#32 Lactation consult

That’s what I need.  I need a lactation consultant here!  24-7!!!  

Maternity rounds consist usually of 2 to 6 patients.  I have one long termer patient that has been here for almost 2 months, but I’ll save her for another story.  I just pray that she lives.  Maternity rounds seem to take longer than surgery (with 20 patients) because until recently I have had less than great maternity nurses.  Now I have a new nurse who is excellent and I am thrilled to death!  

This morning on rounds I had had my long-termer, 2 normal postpartum patients with babies, one laboring patient, and one postpartum patient whose baby died.  To the first time mom who delivered yesterday I asked, “Is the baby eating well?”  (Often I get the answer that the baby hasn’t eaten yet in 1 day, but I have been making the baby eat right away in my presence now if I deliver them.)

“Yes, very well.”

“The baby is eating milk from the breast well?”

“Yes.”

“How many times have you given your baby water?”, I ask in a normal tone.

If you’re not a parent, you may not know that you’re not supposed to give an infant plain water anywhere.  It will throw off the baby’s electrolytes, and the baby will eventually die.  Let alone that the water here has giardia in it half the time.  And there are no nutrients at all in water!  Malnutrition is a killer here!

I used to think that my questions were answered wrong because of my bad French.  “Du lait” or milk is pretty similar to “de l’eau” or water.  But I now realize that there is actually a problem.

“Four times already,” the father pipes up.  

I about lose it.  “What?”  I go into a detailed speech as to why you should not give water to your infant baby.  Well, okay, as detailed as can be with beginner’s French and then translated into the local language by the nurse.

Next mother.  She delivered 2 weeks ago, but had something (uterus or bladder) that prolapsed from her vagina.  People come from far away, and if it’s late they stay in the hospital until the next day when I can see them.  She had nothing prolapsing from her vagina now.  So I said if anything comes out again, come back.  

“Cute baby girl!”  “How is she eating?”  

Again, “Very well.”

“Breast milk?”

“Yes,” she said.

“How many times do you give her water?”

“Several times a day.”

This time I don’t lose it, but explain again somehow calmly how bad giving water to an infant is.  I feel like a broken record.  

Olen tells me often that... it’s the culture.  When the kids run into our yard and take all of the brown paper that was used to wrap furniture in our container, “It’s the culture dear”.  

“Ya, well, they didn’t ask, they are stealing!”

“It’s the culture, to them it’s not stealing!”  

“So when I eventually plant a garden and they come in to take my vegetables, it’s not stealing?  It’s just the culture?”  

Culture cannot be changed I suppose.  But we can educate women to help their babies live somehow.  It’s a simple step.  Only give breastmilk to your babies for the first 4-6 months of their life.  It’s too expensive for the women here to buy formula, though it’s available.  

I would love to have a lactation consultant!  Even nicer if she (yes I said she, it would be weird to have a male consultant here, you know the whole culture thing...) spoke French, Nangerie, Arabic, and all of the other local tribal languages.  

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