baby friendly questions - page 2
The hospital that I work at is in the process of becoming baby friendly, and I have some questions about how the baby friendly initiative is implemented in other hospitals. I want to start by... Read More
7Aug 12, '11 by LibraSunCNMMy hospital is Baby Friendly, and I came to the unit near the very end of the journey towards getting certified, when everyone was going crazy. My manager was really gung-ho about educating moms about the benefits of rooming-in and trying to keep the nursery as empty as possible, but we DEFINITELY did not have crazy, guilt-inducing waivers and if someone wanted formula, after the 1st conversation about why, risks, etc., there were no more. It's not like we educated them every time they wanted a bottle. We just fill out feeding progress notes on every mom to document what we said and what their choices are. The only thing we did that your hospital did is stop giving out pacifiers, which I do support as it's evidence-based to promote supply.
At the end of the day, we can only do so much education. Some people don't want to hear it! And that's ok. I am busy enough helping moms who want to breastfeed that I don't have any time left to sit and guilt someone who doesn't.
1Aug 12, '11 by LibraSunCNMI forgot to say in my last post how important and beneficial the skin-to-skin aspects of Baby Friendly certification are. Having that be the routine after birth has increased BF rates, decreased problems with BF, and I think outweighs any other "negative" or perceived "guilting" practices of the program. Our patients are so happy about it, as are the nurses!
7Aug 12, '11 by klone, MSN, RNQuote from Esme12That's inaccurate and unfair.When did some nurses get the right to bully people into our beliefs. I find this "Baby Friendly" an agenda a bit extreme. If I listened to La Leche League I'd still be breast feeding my son at 14:.
4Aug 12, '11 by klone, MSN, RNQuote from mamabear85Please be clear - the scenario in the OP is not an accurate representation of the "Baby Friendly Hospital" initiative. I am greatly in favor of the BFHI, but I find the stuff described in the OP to be highly distasteful.I'm sorry if this is a dumb question- Is there a database of these "baby friendly" hospitals? I would love to know this before I have my next child, I don't think I would want to deliver in that environment.
4Aug 12, '11 by P B and JHow times have changed! When I had my 1st child, 14 years ago, the nurses offered to take my son to the nursery the first night. They could tell I was clearly exhausted after almost 24 hours in labor. I gladly accepted the offer, and was told they would bring my son back when he was hungry to be breastfed. They had asked me my feeding preferences, and I told them BF, with only the rare supplemental formula. They took him at about midnight, and woke me at 8 am! My nurse brought him back in, and said he wanted fed about 4 am, but when she came in I was sleeping so soundly she couldn't bring herself to wake me, so he got formula instead. I have never been more grateful. The next night, he roomed in with me, but I had gotten some rest the night before and was good to go. I went home happy, well rested, and with a beautiful son!
My last child, 7 years ago, they refused to take her long enough for me to even take a shower. The nurse told me that if I didn't want to leave her alone in my room I should take her in the bathroom with me, shut the door, and leave the shower curtain open so I could see her. Neither she nor I left my room the entire stay. I was exhausted, and preparing to go home to 3 other young children, and got almost no sleep. I'd have given anything for them to take her for 3 hours or so for a little worry-free nap! I brought a pacifier from home to comfort her if needed, never even used it, it was sitting on my end stand. One of my nurses threw it away, and read me the riot act for even having it. By the time I got home with her from the hospital, I was exhausted (we lived far away from family and friends willing to help out). I couldn't, and still can't, believe the differences in the hospital staff/policies in those 7 years!
My opinion? Educate thoroughly, educate some more, explain who, what, why, etc., teach some more, and then allow the parents to make their own (educated) choices, guilt- and waiver- free.
1Aug 12, '11 by ErinSI worked postpartum for a few years, and i encouraged mom's to get their rest for those precious few nights. If they were breastfeeding I would bring baby out and help them latch, and then round in 30 minutes and take baby back to the nursery. While breastfeeding is great, it is a personal decision. I feel once a mom has been told the pros and cons, and have been offered supportive lactation consultation (our LC was a beast and women often asked to not have her come back and help them), then they can make a decision. I would be FURIOUS to have to sign that obnoxious waiver, and you can bet management would be hearing from me.
