breastfeeding gone wrong

[adpiRN]

It was my first day on L&D today and my preceptor and I had a scary moment. The new mom was trying to breastfeed, though the baby was a little sleepy and not latching on well. So we left her in the room to try while her OB was in the room chatting with her.

We came back in a few minutes later and my preceptor took one look at the baby and grabbed her and ran to the warmer, giving her a slap on the back to stimulate her. She unwrapped the baby and she was blue! The nose must have been occluded by the breast while trying to nurse and the mom and OB just didn't notice. After a few seconds of blow-by O2 she pinked right up again. But it was really scary! How common is this and how do I prevent it? My preceptor said that a baby actually once died at our hospital that way. How horrible!

[adpiRN]

I agree, there should have more instruction given to the new mom and I plan to learn from this and give all my patients lots more information, before leaving them alone.

But the thing is, she wasn't actually alone. The OB was in there! You'd think the OB would have noticed the baby turning blue, but she was completely oblivious....

[mitchsmom]

I agree with the others who say, this is probably an apneic epidsode (or choked up on some mucus?), which happens whether at the breast or not. Baby just happened to be at the breast at the time.

As moms who have nursed will attest to (think of nursing a baby who is stuffy with a cold), nursing babies (in regular nursing positions, obviously not if they are under a breast actually, literally being suffocated) will typically struggle/ try to turn their head/ get fussy & dis-attach themselves from the breast if they can't breathe - happily, they won't just sit there and suffocate as many moms are afraid of.

Sorry you went through this & thank goodness someone noticed in time!!!!

[SmilingBluEyes]

I agree with those saying it was apnea. YES a pendulous breast and sleepy mother can occlude an airway, but much more likely is the apneic episode scenario.

[NurseNora, BSN, RN]

I once had a dad holding his baby as I was bustling aroung the room cleaning up after the delivery if the color was OK. It was not OK, it was blue. He was holding the baby perpendicular to his body, head in his hands, feet at his stomach, gazing at the baby's face, a nice bonding thing. However, he had flexed the infant's head so far foreward that he had cut off the airway. No one expects something to go wrong while a parent is actively engaged with the baby, but it can.

MD's do not respond the same way that nurses do to situations. If Mom is holding the infant, their nurse will be watching both of them. An OB may not necessarily be watching the baby. A Ped might have noticed. I once had a 30 week patient with spontaneous decelerations. Just out of nowhere, the FHR would drop to 60 for a couple of minuites. The perinatologist was in the room talking with the patient and her husband and the heart rate would drop and he didn't notice until I started turning the patient and doing the things you do when a deceleration happens. This happened several times. Listening to the heart rate was just not one of the things in his particular mind set. But I don't know one experienced L&D nurse who wouldn't notice an audible deceleration no matter how involved she was in doing something when it happened.

[jenrninmi, MSN, RN]

but i don't know one experienced l&d nurse who wouldn't notice an audible deceleration no matter how involved she was in doing something when it happened. so true, nursenora!

[mommy2boysaz]

I disagree with the statement that this couldn't have been a suffocation. It COULD have been.

This happened in a hospital that I worked in once. A mother was nursing her baby in the night and when the nurse went in to check and see if they needed any help, the mom had dozed off and the baby's head was under the large breast and was dead. Never responded to resuscitation. It was awful.

Like someone else mentioned, mothers are exhausted and may sleep harder than they normally would. They still have the right to feed their babies though. It's hard to monitor enough for safety without being overbearing or annoying to the mother. Plus, nurses don't have time to stay in the room with every mother for the duration of every feeding. It's just not possible.

Very scary situation.

[Elvish, BSN, DNP, RN, NP]

A suffocation under a breast is waaaay different than a suffocation at a breast. Baby is not going to suffocate while breastfeeding. Once unlatched and maybe under a pendulous breast, the story changes some.

Scary all the way around. And agree - it's impossible to stay with every mom for the duration of every feed.