SAN DIEGO — It was 2 a.m. and Sallie Poet was desperate.
At the hospital, nursing her new baby had been, at best, an exercise in hopelessness, she said. But now mother and infant were home, and the problem was becoming more critical as little James Davis Nexsen Poet's birth weight continued to drop.
Exhausted and frustrated, still holding her screaming and inconsolable son, Sallie Poet made what she considers to be one of the most important phone calls of her life.
Dialed the Number
From a friend, she had heard of the San Diego Lactation Program, based at Mercy Hospital. She dialed the number and got a recorded message, informing her that a return call would come during business hours.
Poet tried once more to nurse her son, but the baby wasn't "latching on" to her breast. Fearing the worst, she concluded, "I have no milk." Feelings of inadequacy gave way to a need to "get it right." That night, she said, the baby nursed enough to allow mother, father and himself six hours of blessed rest.
But by 8 the next morning, the problem had reappeared with a vengeance. Her nipples cracked and tender, Poet again rang the lactation clinic. This time Ruth Wester answered the call and within the hour, the Poet family was at her side for the first of several hours of therapy.
The diagnosis by Wester, a nurse practitioner, was swift and sure--engorgement (breasts swollen with milk) and baby sucking improperly. Therapy entailed merely teaching baby the right way to suck and giving mother a big boost in confidence.
Four hours later, James Poet was a champion nurser and his mother no longer felt helpless to quell his cries for nourishment.
The Poets were not the first family to be helped by Wester and her colleague, pediatrician Dr. Audrey J. Naylor, founders of the San Diego Lactation Program. Established in 1977, the purpose of the program is twofold, they said: to educate professionals about the benefits of breast-feeding and to help parents solve vexing breastfeeding problems.
The dedication of Naylor and Wester has not gone unnoticed by those they have helped or by their colleagues.
Chele Marmet, coordinator of the Breastfeeding Clinic at UCLA and director of The Lactation Institute and Breastfeeding Clinic in Encino, said she sought the guidance and support of Naylor and Wester when she opened the Encino clinic six years ago.
'A Lost Art'
"They're well-regarded, highly thought of nationally and internationally," Marmet said. "This is a new profession. Though women have been breast-feeding thousands of years, it's a lost art. We've lost a generation of mothers who can teach women how to breast-feed. Babies suck instinctively--and that's it. Proper breast-feeding is not innate--it's learned.
"Since breast-feeding is a confidence game, women really do need education and support," she continued. "You need somebody when you run into problems and feel trouble. Most physicians don't have the training. Naylor and Wester are among the very few of the most highly trained experts in a tiny field."
Marmet said only three cities in the country offer clinical help to nursing mothers in distress--Los Angeles, Cleveland and San Diego. (USC Medical Center also offers a breast-feeding clinic one day a week.)
A Budding Partnership
Naylor and Wester, both 53, were trained in Los Angeles. Naylor attended medical school at UCLA. Wester spent 18 years at UCLA, part of that time as head nurse of the Marion Davies Children's Clinic where she met Naylor, who shared her growing interest in preventive medicine. A partnership was born.
Wester, an articulate woman with straw-colored hair and a passion for sailing, said many doctors "don't think breast-feeding matters. Many haven't taken the time to read. You wouldn't believe the number of doctors who say, 'That's OK, a little formula won't hurt.' "
Wester and Naylor disagree. They believe a breast-fed baby is sounder nutritionally, more resistant to disease and allergy, ahead of bottle-fed peers in psychosocial development and has better teeth.
Naylor noted that the incidence of breast-feeding among upper- and middle-income families is now 60% when leaving the hospital. The number falls six months later. Among lower-income families, the figure--on leaving the hospital--is less than 40%.
Dr. Beverly Winikoff, director of The Population Council, a New York-based research and technical assistance organization for family planning and health, calls the San Diego program the best of its kind in the world.
'The Model Clinic'
"I think they're great," she said in a telephone interview from her home in Manhattan. "They have the model clinic and breast-feeding training program for the country . . . . They perform a terribly important service, which happens to be supported nowhere near like it should be. It deserves much better."