3Aug 12, '11 by A&OxNoneQuote from melmarie23IMHO, the difference between being home with the baby and being in the hospital, is the mom has just given BIRTH. Exhausted, hurting mothers. I dont think it's a "bad example" to send the baby to the nursery on the first few nights. Whats the other option, like others have mentioned, dropping the baby? Rolling over on the baby? I think a mother saying "I'm too tired to take care of the baby" after birth is the responsible thing to do. Even if she was at home, I would hope she would call for help from the family if she felt so tired she was unsafe to care for the baby. And like others said, in the past, and even now in some cultures, the family takes care of the baby while the mother heals and rests. But that's just my .I get being tired and all and wanting rest (I am a newish mommy too-my son is 7 months), but IMO having the baby sent out to the nursery sets a bad example. You don't just get to send your baby "out" when you take them home. You care for them around the clock. If you are lucky, which I hope most are, you have help at home with the baby duty. But rooming in is essentially what you do when you are home .
2Aug 12, '11 by melmarie23Quote from A&OxNoneI am well aware that the mom has given birth. And I too have personally been in the mom's shoes, as I previously stated that I too am a new mom. I am all too well aware of the exhaustion that the process puts on the body. I am not naive. And dare I even begin to share that I've been a co-sleeping, breastfeeding mom since day one at that? I think the whole "you'll roll over on your baby!" scare tactics are a bit extreme, but that is an argument for another day and time....IMHO, the difference between being home with the baby and being in the hospital, is the mom has just given BIRTH. Exhausted, hurting mothers. I dont think it's a "bad example" to send the baby to the nursery on the first few nights. Whats the other option, like others have mentioned, dropping the baby? Rolling over on the baby? I think a mother saying "I'm too tired to take care of the baby" after birth is the responsible thing to do. Even if she was at home, I would hope she would call for help from the family if she felt so tired she was unsafe to care for the baby. And like others said, in the past, and even now in some cultures, the family takes care of the baby while the mother heals and rests. But that's just my .
I also work for a baby friendly facility and externed in one who isnt, but has many of the practices in place (and who might eventually go for BFHI in the future). Traditional "nurseries" in my state just don't exist. Almost all hospitals in my area practice 24/7 rooming in. I guess my opinion is shaped by the hospital practices that I've been exposed to. And each of the hospitals that I've worked in have rave reviews. When implemented right, BFHI can work wonders for mom and babes.
Additionally, I am not quite sure why I am getting flamed here. I dont bully my patients. I try and honor their requests the best way that I can. And while I am at it, I also educated them and tell the the benefits of 24/7 rooming in, ESPECIALLY if they've stated that they'd like to breastfeed. There is overwhelming evidence out there that supports this in terms of improving the duration and exclusivity of breastfeeding. However, I am not militant and honestly, I think its crap that there is this stigma that BFHI organizations are labeled as such.
ETA: Baby Friendly also also =/= as anti formula. We have formula available to our patients. Its just that we don't take freebees or handouts, nor do we advertise, and we pay fair market value for formula. So if a mom comes in and states that she wants to formula feed her baby, we can assist her with that.Last edit by melmarie23 on Aug 12, '11
0Aug 13, '11 by MKS8806I have found this very post very informative. I work for a hospital that is considering going baby friendly, and I'm not really sure why. We already promote rooming in, but do allow and occasionally suggest that mom's send their babies to the nursery between feeds if they are obviously exhausted, emotionally or physically. We also have lactation consultants that are available during the day and provide consultation by appointments following dismissal. We have formula and pacifiers available by request only. So, I'm not really sure why we need to pay $1200-2000 annually to have a certification that says we are baby friendly? Of course our LCs very much want to accomplish this, but it seems to me that we could be putting that money to better use.
