I work in a hospital that delivers over 5,000 babies a year. We are one of the few hospitals in the state to offer donor breastmilk to severely premature infants. Our population is diverse, ranging from Orthodox Jewish mothers to undocumented immigrants. As a nurse and lactation consultant I strive to encourage the benefits of breastfeeding to my patients regardless of their background while at the same time understanding that not everyone wants to breastfeed or has the support to do so. As is often the case, most breastfeeding mothers I take care of want to provide the benefits that their milk has to offer but also want to feel comfortable and supported during the experience. When I met a patient we’ll call Mary, this was the type of situation she found herself going through. Although Mary personally experienced a lot of struggle and hardship in her life, her breastfeeding experience can translate to women of many backgrounds.
Mary was a single mother who had given birth to her third child, a daughter. She had been compliant with her medication through the Methadone clinic for several years but due to her prior drug use and incarcerations she did not have custody of her two other children. Her mother was at the hospital as her support person and spent most of the day with Mary and her baby. When the subject of how she was going to feed her daughter came up I told her it was highly recommended that she breastfeed or pump for her baby. I explained to her that the Methadone present in her milk would be a continuation of the medication the baby had also been getting in utero and this would help lessen the severity of withdrawal symptoms that the baby might experience. She said she didn’t feel comfortable nursing the baby directly but wanted to try pumping. I set her up with the hospital breast pump and made arrangements to get her a pump for when she would be going home.
After two nights in the hospital it was time for Mary and her baby to be discharged. The social worker had been working on Mary’s case, making sure she had what she needed for the baby at home. Because of her past history, the Department of Family Services was also contacted to see Mary at the hospital and do a home visit and it was still undecided whether the baby would go home with her. When it was decided that the baby would have to stay a few extra days in the nursery, Mary was crying and devastated. It was still unclear where the home of this baby would be and Mary was nervous and distraught. I tried staying positive, encouraging her to visit often and keep up her pumping at home. She nodded and said she would be back the next day to spend time with the baby.
A few days went by and I watched Mary come in to visit her daughter in the nursery. Her milk supply was steadily increasing and she came with plentiful bottles of breastmilk she had pumped. The day finally came when it was decided that Mary’s daughter would be going home with her. As Mary prepared her baby for going home, she came up to me before they both left. “I just want to say thank you for encouraging me to pump for my baby. I feel good that I can do this for her and that my milk is helping her.” I smiled and gave her a hug, wishing her luck in the future and felt that special kind of fulfillment that comes when a nurse has witnessed the positive effects of her care to a patient.
We so often discuss the benefits of breastfeeding for babies but we rarely think about the emotional benefits for mothers. For Mary, providing breastmilk represented something she was in control of and something that was good for her baby. She figured out what she was comfortable with and what worked for her. While the fate of her child’s custody was not in her hands, the ability to provide for her daughter in a way that is strictly unique to mothers was the stimulus that kept her going. Breastfeeding is a personal journey for women. While it is important to pay attention to the physical aspects of the baby in regards to feeding, we must also remember to focus on the feelings of the mother. If we can remember to do just that we can help our breastfeeding patients have babies with full bellies and mothers with bright smiles.