Midwifery, Breastfeeding, Camping and Possums

I have just had a week away doing a couple of the things I love best.
Firstly I was doing some locum midwife cover from Friday through to Monday last weekend. The midwives I was covering for have a fairly busy caseload and so, for these few days, I got to do a full range of midwifery practice. I saw women antenatally at all stages of pregnancy, from booking through to end of care postnatal visits. I was supporting women beginning to breast feed their babies, visiting women at home with new babies and seeing women at varying stages of pregnancy. It is a challenge to step into these women’s lives for a few days and make sure that they receive the care and support they need. I was also able to care for a young woman during the labour and birth of her first child. This young woman had a posterior lying baby but was able to focus in on her body and her labour, with great support from her family, and birth her baby with just a little entenox to help her through transition and birth. My job was just to help everyone stay calmly focussed on the labour, on cervical dilation and on birthing the baby. It was a very joyful and empowering experience for everyone, including me.

While I was there I found out that the midwives had a breastfeeding workshop arranged for the Tuesday and I was welcomed to join them. This was very opportune for me as it is the one aspect of the midwifery recertification program that I had not yet been able to do this year. I leapt at the chance. The facilitator, Dawn Holland, used some really good visual aids to help get her message across. The main points that stood out for me were
• Women have varying amounts of glandular breast tissue.
• Breast size is not a good indicator of the amount of glandular tissue there is in a breast.
• Babies do not realise that their mother has more or less glandular tissue than any other mother but adjust their feeding requirements to meet their (the babies) nutritional needs.
• Babies will obtain adequate nutrition from their mothers’ breast if they are allowed to feed on demand.
• Babies may need to feed very frequently, if there is less glandular tissue, or might be able to feed much less frequently when there is an abundance of glandular tissue.
• The volume that babies receive does not change much over time.
Another interesting point was regarding prolactin receptors which are stimulated through early frequent feeding. Dawn likened this to the buckets with lids on. As the new mother feeds the lids come off the buckets which can then be filled with milk. After about six days no more lids can come off the buckets, so the volume of milk the breast is able to produce is set. This reinforces the importance of early frequent feeding for the establishment of lactation. If the baby is not able to feed for some reason frequent expression is necessary. To establish good and adequate lactation Duration, Intensity and Frequency of feeding are the key factors. It is the DIF in DIFference that makes the difference.

On Wednesday my sister her two children and I headed off in my campervan for the last days of the school holidays. Although it was wet and cold we had a great time. Went to Alexandra, Queenstown, Glenorchy and Arrowtown and home today. It was a shame we had quite a lot of rain but it did not stop us from getting out and about. Now I want to get back to those places again, especially Glenorchy and Arrowtown and really explore them.I came home with some lovely pieces of possum fur, purchased in Glenorchy, ready to get crafty and make some lovely (I hope) things.