Imagine this: You’re sitting with a client you’ve been seeing for some time. Theirs has been a truly hard road. You’ve done your best, and your client has worked so hard. But the problems are still not resolved.
And now, they’ve told you they think it might be time to quit.
Maybe they're thinking of stopping breast/chestfeeding altogether. Maybe they’ve been triple-feeding to increase a low supply and are ready to stop pumping and accept the supply they have. Or maybe they’ve been struggling to woo a non-latching baby to the breast/chest and are weighing the decision to exclusively pump.
As a lactation support professional, what can you do to help?
Drawn from our course When Breastfeeding Fails, below are 10 steps for supporting a parent who has reached their limit and needs to make a change.
Weigh your words. When a client is struggling so hard that they’re thinking of quitting, your words have enormous impact–so choose carefully. Even commonly used phrases can inadvertently shape the narrative a parent is creating. Take this one, for example: “Your baby refuses to take the breast.” What feeling does that create, compared to, “Your baby is struggling to latch”? The first can add to a parent’s feeling of rejection, while the latter helps them realize that their baby wants to breast/chestfeed, but something is getting in the way.
Empower them to decide. What if your struggling client seems to be “asking permission” to give up? You can ask open-ended questions, reflect what you hear, and provide evidence-based information–but they must be the one to decide. Simple encouragements go a long way: “You are in the best position to know what’s right for you” and “At the end of the day, this is your baby and your journey–you’re the parent, and you can trust your gut.”
Honor their efforts. A parent who is letting go needs to be seen for how hard they’ve tried. Avoid easy generalities (“You worked really hard”). Instead, try to review this parent’s specific challenges, all the steps they took, and the efforts they made. A helpful reassurance: “None of your effort was wasted. You can have real peace of mind, knowing you tried everything you could.” Your words can help them see their effort as the important–even heroic–work that it was.
Prepare them for what others might say. Significant people in your client’s life may have opinions about their decision. Ironically, both “I’m so glad you finally gave that up” and “I can’t believe you gave up” can be painful to hear. If your client would like, you can help them think through others’ likely responses and how they want to navigate those conversations.
Remind them that hindsight is 20/20. Sometimes, in retrospect and with a lot more lactation information, a client feels they made mistakes and blames themselves. Reassure them that they made the best decisions they could with the information they had–which is all anyone can do.
Rescue something positive. Whether it’s the hours they spent skin to skin with their baby, the milk their baby got, or the insight they gained at reading and responding to their baby, help them to celebrate the benefits they both received. Emphasize that many babies do not get any of their parent’s milk or any minutes at the breast!
Help set a new goal. What was most important or exciting to them about breast/chestfeeding? If it was bonding with their baby, they could try an at-breast supplementer or feed responsively, feed in arms, and hold and wear their baby. If they were excited about the benefits of human milk, can they explore donor human milk? Understanding their motivation will help identify a goal that is meaningful for them.
Leave the door open. When appropriate, gently suggest that today’s decision doesn’t have to be set in stone and could be revisited in the future, if they desire. For example, a client with a non-latching baby who decides to exclusively pump can try offering the chest/breast again later, if they want to.
Talk about next time. Explore whether your client would like to discuss breast/chestfeeding future babies–many people appreciate the chance to focus on hope for next time. Each baby and each lactation experience is different, and more milk tends to be made with each baby. If there were primary production problems, head-start measures can be tried the next time. Evidence shows that those who perceive themselves to have experienced a lactation failure are less likely to initiate with the next baby … the information you share now could make the difference.
Take care of you. When you’ve worked long and hard alongside a client and the outcome isn’t what either of you hoped for, it can be difficult for you, too. You can find yourself ruminating, questioning your skills, and grieving along with the parent. Take the time to acknowledge your feelings. Remind yourself of consults that have gone well, and seek out the support you need, whether that’s rest, exercise, sunlight, or a colleague’s listening ear. That way, you’ll be ready to help the next family that comes your way.
Ready for More?
This is just a tiny piece of the course When Breastfeeding Fails a four-hour, two-part course deeply exploring the causes (primary and secondary, parent and baby) of lactation failure, as well as in-depth advice for counseling and communicating during the most difficult breast/chestfeeding challenges. Instructor Margaret Sabo Willis, BA, IBCLC, brings rich insight and wisdom to this course, which also includes interviews with parents who have experienced lactation failure.
View the Course