Monday, September 28, 2009

Becoming Alice

So, I have my first gig as a postpartum doula this week. I'm so excited, and also really anxious about it! We spoke on the phone tonight. She just had her fourth baby on Friday - talk about fresh out of the chute! I'll be doing about 7-8 hours Tuesday-Thursday this week (and we'll re-evaluate then to see if she wants one additional week).

I was going to have to limit it to 3 or MAYBE 4 hours due to Lily being brand new to day care (sob) . . . but then my client asked if I would be okay with bringing Lily with me, which pretty much solves everything! I wouldn't have presumed to suggest it myself, especially my first time out, with a brand-new client, during our first week of service to boot, but she just needs the help so much that it's worth it to her. I'm reducing my rate a tiny bit as a result of that (knowing my attention will be slightly more divided), and it was already very low due to the fact that I'm currently in the midst of the training process, so I feel this is a fair tradeoff.

As she already has 3 other kids, all boys, a lot of it will be helping care for the other kids and doing household chores. That's all good. Here's what I'm most anxious about, along with generally being sure that I'm really being of value to her: she said that she really needs a lot of support with breastfeeding. When I first learned about her, I assumed she'd have it down pat since this was her 4th kid. But she has inverted nipples, and thus needs a lot of help. Yes, she's experienced, but part of that experience includes knowing that she needs extra help. Goes to show what assuming will do . . .

I know what you're thinking - but Anne, you know tons about breastfeeding. And I do, yeah, but having gone through such a trial myself, and knowing just how absolutely BAFFLING, not to mention emotionally charged, nursing difficulties can really be when you're in the midst of it . . . I'm just so afraid I won't be able to help her enough. My own nipples were a little flat, so I do have some experience with it, but inverted is even harder. I'm of course going to look up everything I can on inverted nipples on kellymom and in Jack Newman's book, which I'm going to do here in just a minute.

Anyway, wish me luck! Any advice you have for dealing with inverted nipples would be most welcome, too.

(She told her husband "I need an 'Alice'," which is kind of a great description of what postpartum doulas offer, if The Brady Bunch featured lactation information and help with care for a tender perineum.)


  1. I confess to not knowing as much as I want to about inverted nipples (just saw my first case of truly inverted nipples observing last week) but I know that the route to take can depend on different factors like whether they are truly inverted, how the baby's latch looks (can they get enough into their mouth despite the inversion), etc. Has she breastfed successfully before?

  2. Oh and congratulations on your first doula gig!!

  3. Oh! You will be in my prayers! I totally understand your reservations (I had such trouble in the beginning with nursing, too!) but know you will do great! I feel your concerns as I have the same concerns as I am getting ready to begin teaching Bradley Classes!

    LOVED your post on child birth ed!

  4. Thanks, you guys.

    PHD, she has actually already nursed THREE other babies, which is both good and a little worrisome. I'm going to ask her more today about her previous experiences, and whether her nipples have been successfully drawn out more as a result, and by how much if so. The fact that she HAS nursed before, three times, and still listed breastfeeding support as one of her major concerns is what makes me worry that it's a pretty severe case, and that the suggestions I have to offer may be stuff she already knows and might not work so well. But I did a lot of reading last night and feel a bit more confident. Also got these recommended by Jennifer, my own personal IBCLC goddess:

    Good luck with those Bradley classes, roadrunner! "Natural Childbirth the Bradley Way" was my first eye-opening glimpse into this world, about ten years ago!

  5. She is lucky to have you as her doula :)

    And support might just mean that she wants encouragement when it gets hard, support when she feels overwhelmed by the work involved, and some love when she feels like it might not be worth don't worry if you don't have all of the answers! Handing her a glass of water, preparing a healthy snack, telling her how content her and her new babe look while they nurse...these all count as Breastfeeding Support, too!

  6. Thanks so much. And those are wise words indeed!

    Also? I will insist that she take a nice long hot shower every day I'm there. That always made a big difference to me early on in mama-hood. (Come to think of it, it still does!)

  7. Interesting about the supple cups! I bet the LCs I work with haven't heard of them, they seem new. But if they work well, they sound like a great tool.

    I am curious too about her previous breastfeeding experiences! Keep us updated if you can!