Help Becoming Baby Friendly - page 2

by debsgreys

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we are in the process of becoming baby friendly. I have been on the breast feeding com. for some time and active in the process. We have LC s that are great when they are on the floor, hours are very limited. My biggest concern... Read More


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    Thanks again, we have no CNA or techs, when we did couplets average was 4 and an ante or gyne. Many times no lunch or 10 mins. Our policy on M/B units is hourly vs with assessment x 4 and with d/c and admissions, phew! we even have to escort mom and baby out to car many times.
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    Quote from debsgreys
    Thanks again, we have no CNA or techs, when we did couplets average was 4 and an ante or gyne. Many times no lunch or 10 mins. Our policy on M/B units is hourly vs with assessment x 4 and with d/c and admissions, phew! we even have to escort mom and baby out to car many times.
    Geez, hourly VS? Like, the whole PP phase? Id love to see data that supports the necessity for hourly vitals if you've had normal VS for 12 hours, normal bleeding, appropriate weight loss, normal urine output, good feeds, etc.
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    no, no jewels26 1st 4 hours on the floor are hourly then q 4 for 24 hours then q 8. I think my problem with staffing is the rest of the hospital has CNAs we do not. Infants vs q 4 for 1st 24 hours then q8
  4. 0
    Quote from debsgreys
    no, no jewels26 1st 4 hours on the floor are hourly then q 4 for 24 hours then q 8. I think my problem with staffing is the rest of the hospital has CNAs we do not. Infants vs q 4 for 1st 24 hours then q8
    Ah ok that makes a lot more sense! Thats pretty much what we had to do as well but our CNAs have never ever ever done vitals for us lol. American nurses are spoiled with all this delegation :P
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    Quote from debsgreys
    Thanks again, we have no CNA or techs, when we did couplets average was 4 and an ante or gyne. Many times no lunch or 10 mins. Our policy on M/B units is hourly vs with assessment x 4 and with d/c and admissions, phew! we even have to escort mom and baby out to car many times.

    We are so busy I don't know how you guys manage to do that without a tech. I was a tech on the floor before I became a nurse so I'm really not the best at delegation in general... I tend to try and do everything I can, which means I never sit LOL But I am so grateful for the techs who are able to do vitals or wheel mom and baby down to their car so I can help another mom breastfeed or give pain meds. Did your whole hospital do away with techs or just your unit? Is it temporary? Yikes. And when you get patients up for the first time (vag deliveries voiding for the first time... or c/s patients walking to the bathroom for the first time 4-6 hours after getting to Mother Baby), do you have another nurse with you then, in case the pt passes out or becomes dizzy? Now I have questions :-P
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    Pinknblue, yes like I mentioned before its hectic, little time to eat, drink, etc. I have always taken care of my pts. as they were my sister, for years my daughter ( she is 36 ) LOL Oh no the rest of the hosp. has CNAs, we had them briefly over a year ago and it was greyt! Yes I always get my pt. up 1st, most of the time my assistant is amnonia salts
    You see our OB delivers average 1100/yr. so we are told our unit does not bring in much $$, so we are staffed for # pts. on floor, many times being put OC, if there is 5 couplets on floor its just you. L&D is right up the hall. Like I said before we always have a nursery nurse.
    Our Best Practice mtg. is next week and I want to bring all this info with me.
  7. 0
    Create staff positions for IBCLCs who only perform IBCLC duties. You don't have to be an RN to do the job of a lactation consultant. Your hospital could save a little money, and get a team member who may even have a broader range of experience and expertise, by hiring a non-RN IBCLC. You will need to provide opportunities for mother-to-mother support, or have local resources that you can refer to.

    Have you been here? Baby-Friendly USA
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    The baby-friendly initiative is great and I wish I had time for it! I'm not going to lie when a mom is having a really hard time with breastfeeding and finally decides to ask for a bottle, I give it to her because we too are understaffed and I rarely have time to help with breastfeeding, especially with those SLEEPY babies that I would like to stick ice cubes in their diaper because they won't wake up no matter what LOL

    I do always ask all breastfeeding moms to call if they have questions and I assess for nipple pain/cracking so that if it happens I can do something about it so they do not get discouraged.

    I also offer them to pump before they completely give up.

    I do not offer formula, not unless they ask for it or if baby has a low blood sugar.

    If there is a LC working I try to ask them to spend some time with my breastfeeding patients if they look like they need more help.

    I think proper staffing would make a big difference. I also really wish there were breastfeeding classes or seminars offered at my hospital that teach RNs how to assist patients.
  9. 0
    Quote from M/B-RN

    I also really wish there were breastfeeding classes or seminars offered at my hospital that teach RNs how to assist patients.
    BCEP?
  10. 1
    We are baby friendly, and we do LDRP. Recently one of the major change to baby friendly is skin to skin immediately after birth for one uninterrupted hour! That means no baby weight, no meds, nothing besides vital signs, all this of course if baby comes out with no complications. This has extended our vaginal birth recovery from time from 3 hours to 4.

    Also on each shift (we do 8 hours shift here) we have at least one nurse who is IBLC as a resource for nurses if needed, and all nurses are oriented to breast feeding. Nurses who are doing mother baby care are also required to observed at least one feeding and give a latch score. Other breastfeeding times are also documented as reported by the moms or as written by the moms on their breastfeeding diary that we give them. All breastfeeding times are scored with a latch score whether it is observed feeding or reported by moms.

    Here at this facility, active labor we are staffed one to one. Mother Baby care we staff one nurse to 3 couplet care, which is really nice.

    If we haves any breastfeeding issues or with latch, we have a nurse who works on day shift solely focusing and providing additional help with breastfeeding.

    I rarely see formula ...or given formula since I have been here at this facility (been here for 9 months now). If parent chose formula they must sign consent and be explained risks and benefits of both formula and breastfeeding. I rarely see pacifiers as well.

    We offer breast feeding classes to expecting moms. Also in patients room we have breastfeeding videos they can watch for additional information or help. We also have handouts to use if needed. If latching is problem, we do hand expression and count number of drops for breast feeding times. These latch scores and if hand expressing are always passed during shift change.


    Baby room in with mom at all times unless of course there are any complications.
    Last edit by winter_green on Mar 20, '13 : Reason: errors
    melmarie23 likes this.


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