Discouraged breastfeeding patients- lack of resources! Help!

[NICU_Nurse, BSN, RN]

Hello, all! I have a situation I need some assistance with. I work on a NICU, and we float between levels 2 and 3. I had a baby the other day whose mom wanted to breastfeed. Apparently she had been handed a breast pump, given a pamphlet of instructions, and left alone for almost 24 hours with no one-on-one instruction. She said she had called the nurse in charge of her care multiple times on the intercom, and asked for help numerous times from various people during the day to no avail. She was put off time and time again, until, when I came in at eleven pm, she told me that she was frustrated and didn't want to bother with it and would rather feed her baby formula. I was shocked and tried my best to help her, but am sitting here at home angry and wondering how this can be fixed. Our hospital is relatively poor, in a large urban area. We accept ALL patients, and ninety percent of our patients are homeless or indigent or have little to no medical insurance. They are poor. It is our job, in my opinion, to provide the best service for them we possibly can, especially because the only time they may see a doctor is when they are hospitalized (or their families, even). These people cannot afford to visit a doctor routinely, have virtally no contact with medical staff outside of the hospital, and rarely even have transportation to take them to FREE clinics. Our unit (the Mother/Child area, that is) has ONE lactation consultant, who is only in M-F for eight hours a day. To me, this is a horrible embarassment!! I am only out of school six months, and I am limited in my knowledge. I was wondering what suggestions you guys might have as to how this can be improved? I mean, there she was, wanting to breastfeed, and there goes another missed opportunity right out the door. Now, in all liklihood, this has colored her perspective and she probably will not breastfeed once she is home. Thanks to us. I gave her some materials to read, and called her nurse on the unit to suggest that they work harder with her (yeah, not happening- they're sorely understaffed but I did it anyway), and told the incoming nurse for the baby to make sure that our consultant contacted the mom, but I wish there had been more I could have done right there. Help me! I guess my question is two-fold: One- What can our facility do (with limited means) to improve this, and Two- What can I do to ensure, at least while I am present on the unit, that this doesn't happen again? In other words, what types of education are out there for someone like me, or certification, or whatever, that will make me an asset to this unit and to these moms? Thanks in advance, and once again, sorry this is so long!

[live4today, RN]

How about suggesting to your unit manager to offer a breastfeeding class for first time mothers BEFORE they are discharged. We held them in the newborn nursery classroom where I use to work in a military hospital. It's the best way to reach the first time moms soon after the baby's are born. Also, you could recommend the LaLeche League to the first time moms who want to breastfeed so they can contact them, or even have one visit the mothers before discharge. Also, during the first time mothers class, we taught them care of the newborn, and also bottle feeding tips, etc. Hope this helps. :)

[cpgrn]

La Leche League International is a great resource. They have a website full of information if you don't have a group in your area. They may even be able to tell you how to become a lactation specialist. Good luck!! Carol

[SmilingBluEyes]

Yep I recommend La Leche League too! Go to:

http://www.lalecheleague.org

Good luck!

[OBNURSEHEATHER]

Kristi - I would ask your manager if it would be possible for you to take classes or attend some seminars on breastfeeding. Perhaps they could even set you up with a preceptorship with some of the lactation consultants.

I can tell you, as a post partum nurse, that I am willing to answer questions and offer support, but I cannot accompany my patients to the unit to breastfeed their babies. In our NICU, the nurses are all awesome at breastfeeding assistance. They are often times more adamant than us that those babies get breastmilk. If you think about it, most of your babies have mothers that will only be in the hospital for 2-4 days. What will you do after that?

You need to be prepared to handle that, especially since you will be working when there is no LC in house. I don't think it is out of line for you to ask for more from your supervisor.

Heather

[SmilingBluEyes]

Did you know, LLL visits patients in the HOSPITAL TOO? ALL you need to is find a leader in your area and ask about this. I have had them come in where I used to work and we did not have access to a lactation consultant in-house. Also WHO (World Health Organization) offers excellent classes on bf and helping new families w/bf issues and problems Often, these are taught by certified lactation consultants and emphasize bf issues within the birthing center or hospital settings.

If this is a HUGE issue at your hospital I agree w/Heather! Time to ask for more help...e.g. a part-time lactation consultant or maybe certification for some of the staff that work there. This is too big an issue to let go and a special interest of JCAHO......so don't be afraid to ask for help!

[prmenrs, RN]

Breastfeeding is the CORNERSTONE of preventive health care. That's selling point # 1, 2, 3 & 4.

First of all, help the mom the best you can. Then express your outrage to your NM, DON, MD Head of Department, Chief of Staff, And anyone else you can think of. Suggest using grant $ (does the hospital have an auxiliary or volunteer dept?) to educate more RNs on post-partum AND NICU!! as lactation educators/consultants. What you wrote above is compelling, use it, Kristi!

Our unit has a committee or nurses to promote breastfeeding, and each shift is represented, so that a mom who's having a problem is more likely to have a resource. The hospital could sponsor a CEU offering (even a day-long conference) to bring more nurses to some awareness about the benefits of breast feeding--higher IQ's, better overall health, decreased ear infections, etc.

I really wish you good luck with this--it's so important.