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OJT: On the Job Training

Pat Kufeldt
Burke, Virginia, USA
From: LEAVEN, Vol. 34, No. 3, June-July 1998 pp. 60-61

We all know about the learning that a Leader Applicant does as she prepares to become a Leader. In addition to her own experience, an Applicant reads LLL materials and discusses selected topics with both her sponsoring Leader and Leader Accreditation Department representative.

She attends Series and Planning/ Evaluation Meetings, District Workshops and Area Conferences. She becomes more familiar with THE WOMANLY ART OF BREASTFEEDING and THE BREASTFEEDING ANSWER BOOK. Once an Applicant becomes an accredited Leader, she has accumulated information and a personal store of experiential knowledge to support her. And yet, there is still more learning to come. It's called "on the job training" (OJT).

What kinds of things does she learn "on the job?" She learns how to interact with people one-to-one and in a group, how to balance her family obligations and her volunteer work, how to speak passionately about breastfeeding without being labeled a fanatic, how to listen so that she answers a mother's question first, how to build trust and confidence in the mothers with whom she has contact. Sometimes the hardest part of OJT is learning how to provide information and then trust that each mother will use it in the way that best benefits her.

How does a Leader learn these things? Are they in a book somewhere? Does she learn through classes? Do other Leaders tell her about them? They may well be written down, but probably not all in the same book. Workshops are offered frequently and other Leaders can answer puzzling questions, but most Leader skills are learned through OJT. Leaders encounter new situations every day and in the process of working through them they learn something that may change their style of interaction and make them better at their job. Perhaps the most important lesson a Leader learns is the fragile nature of communication between people. The verbal word is filtered through a lifetime of experience.

A Leader friend of mine, Heidi, related how her eyes were opened as a result of dealing with a series of what started out as routine helping calls that became more and more disturbing. The mother, whose baby was not gaining well, stated that she had tried to nurse before but had not been successful. The mother recounted her experiences with lactation consultants and doctors. Heidi became alarmed as she heard what seemed to her to be inaccurate information relayed by these other health care providers. When the situation became critical, Heidi called the lactation consultant, compared notes and made several discoveries.

She found that the lactation consultant knew the mother well. She had counseled her after the birth of her three previous babies. She had indeed given the mother accurate information. The mother hadn't processed the information the way it was presented.

As a result of this tangled web of information and action, which ultimately involved child protective services, Heidi came to several conclusions about how she would handle complicated or disturbing situations in the future.

Follow up all communication channels. If a mother is working with a lactation consultant or another Leader, ask for her name and phone number, or ask the mother to give your name to her. Tell the mother that you would like to get an additional perspective. All of you are working toward the same end and comparing notes can only be helpful.

Define terms. Nursing "often" may mean "every two hours or more frequently" to you but "whenever this sleepy baby is awake" to the mother. Telling a mother that she needs to count wet diapers (nappies) may not be enough. Telling her that a wet diaper is one that holds from 2 to 4 US tablespoons (30-60 ml) of liquid is better; suggesting that she experiment by actually putting liquid into a dry diaper makes it an even stronger definition.

Keep in mind the possibility of a difference between what you hear and reality. It may be that a mother sees things differently than you do, has forgotten what's been said, or feels inadequate in some way and is stretching the facts to fit her needs. Heidi remembers another mother who wondered whether she had an adequate milk supply. She began the conversation by saying that she was breastfeeding and the baby would only nurse for 5 minutes on each side. She went into great detail about how often the baby was fed, how much the baby was gaining, how many diapers he wet and soiled. Only after Heidi reassured the mother that this all described a baby that was getting plenty to eat did the mother mention that she was giving supplemental bottles.

Follow your instincts. If something doesn't sound right, it probably isn't. Be skeptical. Ask more questions. However, Leaders can get involved in sticky situations involving mothers with personal or family problems beyond our area of expertise. Don't be afraid to bow out if a situation becomes more than you can handle. There are ways to exit gracefully.

Keep detailed notes including name, address and phone number. Use the Leader's Log or other preprinted sheets created for this. They will remind you about pertinent information. No matter how casual the conversation may seem, taking notes will keep you focused on what you have already discussed. It will give you a solid reference to go back to and avoid confusion, This may be important if you are dealing with a person who processes information slowly or in a different way.

Give information in small bits; find ways to include it in the conversation three times. Use statements like, "We talked about putting the baby to the breast at least every two hours." "When you put the baby to the breast more frequently, at least every two hours, you will increase your milk supply." "Before we hang up, let's review the things we talked about that can increase your milk supply. You can nurse more frequently, as often as every two hours from the beginning of one feeding to the beginning of the next."

Heidi's "on the job training" has strengthened her commitment to better communication by keeping her eyes and ears open and using her instincts. She says, "I am reminded again that you can give a person all sorts of information, but the individual has to process it and decide what she is going to do. The outcome may not be what you think is best or even what you anticipate. So much of what we do is just listening and being there while a woman is going through a difficult time. She is the one in the end who is responsible for her own choices and outcomes."

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