6Aug 13, '11 by rn/writerQuote from melmarie23No, "you don't just get to send your baby 'out' when you take them home," but hopefully by the time you do go home you'll have gotten some rest and you won't be on narcotic pain meds.You don't just get to send your baby "out" when you take them home. You care for them around the clock. If you are lucky, which I hope most are, you have help at home with the baby duty.
It isn't at all uncommon for the dad to go home with the other children, leaving mom and baby in the room alone. I have seen too many dangerous situations--dropped babies, squished babies, babies buried under blankets-- due to exhaustion, pain, and narcotics to ever turn down a tired mom's request for me to take the baby to the nursery. I am glad we have a nursery to offer. Sometimes just three or four hours of uninterrupted sleep gives the patient a much different outlook and a feeling that, yes, she can be successful with breastfeeding. That little bit of rest gives her more patience and determination.
We are being asked to make our patients sign a waiver before their babies will be allowed in the nursery. The waiver lists an entire page of reasons why baby should room in and at the bottom it says something like "I would like my baby to be separated from me despite all of the benefits of rooming in. I give permission for my baby to go the nursery despite the fact that we will not receive the mutal benefits of rooming in."
Baby-friendly should not mean mom-unfriendly, as if they're on some giant teeter-totter, where if one is up, the other must be down. It's not a zero sum game. Let's find some balance, for pity's sake and take care of both patients.
I am very fortunate that the postpartum unit where I work does a very good job of educating and supporting families. Even though we work hard to inform moms of the possible outcomes of their choices, we don't dish out guilt with a trowel. And we never, ever forget that the babies are theirs and not ours. This results in high patient satisfaction scores, but, more important, it's the right thing to do.
I wouldn't last long at the OP's hospital.Last edit by rn/writer on Aug 15, '11
4Aug 13, '11 by okchugit's sad to hear that intimidation and guilt are being used under guise of "baby friendly". This is no better than in the 70s when my mother was given no choice to BF- her breasts were bound with Ace bandages...babies were taken away directly to the nursery.....they also didn't ask for consent to circumcise my brother. Times have changed & they haven't.
Before becoming a nurse, I was a doula. I've worked with many women and some really wanted to BF but even with support and time, it just didn't work. They already feel like a failure, the last thing they need is more guilt!
I have two kiddos and BF both, actually the 2nd til he was 3 yo!! AND my first baby kept her "wooby" aka pacifier until she was 4- & now has naturally beautiful teeth without braces. I support each mom's choice on feeding, pacifiers, sleeping, diapering. You do what works for your baby and family.
Education NOT intimidation should be the approach here. We want people to make an informed decision, but it's their decision.
I also agree with many posts about extended families. Geez, moms and babies used to stay in the hospital for a week for a vag delivery! Then they came home to a MIL!
1Aug 13, '11 by Esme12, ASN, BSN, RN Senior ModeratorQuote from kloneIt's my experience. I mean no offense but it is what I feel and what my personal journey and experience has been. Anytime a mother is asked to sign a waiver to have her child go to the nursery to get some rest she chastized and told she's a bad aprent and won't be able to bond with ther child to me IS extreme and is using intimidating tactics to bully/guilt/shame someone into compliance.That's inaccurate and unfair.
"We are being asked to make our patients sign a waiver before their babies will be allowed in the nursery. The waiver lists an entire page of reasons why baby should room in and at the bottom it says something like "I would like my baby to be separated from me despite all of the benefits of rooming in. I give permission for my baby to go the nursery despite the fact that we will not receive the mutal benefits of rooming in."
It's accurate to my personal experence and just my opinion. I mean no offense to you personally but I think it's unfar to call my experience inaccurate. This is obviously a hot button subject matter and I am not an OB/LD nurse......It is just my personal experience and my own personal feelings towards the extreme concepts by the OP's hospital and that a baby shouldn't have a pacifier. I respect your thoughts and opinions...Peace