In midwifery when we hear the word ‘cascade’ I bet many of us automatically think of that well understood concept a ‘cascade of intervention’ – the idea that one small invention can cause another to become necessary, and another, and another… Until we’ve stepped very far from the physiological birth process.
In my life before midwifery I had jobs and roles that included training others and many of these roles used the ‘cascade method’ – training one or some to pass it on to others.
I joined my current Trust a few months ago and, because we all work out of one base in the Birth Centre, have enjoyed lots of opportunities to discuss, observe and share skills, knowledge, enthusiasm with others in the team. I was initially surprised when some of the breastfeeding positions / techniques I suggest to women generated interest from others but I was very happy to show and share what I was doing. Over the last few weeks I’ve realised that even when I’m not there my colleagues are sharing the information and passing it on to each other and to breastfeeding women.
At morning handover one of my colleagues reported successfully using a modified biological nurturing position for a mum and baby to achieve a good latch overnight. After my shift I was delighted to feed back to my colleague how successful her support had been – mum and baby had breastfed comfortably all day and were enjoying the time together. Mum had no nipple soreness and was relaxed. In the evening I admitted a new postnatal patient who was struggling with breastfeeding and a few minutes later found the first mum offering encouragement and using her experience to illustrate how things can improve.
It was a beautiful, exciting demonstration of a positive cascade.
