Carol Marinelli

The Outback Nurse


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her hair unbrushed, her eyes red and swollen from crying.

      ‘Oh, Clem, I’m so glad you’re here. He’s been screaming all morning.’ She ushered them through to the family room, apologising for the mess. The house was in chaos. Toys littered the floor and piles of washing lay over the chairs and sofa. The morning’s breakfast dishes were still on the breakfast bar. ‘Please, sit down,’ she said to Olivia, removing a pile of nappies.

      Clem peered into the crib. ‘He’s asleep now.’

      ‘Yes, but it won’t last.’ Her eyes brimmed. ‘Can I get you a cup of tea?’

      Clem turned to Olivia. Taking her cue, she jumped up.

      ‘I’ll sort out the tea. Why don’t you let Clem examine you while Sam is asleep?’

      Clem nodded appreciatively.

      ‘He’ll be awake before you know it. Six weeks old and he’s hardly slept for more than two hours at a time. The girls were so easy—I just don’t know what it is I’m doing wrong. Brian’s so thrilled at having a boy, he just doesn’t understand...’ Jean’s voice broke and her shoulders shook with emotion.

      Clem, towering over her, put his arms around her heaving shoulders and spoke softly. ‘Come on, Jean. Let’s go through to the bedroom and I’ll do your postnatal check, then we’ll sit down over a nice cuppa and try to sort something out.’ Gently he led her away.

      After switching on the kettle, Olivia hastily did the breakfast dishes and wiped down the benches. The family room wasn’t dirty, just untidy. She put the toys back into their box and started to sort out the laundry, folding the nappies into a neat pile and placing the rest into the groaning ironing basket. The place looked a lot better, and by the time Clem retuned she had made the tea.

      ‘Jean’s just getting dressed.’ He raised his eyebrows ‘You’ve been busy.’

      Jean was eternally grateful. ‘Sister, you didn’t have to do that.’

      ‘No problem, Jean. I’m glad to help.’

      While they drank their tea, Jean, in a faltering voice, told them her problems. ‘If I could just get a decent sleep and the house in order I’d be all right, but Sam takes for ever to feed. Then, when I finally get him off, no sooner have I put him down than he’s awake and screaming again. I’m at my wits end.’ She ran her fingers through her unwashed hair.

      ‘Does Sam have any long sleeps at all?’ Clem asked.

      ‘Sometimes, at about five, which is useless for me. The girls are home from school then, wanting their tea, and then Brian gets in. As the girls go off to bed up gets the little fella, and that’s me for the rest of the night, trying to keep him quiet so that Brian can get a good sleep.’

      ‘Could Brian get up to him for a couple of nights, at the weekend perhaps so you could get a break?’ Olivia volunteered. ‘Perhaps if you expressed some milk?’

      Jean shook her head. ‘He’s up at five a.m. to go to the farm. It’s the same at weekends—the cows still need milking. I can’t expect him to be awake at night with the kids.’

      Olivia finally realised the woman’s predicament. Just then Sam stirred and let out a piercing cry, which made them all jump. It was amazing just how much noise a small baby could make. Clem picked up the infant as Jean started to weep.

      ‘What’s wrong with him, Clem?’

      ‘Put him to your breast, Jean, and let me see you feed him.’ Olivia spoke calmly, and Clem handed Sam to his mother. The irate baby arched his back and butted against Jean’s breast, searching frantically for and finding her nipple. He latched on and mercifully relaxed. Making little whimpering noises, he suckled hungrily.

      ‘Very good, Jean, you’re doing wonderfully,’ Clem encouraged. ‘Just try and relax.’ At that point Sam let out a furious wail and the angry protest started again.

      Jean was just about at breaking point. ‘What’s wrong with him?’ she screamed above the ear-splitting shrieks of her son.

      Olivia walked over and gently took the baby from the distraught woman. The baby snuffled against her. Olivia felt his hot, angry little face against hers, breathing in the familiar baby smell. Rocking Sam, gently trying to soothe him, she contemplated Jean’s situation. For all her knowledge and training she had no real experience. Here was a woman who had borne four babies to her nil. She had a husband and children to care for and a house she was proud of. The well-rehearsed platitudes of ‘persevere’ and ‘things will get better’ seemed woefully inadequate. Olivia could see what was wrong. Jean had plenty of milk but she wasn’t letting down, probably because she was too tense. Appearances mattered, and to tell this woman to ignore the housework and concentrate on the baby, to get a take-away and not worry about dinner, would be like speaking a foreign language. Heck, there wasn’t a burger bar for two hundred kilometres.

      Clem watched Olivia closely as she rocked the baby. Sam rooted hopefully and, finding her finger, sucked hungrily, but again there came the same wail of frustration.

      ‘He’s hungry, Jean,’ Olivia said.

      ‘He can’t be. I fed him just an hour ago. You saw me just try—that’s not what he wants.’

      Olivia gently but firmly explained about the letdown reflex. ‘It’s automatic in some women, as it was for you with the girls. But anxiety, tension, lack of sleep—any one of these can affect it. It’s a vicious circle. The more Sam cries, the harder it is for you to relax and for your milk to get through. Have you considered trying him with some formula?’

      ‘But breast milk’s best—everyone says so,’ Jean protested.

      ‘A contented mum and baby are what’s important. Anyway, giving him a bottle now doesn’t automatically mean you have to give up on breastfeeding. Perhaps after a couple of feeds and a good sleep you’ll be ready to do battle again. You could maybe give him a bottle at night and concentrate on breastfeeding in the day. There are lots of options. Even if he does end up on the bottle, you’ve given Sam your colostrum in the first few days, which is full of antibodies, and he’s had six weeks on the breast. You’ve done very well.’

      ‘What do you think?’ Jean turned to Clem.

      ‘I totally agree with Livvy.’ He stood up. ‘I’ve got some formula samples in the car. Why don’t you make him up a bottle and we’ll see how he goes?’

      Half an hour later a much happier Jean cuddled her satisfied son. Young Master Sam made contented little noises.

      ‘Feeling better now?’ Clem enquired.

      ‘Much, but I’m a bit disappointed.’

      ‘Well, don’t be,’ Olivia said firmly. ‘Like I said, it might be a different ball game tomorrow. But whatever you do, don’t go getting stressed—just enjoy each other.’

      ‘Thanks ever so.’ She looked over at Olivia. ‘You’ve both been wonderful.’

      ‘We haven’t finished yet.’ Clem darted outside and returned with a huge casserole pot. ‘Ruby’s forever trying to fatten me up. There’s more than enough here to feed the family, Jean.’ He took Sam from her and put him gently into the crib. ‘Now, the place is tidier, the baby’s asleep and dinner’s taken care off. You get to bed.’

      ‘I should get some ironing done,’ Jean protested, but Olivia quickly jumped in.

      ‘Don’t you dare.’ She shooed her down the hall.

      ‘I wouldn’t argue with Sister Morrell if I were you, Jean. I’ve a feeling she’d win. Now, off to bed, Doctor’s orders. We’ll see ourselves out.’

      Back in the car Clem praised her. ‘You did a great job in there.’

      ‘Only because I listened to you first,’ Olivia admitted. ‘I shudder to think of the mess I’d have made if you hadn’t forewarned