Health Coach: Nursing a baby is hard work. You should really feel good about how you've gone that extra mile.
Samantha: Thanks.
Health Coach: Zoe is doing wonderfully. And that's all thanks to you.
Samantha: It is important to me. I mean, I've read all this stuff, "human milk for human babies," and how it'll make her smarter and healthier. I wanted to nurse as long as I could. It was going fine until I started having to pump.
Samantha’s thought: I really thought I could do it all.
Coach: By affirming the sacrifices this mom has already made, the Health Coach helped her feel more committed to continue breastfeeding and better able to trust her own judgment about what's right for her baby.
Health Coach: It sounds like pumping is the real problem for you.
Samantha: I mean, no offense but you have no idea what it feels like to have to get up from meetings three times a day and go strip down in some closet, hoping no one walks in on you.
Health Coach: It can be really awkward.
Samantha: And none of my co-workers have kids, and I just feel how annoyed they get. (exhausted, a little teary) And all that time I spend pumping is either work I'm not doing, or overtime I have to put in away from Zoe just to keep up.
Coach: Even though this mom is focusing on the negative aspects of breastfeeding right now, the Health Coach’s reflections are helping her look at the problem in a more productive way. Instead of stopping the nursing, which she likes, the Health Coach and Samantha can focus together on a plan to make pumping work better for her.
Health Coach: (sympathetic) It's been incredibly stressful for you. It sounds like what you really want is a way to keep nursing, but not have to pump as much at work.
Samantha: (sarcastically) Sure, let me just clone myself.
Health Coach: (gentle) We don't need to go quite that far.
Coach: This was a great response! When Samantha raised a barrier, pumping at work being difficult, the Health Coach used an action reflection to turn it into a potential action step. Next, he should help her come up with a plan to take that action.
Coach: The health coach is now in the plan stage of the conversation. His goal is to collaborate with this mom on a plan to address her trouble with pumping so she can continue to breastfeed.
Health Coach: What's a solution that might work for you?
Samantha: (considering) Maybe I can nurse in the morning and at night and use formula during the day? But won't that make my milk go down?
Health Coach: (non-committal) Mm.
Samantha: Maybe I can pump just at lunch? There's a lot less people around. And on the weekend? It would definitely be easier to do it at home.
Coach: By asking the mom to come up with her own solutions, the Health Coach is more likely to find a plan she'll actually use. And he saves time he might have wasted offering suggestions that don't work for her.
Health Coach: What I'm hearing is that pumping at work has been the problem for you. Not pumping in general.
Samantha: Yeah. Maybe I could do more of my pumping at home? Like, try to stock up on the weekends?
Health Coach: Weekends will work. What about during the week?
Samantha: Well, can I pump after she nurses? Will there be anything left?
Health Coach: Yes, that’s a great idea. You can definitely pump after nursing. It might take a week or so for your body to catch up with the increased need, but after that it can be a very effective time, because you’re relaxed and your milk already let down. And pumping at lunch should help with engorgement during the day.
Samantha: That could work! Though, my mom’s going to think I’m an idiot for going to all this trouble. I mean, I had formula, and I turned out fine.
Health Coach: (sympathetic) It sounds like it's hard to talk about your decision to breastfeed without your mom feeling like you're criticizing her choice not to.
Samantha: Exactly! I mean, she's right, it didn't hurt me. So how do I get her to see why I care so much about doing it differently for Zoe?
Coach: The Health Coach did a great job! As long as her own mother is actively opposing her, this mom may be unlikely to continue breastfeeding. But, by empathetically reflecting both sides, he made the problem seem more like a miscommunication, not an impossible obstacle.