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Aditya Newborn Care Unit - Lactation Diary 19.05.2022 | Dr. Shaarduli Terwaadkar


9 Jun 2022
Lactation Professional from Sangli, Dr. Shaarduli Terwaadkar sharing an experiance of newborn baby's treatment. No wonder it's said that it takes a village to raise a child. As children are future and assets of every community, a tiny baby brings together a whole family and a community too.
I had a wonderful experience at our hospital.
A family from a village, admitted their 6 days old baby in our hospital being Preterm baby with complaints of apnea and sepsis, while mother stayed back home due to incapability of traveling long distance.....at previous hospital, baby was RT fed with formula and no breastfeeding was given as the mother was not having enough flow.
As lactation Professional, I took detailed history from Resident Doctor. When I called the mother for counseling, came to know that they can't afford to get a room so left mother at native place. I discussed with the father and requested him to have mother in premises and she must remain in vicinity. As he openly showed his inability to get a room, we suggested to make some arrangements at relatives' place nearby. Luckily they had a relative in nearby town and they arranged for her stay there. After 2 days of pursuation, finally I met mother and found out that she was weak and as staying at some stranger's place, was not getting enough food. It was heartbreaking to see her crying. Also she used to travel to and fro for feeding and again maon purpose wasn't served. Hardly 5 ml breastmilk was available for baby.
As lactation policy of our hospital, I gave counseling to the whole family again and trained her for massage, press and express technique alongwith diet and rest counseling. 
Mother was encouraged to express milk as much as possible and that feed was introduced topped up with formula feed to compensate the deficit.
Yesterday when I visited NICU again, sister told me that baby is not getting enough milk as mother is not having enough flow. That was really disturbing and called the father. He said that just because of my request, he brought her at a relative's place in nearby town and as she stays in their distant relative's place, she has not courage to ask for food. I was disappointed to hear this. I requested him to look after this matter seriously or else the baby will take many more days to recover adding to the expenses now and also in future due to low immunity. Anyways he didn't bother about weakness and diet issue of his wife in previous consultation, I pushed this button and it worked. He agreed to provide food from a mess nearby.
While I was discussing the matter with the father, two men stepped up to listen to the conversation. I was not happy at that moment to have this interference in a serious conversation, but they politely introduced themselves and the father also seemed okay with their presence. One of the fathers of other patient said that he had been observing this family struggling and to hear to the concern in my voice, he dared to interfere and offer some help. It was a pleasant surprise to me to have this friendly gesture by these kind people. The other one not only took permission from me to help actively, but also when I came to hospital today, he showed me a box of Shatavari Kalpa and took guidance about the dosage and preparation method. Now I was assured that atleast that mother will get 2 glasses of milk with Shatavari Kalpa. 
We decided not to insist on rooming in anymore as they were reluctant to spend money. We suggested to bring in mother and she will rest in feeding room for whole day and will give expressed milk for night before leaving. 
But flow was not enough due to emotional stresses and obvious less intake by mother. So finally the father decided to get a room for feeding. When I was giving counseling again, she seemed to be stressed due to excessive financial burden due to this baby. She said that she raised 3 daughters who are ok and now finally I have a son but he is so weak. I advised her to stay calm and focused. Taught her few breathing techniques, massage, fomentation with hot water bottle and thorough hand pumping with advice for 10 pumpings with 2 hrs interval. Also gave her customized diet and relaxation guidance to improve nourishment.
In the evening round, i found out that her family was feasting on restaurant takeaway and she was having a little rice and dal. I had a little chat with all of them in light mood and requested to give her a proper meal. But she said that she can't tolerate spicy food now and don't know where to find a healthy mild food. I was surprised to see that her whole family was not taking any effort to provide her special food and that would have been cheaper than their restaurant feasts. But as a counselor, we must know about our limits too. I suggested few names of few local tiffin suppliers who provide good food at affordable prices. 
In the afternoon, before I was leaving, thought of dropping in the rooms and found out that mother is feeding the baby with formula. I was surprised and asked her about her flow. 
She said that now flow is improving but she was convinced by her family that she is too weak to provide a healthy feed to her baby as she was multipara and currently undernourished. So she should feed the "Healthy" formula. 
I was stunned to know about it. Somehow I had a light chat with the whole family and once again tried to convince them about goodness of breastmilk and it's dire need in that situation. Also told them why and how Dr. Tagare is promoting Breastfeeding and Early Discharge. Also how it's going to reduce their further formula expenses, hazards of formula dilution and probable episodes of health problems in baby due to low nutrition and immunity. 
That seemed to show a little impression. 
Within two days, the baby got discharged. 
We congratulated the family and appreciated the two supportive families who helped them in that tough time. It's always a great emotional and grateful moment to see the bonding created by those little ones in our staff and also in other families in IPD.
Last week I received a call from the father expressing his gratitude for us. He was calling me to their village to help the other women in community who have problems in breastfeeding. Jokingly he said that my wife says that she is missing Madam's smile and her voice. I was touched by this great gesture of appreciation. Sometimes we can't help the families as much as we want due to various situations and certain professional limitations. But it's great boost for confidence and humanity, I must say, to have such incidences in life.
He was very much grateful to Dr.Tagare for his genuine efforts and also for giving concessions on the charges after considering their plea about their financial problems. 
And lastly, he told me, " Tai (Elder Sister), you were very calm, soothing and friendly to us. We have developed a bond with you. We remember you every day." He was laughing while telling that they were surprised to see that his weak wife was also able to provide breastmilk and they used to joke around that she can produce that much feed when she hears me coming for round. Jokes apart, I have realised that lactation consultant needs a thorough knowledge but most importantly, a lots of understanding of the background of patients, love, patience and perseverance.
Previously as an Ayurvedic Consultant and Lifestyle Consultant, I had been giving counseling to my female patients coming for treatment of hormonal imbalance,  infertility, Garbhasanskar and Postnatal Care. I also had experience of working for Women's Health, especially Menstrual Health Management in South Africa and India. But I have realised that having exclusive focus and guidance about breastfeeding encompasses the comprehensive support on holistic health of a family.
Thanks Dr. Amit.... for giving me this opportunity and inspiration for pursuing my interest. 
Thanks Dana....for your cheerful and motivating approach towards wholesome training in Mother and Child Nutrition and  specifically. It's really commendable job done by making such a well-designed and illustrative course that made me clinically empowered in the field of lactation. 
It seems to be a great journey ahead !!!
 
Dr. Shaarduli Terwaadkar
Lactation Professional
Aditya Newborn Care Unit,
Sangli

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