baby friendly questions - page 7

by Rhee 20,813 Views | 109 Comments

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 saying that I think that... Read More


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    Quote from anurseatlast
    Actually, having a mom hand express colostrum and spoon- or cup-feeding it to the baby is an appropriate intervention if the baby is not yet able to latch. There are many advantages to the baby receiving colostrum as early as possible (and for the mom to express or nurse ASAP after birth) and amazingly, newborns often do well with spoon- or cup-feeding which can help to maintain their blood glucose. Your comment about "milk hasn't come down all the way to the nipple" shows lack of understanding about breastfeeding.!
    So please offer suggestions as to how to assist a mother in this situation who is unable to express colostrum (either by hand or pump), keeping in mind that most hospitals do not offer DBM, and some parents prefer not to use it, even if available.
    Jen3456 likes this.
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    Quote from dscrn
    \ What happens to babies who are up for adoption-or on DYFS holds. Where do they go? Is ins charged a larger amount, because there is no nursery..and they must go to special care or NICU. Are all rooms private, and are family members aware, in advance of delivery, that they are expected to stay with mom, and assist her with baby?
    BUFA's and DCYF holds become "nursery" babies and thus into our special care nursery (as its our only nursery). Yes, all our rooms are private and yes, parents are told this in advance and that we encourage 24/7 rooming in. This info is made available to them on our website, during tours and during our childbirth classes.

    We rarely get complaints over our rooming in policy. And we only occasionally have babies that are sent out by request of the parents. Most want their babies to room in.



    Change isnt easy, and I get that. Something that works differently than what one is used to...its hard to envision the logistics. I get why some might be resistant to it, but the only way to know if it wil work is to try it out and work out the kinks as they arise.
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    Change is not easy...I think that the success of this program depends in large part to the sector of people that the hospital serves. And yet, there are still a fair amount of patients who expect to get some rest in the hospital who expect and need to get rest in the hospital...those who do not have family near by to assist, or who have many children at home to care for-and I feel that their needs should not be overlooked...When all is said and done, this trend all comes down to saving money for the hospital..
    morte likes this.
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    There are lots of ways to encourage rest that do not necessiarly result in removing baby from the room. Limit visitorsand instill a unit "quiet time." Encourage mom to sleep when baby sleeps (because lets be honest here...most healthy babes sleep quite often, espeically in that first day). Cluster your care. Keep mom comfortable and medicated for her pain. Ensure babies are feeding adequately (however it may be...via breast or bottle). So on so forth.
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    ...some Moms WANT to send baby out of room for a spell-what about their request? I still feel that too much guilt is being laid on..
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    I'm glad I'm not alone! I feel like I'm going against the parents' wishes when I have to persuade them to not supplement. The milk is not in yet, the baby is starving, show me the literature where putting that stress on the baby is more healthy than supplementing with formula until the mothers milk fully comes in. It doesn't make sense to me.
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    A lot of these comments sound all too familiar to me. We have a nursery that is open at night from 11p-6a. It is always the mother's choice if she wants to send the baby or not. In my experience, they usually want to keep the baby in the room the first night. But the second night, after having no sleep for a day or 2, they are ready to send the baby then. I personally don't care either way, but when the moms are exhausted, especially on that second night, I encourage them to send the baby and get some rest. If they are breasfeeding, we return the baby when it is time to eat. As far as breastfeeding goes, I think it's great, but it's not for everyone. It requires a very strong commitment. I support the mother either way. I really don't care how the baby eats, as long as it eats. While breast milk may be best, there is nothing wrong with formula either. It is not the poison that most LCs think it is. There is a huge wall between the nurses and the LCs where I work. I really wish it wasn't that way. It shouldn't be this way. We refer to most of the LCs where I work as boob nazies. That may sound harsh, but that is a very good description for them. I often have very fussy babies, with high weight loss and obvious dehydration, dry lips, etc. We are not allowed to even suggest formula for these babies unless the weight loss is greater than 10%. If we do, or even if lactation suspects we did, we get in trouble. We also get in trouble sometimes if we take a mother a breast pump. Our policy is that babies eat within 7 hours, or they must be given formula. So if the baby won't latch for what ever reason, I offer them a pump. The LCs think it's ok for a baby to go over 7 hours before eating. I think this is just cruel. Who wants to let their child go that long without eating? We have no LCs at night, and that's when most of the breast feeding issues occur. I am really tired of having to justify my nursing care to lactation. Maybe instead of complaining about our care, we should just call them at 3 am to come in and get a baby to latch after we have tried for hours, when Mom, baby, and nurse are all exhausted. Maybe then they would change their way of thinking.
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    Quote from dscrn
    ...some Moms WANT to send baby out of room for a spell-what about their request? I still feel that too much guilt is being laid on..
    I think that some are not reading the responses fully and getting a bit defensive. We will honor their request in this instance, provided we have enough coverage in the nursery at that time. There is no outright denial to mom's. And again, these requests, at least on my unit, are extremely limited. Mom's truly do, for the most part, want their babies to room in.
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    Quote from carrie_c
    A We refer to most of the LCs where I work as boob nazies. That may sound harsh, but that is a very good description for them. I often have very fussy babies, with high weight loss and obvious dehydration, dry lips, etc. We are not allowed to even suggest formula for these babies unless the weight loss is greater than 10%. If we do, or even if lactation suspects we did, we get in trouble. We also get in trouble sometimes if we take a mother a breast pump. Our policy is that babies eat within 7 hours, or they must be given formula. So if the baby won't latch for what ever reason, I offer them a pump. The LCs think it's ok for a baby to go over 7 hours before eating. I think this is just cruel. Who wants to let their child go that long without eating? We have no LCs at night, and that's when most of the breast feeding issues occur. I am really tired of having to justify my nursing care to lactation. Maybe instead of complaining about our care, we should just call them at 3 am to come in and get a baby to latch after we have tried for hours, when Mom, baby, and nurse are all exhausted. Maybe then they would change their way of thinking.
    I only speak of my own experience working at a Baby Friendly hospital. The horror stories that have been presented in this thread (not just your post either) are not how we operate at all. We provide formula to those who want to feed their children formula, or who choose formula for supplementation. We also have donor milk for supplementation if they wish to travel down that route as well. We have great LCs who offer awesome breast feeding support, as does our nursing staff, pediatricians and OBs. We have great breastfeeding rates. We dont guilt women who dont exclusive breastfeed, or who dont breastfeed at all. That is not what being Baby Friendly is about.

    I think its extremely unfortunate that there are units who operate in the manner in which you describe. However, I dont think that what is described is a Baby Friendly issue. I think its a systems issue more so than anything else. Nursing staff, medical staff and LCs need to be all on the same page and support mother and baby in the same manner. This conflict between all persons is doing nothing but a huge disservice to mom and baby and has the potential to leave them more confused and with more problems by the time they go home.
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    I think a main problem with a lot of LCs is they think a mother should breast feed exclusively no matter what. In some cases, this is just not possible. When I have a very fussy baby that's also dehydrated and obviously starving, despite latching well and being at the breast constantly, I think it's time to supplement. I don't think it's right that I am not allowed to offer this to the mother, even though the baby is my patient and I am responsible for him/her.


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