A rough week.

One of the great things about being a lactation consultant is that you can often solve breastfeeding problems quickly, and the results are often dramatic.  Sometimes it sounds something like this:  "Oh my God, it doesn't hurt!" or "Is this scale right?  Could he have really gained that much?"

The not so great thing is when, in spite of your knowledge, your genuine empathy, your willingness to listen, and all of the tricks you know, it just isn't working.   The visual for that:  Me sprawled on the couch eating leftover Halloween candy.

I've had one of those weeks.  And for some reason these weeks weigh so much more heavily than the good ones.  Here are a few of the cases that made it a rough week:

• A family who got off to a bad start with milk supply, who left the clinic with a good plan and lots of hope, calling me the next day for advice on how to wean.
• A mother calling in tears because she had been advised to suddenly drop a significant formula supplement and the baby was a mess all day.
• A baby who hadn't latched since a circumcision four days earlier, and who screamed when put to breast.  I was unable to get the baby to latch during our appointment.
• And the worst:  A friend I've been helping who continues to experience painful problem after problem.  It's bothering me so much that I put out an APB to the other lactation consultants in the area.

First, I should say, I know that this isn't about me and my feelings.  The frustration and anxiety I feel is nothing compared to the feelings of those families.

And rationally, I know that I'm often in an impossible situation.  Sometimes being a lactation consultant can be a little like being a relief pitcher - the closer.  You usually get called in when your team is down (there's already pain and abnormal weight loss), in the final innings of the game ("I'm about ready to quit"), with the bases loaded (grandma has a bottle in hand).  But if I've pulled it off before I expect to be able to do it every time. 

At some point I get angry, and start to look for someone to blame.  Why are women told "the latch looks fine" when they are in excrutiating pain?  Why are mothers given nipple shields with no information on how to use or get rid of them?  Why am I the first person to notice a tongue tie when a baby is a month old?  Why doesn't anyone tell women that having gestational diabetes often causes a delay in milk coming in - and develop a plan for her and her baby?  I get all riled up and then come home and collapse on the couch.

Believe me, I know that I am far from perfect.  I try to communicate clearly, but things don't always come out the way I want them to.  I know a lot, but I certainly don't know everything there is to know about lactation.  I also struggle to figure out how much responsibility I should take for solving a problem.

Last Wednesday was especially busy - I think I saw twelve families in two hours.  Just before leaving I called a woman who I'd seen earlier in the week.  She'd had significant pain while feeding, but we'd been able to get a really comfortable latch each time she came in.  I've done this enough to know, however, that it's often a different story when you go home.  When I called to check in she said that the small changes in positioning and latch we had tried had turned the situation around overnight.  She'd had a day and a half of pain-free nursing, and was thrilled.

Again, I know it's not about me.  But it was just what I needed to hear.