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: I'm sure your mom will understand. She wants the best thing for Zoe, just like you do.
Samantha: (uncertain) Yeah, I guess you're right.
Samantha’s thought: She's just sure she knows what's best, better than I do.
Coach: The support of family members is important for breastfeeding moms. By dismissing this mom's concerns, the Health Coach missed an opportunity to help her work through a significant obstacle.
Health Coach: If your mom has questions about breastfeeding, I have some literature here that she could read.
Samantha: (dubious) Yeah, maybe that would help.
Health Coach: I'll give you some handouts to take home.
Samantha: Okay. but I don't know if she's actually going to read it. (trails off)
Coach: The Health Coach should be careful not to jump in too quickly to solve a client's problem for her. Instead, he should try to involve the mom in finding a solution.
Health Coach: So, let's just make sure we have a solid plan. You've done a great job breastfeeding. Zoe is happy and healthy and it's been a special time for both of you. So in order to keep going, you'd like to change your schedule a bit so most of your pumping happens at home, and maybe on your lunch break, so it doesn't interfere with work.
Samantha: (hesitant) Yeah, I guess I’ll give that a try.
Health Coach: Is there anything else you wanted to talk about?
(A baby’s cry from the car seat.)
Samantha: Oops. Uh, no, no, no. But I did want to maybe just get a few formula samples to take with me. Just in case it doesn’t work out.
Pic 11: The exam room disappears and the screen returns to a close-up on Eva.
Eva: In this conversation, the mom had a lot of ambivalence about her decision to stop breastfeeding, and reflecting those feelings was the best way to help her resolve them. Now let’s look at the dashboard, which will analyze the Health Coach’s choices and offer some suggestions for how to best use MI in your practice.
Client Motivation: Overall, the Health Coach struggled a bit to get this mom to reconsider breastfeeding. Reflecting her feelings might have worked better than pushing his agenda.
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