03/04/2026
I haven't posted for a while- between 3 jobs and studying 3 university diploma subjects (as well as being a mum, trying, and failing, with keeping up with the housework and landscaping my garden) you could say that social media posts have taken a lower priority.
But, I felt a compelling need to share some reflections.
I have been thinking a lot about a family I recently cared for. The baby hospitalised and having treatment for jaundice, poor feeding and weight loss >11%.
My reflections could be categorised:
Conflicting advice
It always sits with me how overwhelming it is for families to hear what I have to say after hearing something completely different from other health professionals. Then comes the cognitive overload of cramming in all the information in one go. Pump fl**ge fitting continues to be incorrect. decreasing the fl**ge size had an immediate positive effect on pump output.
Lack of information
When families are not told the basics, like volumes that babies thrive on, breastmilk being dynamic and changing across the day, breast-seeking reflexes and breastfeeding behaviours, they are not able to make choices that help baby to feed well. It's so frustrating and overwhelming for families to have to do a breastfeeding 101 cram session on top of everything else.
Holding space/Being with
As a younger person, emotions were confronting. I feel what others are feeling, so I would put up barriers to protect myself and not cry (or try to get the person to stop feeling what they were feeling). Today, I reflect on my own personal progress and how far I have come (14 years of dealing with an emotional topic and supporting mothers and lactating parents in their grief will do that).
When preparing for the next feed, I noticed a big sigh coming from mum. knowing I was opening up a bag of worms but not afraid of what was to come, I gave mum the opportunity to express those feelings. And then came the cry (to be expected under the circumstances). And I held space for those emotions to play out. Emotions that can be suppressed and held in the body. Emotions that create tension and impact on feeding.
Holding space and 'being with' is SO important in the lactation support role.
And then we worked through it, together.
I explain that the body protects itself. When an activity has been previously stressful, the body braces (TENSION) as it goes into protective mode. It is a subconscious process. But when we know that its happening, we can send "conscious thought" to the body to reassure and calm it.
We worked through some relaxation strategies pre-feed: breathing, soften the jaw, drop the shoulders.
Recognising, validating and providing strategies allows the body to prepare for a successful feed.
Ignoring these emotions to maintain my own comfort zone would have been detrimental for this mum.
Ni**le shields
Shields are a last resort in my practice (NEVER without a proper assessment). I believe that shields are overused and often a bandaid for underlying feeding issues that end up not being effectively addressed.
But they are a tool.
And for this dyad, was one of the rare times that I initiated this tool (with informed consent).
After assessing 2 feeds and utilising conservative strategies, I had identified that this baby was struggling to trigger a suck reflex. I hypothesised that some additional palate stimulation might help as the baby coped well with finger feeding.
Reluctantly, I started the shield, with a supply line.
I was so delighted when this little baby suckled at the breast, took the expressed milk via the supply line and continued to suck effectively after the supply line flow had stopped. Mum voiced how impressed she was with her baby, and it felt like major progress.
I stayed back 30 minutes after my shift had ended to see it through to the end.
I will not initiate a shield unless assessment and clinical picture warrants it. But this was one of those times when I was so happy to have a shield as a tool in my belt.
This was the happy ending after 3 challenging feeds.
Don't underestimate dads
The dad in this family unit admitted that he did not understand why breastfeeding was so important to mum when there was the option of pumping and bottling. He wanted to understand and he wanted to help but didn't know how. He was so present and so keen to learn. Once I explained the biology and psychology (and suggested further reading material: "Why Breastfeeding Grief and Trauma Matter"- Amy Brown), I felt he had better capacity for practical and emotional support. Dad's (and coparents) are such an important part of breastfeeding success.
We can't forget they too are on the journey.
This little family needed my time and energy.
Making a difference is the reward of the job.
The bonus was the gratitude expressed by mum and dad.
If you have read this far, thank you.
I just needed to send this reflection out to the universe.
Maybe it resonates with someone.
xx josie
