Charts and Checklists: Friends or Foes?

Linda J. Smith, BSE, FACCE, IBCLC

New mothers are in a unique mental, emotional, and physical state. A new mother is physically drained after labor and birth, emotionally open to her precious new baby, and in a state of remarkable hormone fluctuations. Yet she is expected to take care of herself and her baby, and sometimes the rest of the family too!. There is an ongoing debate among lactation professionals whether charts and forms are helpful tools or significant barriers to mothers getting to know and trust their babies. I think they can be both - here's why:

People learn in many ways - auditory, kinesthetic (hands-on) and visual. Most of us favor one or two modes; over 85% are primarily visual learners. There's no rule that says we can only learn one way. The more modalities used, the higher the retention/understanding of the information. Breastfeeding is mostly a kinesthetic experience, like learning to swim or play a musical instrument.

Right-brain learners need to see the "big picture." They thrive on "watch for long, slow gulping" and other subjective measures of "success." They don't comprehend numbers/objective stuff as well, especially in the postpartum period.

Left-brain learners thrive on numbers and logic. They tune in to "watch for 5 stools on day 5," written instructions and other objective measures of "success." They don't comprehend subjective/watch-the-baby ideas as well, especially in the postpartum period.

BOTH approaches have validity - depending on the mother, of course! And most moms have someone in the family who has other learning styles that will be addressed by the approach that the mom doesn't prefer/use well.

Remember, it's been shown that moms lose 10 IQ points immediately postpartum (dads only lose 5.) [Eidelman, AI, Hoffmann NW, Kaitz M: Cognitive deficits in women after childbirth. Obstet Gynecol 1993;81:764-7.]

I can't think of a good reason NOT to use multiple approaches, just as long as the information leads to the same goal - baby getting enough milk at breast.