As the course creator for an IBCLC prep course, I teach how to “ascertain the mother’s breastfeeding goal.” How can I teach someone to do this? It’s not easy.
In my experience, simply saying to the mother, “What is your goal for breastfeeding?” accomplishes little. If I’m lucky, the mother can articulate that she plans to breastfeed for a certain number of weeks or months. But that tells me little about whether she wants to do exclusive or partial breastfeeding, whether she wants to feed her milk to her baby in a bottle, or whether she wants others to feed the baby. So, to get some real answers about the mother’s breastfeeding goal, I try to use the Darn4 model.
The “desire” is often more of a wish or a hope than a goal. That’s okay; we all need to start somewhere. So, the mother says she wants to exclusively breastfeed for 6 months. Okay. After offering some praise and reassurance that this is a good idea, it’s easy to drop in a few open-ending questions.
That means I will avoid the closed-ended question, “Do you want to put your milk in a bottle,” especially after interviewing Kathleeen Rasmussen. But I do like to ask, as casually as I can, “Okay, so what do you think will make breastfeeding easier or more difficult for you?” This question helps to better clarify the mother’s breastfeeding goal because it opens the door for further dialogue about the how-to aspect of reaching the goal.
The next question might be along the lines of, “Did you breastfeed your last baby? How did it go?” Or, if this is her first baby, you might ask, “What have you heard about breastfeeding?” This is a great way to uncover any myths she has heard. These myths could seriously impair her ability to actually carry through with her breastfeeding goal.
Does she have the ability to make breastfeeding work? Does she have the knowledge, support, and life circumstances to make it work? If she has a critically-ill baby, she might have ability to nurse, but her baby will not have that ability.
So, make sure you ask enough questions to determine if the mother’s breastfeeding goal is realistic in the circumstances.
The key here is to get at the reasons behind the mother’s breastfeeding goal. What’s her motivation? It might for some perceived benefit to reap (e.g., “best for the baby,” or “best for the environment”) or some risk or adverse effect to avoid (e.g., “my other kids had allergies”).
I try not to lob too many “why” questions; I worry that it puts the client on the defensive. But I might ask, “How did you come to your decision to breastfeed? I know, I know, it’s really just a “why” question in disguise, but it does sound less threatening.
“Why” is an important factor. Most life coaches agree that if we have a big enough “why” we will be willing and able to stay the course until we find the “how” of starting and continuing, on our journey. The same is true for the mother’s breastfeeding goal.
The aim here is to figure out the importance of the perceived need. How important is this? This is different from “reason.” Whereas the “reason” is more about motivation, the “need” is more about the outcomes — the perceived impact.
Try asking a question structured like this: “If you … then what …” This helps the client focus on the outcome for herself. “If you exclusively breastfeed for 6 months, then what would that do for you or your family?
I admit, parents often can’t answer that. I give some examples. “Do you think that might help you to avoid all of those doctor-visits you made for your firstborn’s multiple ear infections?” This helps address the mother’s breastfeeding goal from a different angle.
Notice that protection from ear infection is largely baby-focused; not having to repeatedly schlep the kids to the doctor’s office is a game-changer for the mother. That’s “need” rather than “reason.” (Admittedly, there is some overlap.)
Interviewing with the Darn4 isn’t easy, and it doesn’t always work. But it’s a great step beyond just asking, “What is your goal for breastfeeding?”
How do you inquire about a mother’s breastfeeding goal? Share your thoughts in the comments below!