother constantly and as a result, I privately began questioning my own beliefs of breastfeeding. Was it the best if the bond between mother and the baby was being broken down by physical factors that affected lactation?  I would often feel guilty, as a professional trying to promote breast-feeding, it was wrong for me to think in this way, was it not? It became necessary for me to explore this incident, opening up opportunities to learn from it and improve the practice. I had so far not seen any woman struggling to breastfeed, and had felt confident in suggesting positions and advice, but with Kelly, I admit to feeling a little out of my comfort zone and unable to close the gap between theory and practice. Recognizing the situation, for it was an area outside my limit I took a step back and allowed my mentor to take the lead during the visits. I watched how my mentor interacted with Kelly and from this appreciated the importance of embracing objectivity when addressing the issue. Discussion Kelly’s major problem was her insufficient milk supply. Therefore, it is important that Kelly was made to understand, that her natural instincts as a mother would help her to feed her baby more comfortably rather than depending on the support staff. Although emergent societies have developed divergent views, it is generally agreed that the most successful mode of feeding depends on the natural instincts of the mother. Accordingly, reliance on natural instinct and evasion of any interference causes an ease in breastfeeding (Lennart, 2008, p.2). It is important that mothers are confident about breastfeeding their babies. The doubts created in their minds regarding their incapability of feeding are more due to supervision of this act by the medical professionals. It is observed that the process is often mishandled and has turned into a medical procedure rather than a natural process (Walker, 2007, p.549). It is evident from studies, that a woman is more prone towards the risk of mood disorders while going through the postpartum period. Sometimes the depression is such that it might lead to admittance in a psychiatric hospital in the early weeks of the period after birth (Kendall, Chambers & Platz 1987). After a caesarean section, a woman experiences difficulties in breast feeding the child. This might become a significant cause in leading her towards postpartum depression. The difficulty in latching the baby to the nipple is somewhat frustrating to the mother who feels that it is a natural process and should come across easily. As the frustration level rises, it may lead to a shift in the hormones, causing mood swings. The situation is further complicated when the mother starts blaming herself for something seemingly natural. It is often observed that difficulty in breastfeeding, after a caesarean section can be rather painful, causing a lot of physical discomfort, as well. This affects the hormonal levels of prolactin, causing a reduction in the supply of breast milk. This problem is further complicated when the mother has difficulty in latching the baby onto the nipple and the baby is not fed properly. It is observed that a failure in removal of breast milk might lead to a chemical inhibition in the milk glands, thus further decreasing milk production (Australian Breastfeeding Association, 2012). The difficulties of latching the baby to the nipple have particularly been painful (Neifert, 1998). There are many possibilities for this problem, the first being the size and shape of the mother’s nipples. If the nipples are very large or are inverted or flat, it proves difficult for the baby to feed. In case of a caesarean, it is very common for a baby to have difficulties in latching on since the mother has been administered anesthetics and narcotics during labor. This will interfere with the suckling action of the baby. Another common factor which is often neglected is the concept of feeding the baby every three hours after birth. Force feeding will also result in non compliance of the infant towards the feeding pattern; rather they develop a sense of dislike for breast feeding. It is important to promote the development of skin to skin contact with the infant. This provides an effective approach towards exploring the close bond between the mother and child. The contact will provide for the baby enough time to latch on naturally, while being close to its mother (Cindy, 2003). UNICEF/ WHO endorses that sharing a bed with the mother enables effective breastfeeding (Buswell & Spatz, 2007, p.22; Hormann, 2007, p.355-356). Another study conducted by McCoy states that a strong relationship is developed between the mother and child by bed-sharing, which also helps in facilitating breastfeeding due to development of a close contact between them (McCoy et al, 2004). This practice should be encouraged by the hospital. I feel that having regular skin to skin contact would help Kelly to develop a strong bond with her baby. This is because it would make her more aware of her baby’s needs, feeding behavior, and the ability to latch on properly to the nipple and develop a natural breast feeding