baby friendly questions - page 11

You clearly want to support your moms, but it sounds like your tools for doing so are limited, as well as the time frame you're given to work within.

Pumping in the first 24-48 hours isn't bad per se. It may even be necessary if the baby isn't latching at all (combined with hand expression, of course). If possible, assure there are colostrum cups available (sits between the bottle and the breastshield fitting) since small quantities of colostrum can be lost in the bottle and pump assembly. I'm not sure why you're actively being discouraged from providing mothers with pumps when necessary. That's very confusing to me.

As far as when to offer supplements goes, it appears that your facility is behind the times when it comes to evidence-based practice. From the Academy of Breastfeeding Medicine protocol on supplementation, when supplementation is "NOT indicated":
"Careful attention to an infant’s early feeding cues, andgently rousing the infant to attempt breastfeeding every
2–3 hours is more appropriate than automatic supplement after 6, 8, 12, or even 24 hours."
Under recommendations: "Healthy newborns do not need supplemental feedings
for poor feeding for the first 24–48 hours, but babies who
are too sick to breastfeed or whose mothers are too sick
to allow breastfeeding are likely to require supplemental feedings"
Please see table 2 in the link for indications for supplementation.

I realize this is an old topic, but I was interested in seeing what had became of the situation.

In the hospital where I had my daughters (4 years ago and 14 months ago) , I was simply asked if I was BF or formula feeding. I chose to formula feed for personal reasons that I wont go into detail about here. I was NEVER questioned, NEVER bullied, and NEVER made to feel bad for my choice.

As far as sending the baby out at night, it was recommended. At ANY time that the newborn was in the room, one adult over the age of 18 MUST be awake and a light must be on. My husband and I were exhausted, I was post c-section both times (actually doing quite well ,but still sore, tired, and hormonal!) and needed our rest. The wonderful, kind nurses took my baby (babies lol) to the nursery and I was able to get rest and my baby was brought back to us in the morning as soon as we awoke.

Hah awake with the lights on? What do they think is going to happen when you go home? What a silly rule!

Sending babies to the nursery is not an all-or-nothing proposition. Many of our breastfeeding babies are what's called "out on demand," meaning that we keep them in the nursery until they start to rouse. Then they go out to mom for a feeding. And many times they come back to us afterward. This works the best with babies who have cluster fed prior to leaving Mom's room, but even if that isn't the case, sometimes just a couple of hours of sleep really help both Mom and baby do better.

The question that should help keep everyone honest is, "Whose needs are the biggest priority?" If it's the administrators who are trying to squeeze every last buck out of the situation, that tells you where the babies and mamas rank.

The other important consideration is that you really need to take a hard look at any LDRP or PP unit that ends up pitting moms, babies, and staff against each other when collaboration should be the rule of the day.

Guilt is a poor choice for a motivational tool, especially when information and inspiration can accomplish so much more. The bottom line is that moms should do what works for them and their babies.

We are a "baby friendly" hospital...and I had a nurse tell me "it hasn't been an hour yet, take the baby back!" Well mom was tired, her delivery was HARD and this wasn't the first baby. I was yelled at because the nurse was angry mom wouldn't breast feed yet and didn't want skin to skin and at one point said "I don't care what mom wants, unless she wants to be a bad mom, but I guess that's what she wants" really?!?!?! I was ashamed for the nurse!