pattern. (Feldman, 2004, p.150; Karl, 2004, p.292; Moore, Anderson & Bergman, 2007, p.2; Naish & Roberts, 2002, p.36). The instinctive nature of the baby allows it to go through pre feed rituals like licking, mouthing, touching and smelling the breast before sucking the nipple (Lennart, 2008, p.1; Naish & Roberts, 2002, p.36). In a hurry to breastfeed her baby, Kelly tried too hard and was overwhelmed with anxiety and emotion, blaming herself as being an incompetent mother. It was important that Kelly was given support from both her family and health care professionals. My mentor provided her support by teaching her methods and different positions in which she could get comfortable. Specifically, she was informed that lying down on her side and positioning the baby to support it by cradling and putting a rolled towel or a pillow to nestle it closer would help the baby to feed properly. Additionally, it would put less pressure on the abdomen of the mother thus causing less discomfort. It was also important that Kelly was taught how to evaluate, and give time to her baby to explore and develop the inseparable bond. This would be attained by letting her baby sleep with her. The interaction and development of the direct skin contact would eventually make her baby to start breastfeeding naturally. Other methods such as the hands off experience were also introduced to her. Similarly, this would help her feed her baby in a better way. Conclusion My evaluation of the incident made me to review my beliefs about the midwifery care. I felt that the negative response was due to my limited knowledge regarding the situation. I was uncomfortable when handling the situation since my limited knowledge compromised my ability to understand Kelly’s situation. Kelly’s frustrations took toll on me and greatly affected my ability to help her. My experience made me to believe that it is important to provide healthcare support to mothers experiencing difficulties in breastfeeding. At the same time, I was able to acknowledge that professional help is of utmost importance. Thus counseling Kelly to develop a skin to skin contact, to share and sleep with her baby with her baby and hold on to it helped her to develop an inseparable bond as well as initiate an instinctive response from the baby towards breast feeding.  It is my ethical obligation to support breast feeding experience for women and to educate them regarding the procedure (Miracle & Fredland, 2007, p.545). Therefore, it is necessary for the midwife to be educated and informed about relative concerns. As aforementioned, it is important for professionals to be up to date with the latest research and techniques so as to help the patients effectively. At this point, it is worth noting that it would be difficult for the mother to implement her rights to an independent decision about breastfeeding if she is not provided with relevant information by her healthcare provider. List of References Australian Breastfeeding Association, 2012, Attachment to the Breast, Retrieved from: http; //www.breastfeeding.asn.au/bfinfo/bla.html on March 21 2012).  Buswell, S.D. & Spatz, D.L. 2007, Parent-infant co-sleeping and its relationship to breastfeeding, Journal of Pediatric Health Care, 21(1), pp22-28. Cindy, C, 2003, when the baby refuses to latch on, Retrieved from :http://www.breastfeedingonline.com/Refusaltolatchpdf.pdf. on March 21, 2012 Karl, D 2004, Using the principles of newborn behavioural state organisation to facilitate breastfeeding, The American Journal of Maternal and Child Nursing, 29(5), 292-298. Kendall-Tackett, K. A 2005, Depression in new mothers: Causes, consequences, and treatment kendell RE, Chambers JC, Platz C, 1987, epidemiology of puerperal psychosis Br J psychiatry alternatives. Toronto: University of Toronto Press. Lennert, R 2008, The baby is breastfeeding- not the mother. BIRTH, 35(1), pp1-2. McCoy, R.C., Hunt, C.E., Lesko, S., Vezina, R., Corwin, M.J., Willinger, M., Hoffman, H. & Mitchell, A 2004, Frequency of bed-sharing and its relationship to breastfeeding, Journal of Developmental and Behavioural Paediatrics, 25(3), pp141-149. Miracle, D.J. & Fredland, V 2007, Provider encouragement of breastfeeding: efficacy and ethics Journal of Midwifery and Women’s Health, 52(6), pp.545-547. Mitchell, A 2004, Frequency of bed-sharing and its relationship to breastfeeding. Journal of Developmental and Behavioural Paediatrics, 25(3), pp141-149. Moore, E.R., Anderson, G.C. & Bergman, N. (2007). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 3(unknown), pp 1-14. Naish, F. & Roberts, J. (2002). The natural way to better breastfeeding. Sydney: Random House. Obstetrics & Midwifery Guidelines. (2005). Hands off technique (HOT). Western Australia: Department of health. Neifert, R, 1998, Common problems encountered by breastfeeding women, Data retrieved from: http://life.familyeducation.com/breastfeeding/36050.html on March 21 2012. Walker, M. (2007). International breastfeeding initiatives and their relevance to the current state of breastfeeding in the United States. Journal of Midwifery and Womens Health, 52(6), pp.549-555 Read More