My hospital is working toward becoming baby friendly. This entails that we promote rooming-in and breastfeeding, which I have no problem at all with- what I do have a problem with is how we are being presented with it- and how we must now interact with our patients. Our patients come from a very diverse spectrum of cultures who are set in their ways and I guess I don't really feel it's my place to be like "well welcome to America- this is how we do it, too bad so sad."
We have been ordered to move all formula, nipples and pacifiers to the back room of the nursery (which has also undergone a name change to make it less accessible and friendly sounding) so that NOBODY sees it, patients or family. We don't want them to think we promote formula or artificial nipples. We are instructed now to council every mother who has chosen to formula feed, or do breast/bottle combo on the "dangers of feeding formula to your baby". Yes, these very words were uttered and in writing. There's serious talk of making the mother sign an informed consent before giving the baby any formula- acknowledging that she is aware that she is causing harm to her baby by giving him/her formula, and that they understand that breast milk is superior to formula.
We must extensively chart WHY mom is choosing formula. We have to now keep all the shades in the nursery down so that people don't look in, and THINK it's a nursery and again to make it an in-accessible place.
This really seems out of hand to me. I love where I work, I love the field but boy, we are in for some troubles when a mom from another culture other than white-upper class wants to put their baby in the nursery so they can sleep, or can go for a walk, or wants to formula feed and then gets a 20 minute lecture implying that they're a bad mom for choosing this method. Is this true of any other hospitals out there that are baby friendly or are in the process? I feel like they're trying to brainwash us, or like it's becoming a cult-like atmosphere!
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Please give an example of a counseling session with new parents and how you educate them on the dangers of formula use.
All you want to do is list the risks just like you list the risks with medications or surgery. You do not talk about them being a bad mom or negligent or anything like that. You want to simple state the risks. Very fact based...leave opinion out of it.
My whole thing is that we serve many cultures who, no matter how many times you try to convince them that they DO have milk, and the baby is getting colostrum, too, they refuse to believe it. Even if you teach them to hand express they don't beleive it's enough and baby will starve. Grandma is standing by with a bottle and in some of these cultures- grandma is the wise woman you don't argue with- and they don't want to argue either.
Secondly, many of these mom's are on baby number 5-6 (7,8,9) and what happens is dad brings the siblings in to meet the new baby (and often the next youngest is no more than 15 months old or so) and drops them off....buh bye. OR the siblings and the WHOLE DANG FAMILY, all 24 of them come at once to visit. Dad hangs out with the other men, outside the room. I frankly don't begrudge mom for bringing baby to the nursery so she can sleep because once she gets home she's going to have a zoo on her hands (and many times those are the kids we- the crabby old nurses are scolding to not run screaming down the hallways and climb on chairs and pound on computers and run into other people's rooms.)
I agree that breast milk is better for baby- unless you're like our second biggest population, the kids who decide it's fine to drink and smoke THC while pregnant with no intention of stopping, or using Meth. I'm just saying we're so big on kissing fannies, we're going to tork off a lot of people.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
My whole thing is that we serve many cultures who, no matter how many times you try to convince them that they DO have milk, and the baby is getting colostrum, too, they refuse to believe it. Even if you teach them to hand express they don't beleive it's enough and baby will starve. Grandma is standing by with a bottle and in some of these cultures- grandma is the wise woman you don't argue with- and they don't want to argue either.
Secondly, many of these mom's are on baby number 5-6 (7,8,9) and what happens is dad brings the siblings in to meet the new baby (and often the next youngest is no more than 15 months old or so) and drops them off....buh bye. OR the siblings and the WHOLE DANG FAMILY, all 24 of them come at once to visit. Dad hangs out with the other men, outside the room. I frankly don't begrudge mom for bringing baby to the nursery so she can sleep because once she gets home she's going to have a zoo on her hands (and many times those are the kids we- the crabby old nurses are scolding to not run screaming down the hallways and climb on chairs and pound on computers and run into other people's rooms.)
I agree that breast milk is better for baby- unless you're like our second biggest population, the kids who decide it's fine to drink and smoke THC while pregnant with no intention of stopping, or using Meth. I'm just saying we're so big on kissing fannies, we're going to tork off a lot of people.
The fact that they have a strong culture isn't a reason to not educate. You educate, they listen and what they do with the information is up to them. If they decide to listen to grandma you can at least document that the education was done. We can't decide to not educate because of culture or a patient being unlikely to listen to or to care about what we say.
We still need to educate...we need to provide informed consent.
If the hospital had refused to let me bottle feed my baby then my husband would be driving to the pharmacy across the street and buying some. It's the mother's CHOICE to breastfeed or bottle feed and to use a pacifier or not. I bottle-fed both my kids and they're just fine. Moms who don't breastfeed are almost bullied by those who do breastfeed, yet the breastfeeding moms can't feed in public or else they're ridiculed for public indecency. Nurses and moms need to respect each other's decisions regarding feeding our own children. And who in their right mind would refuse to give a pacifier for a screaming newborn? It's called a PACIFIER because it PACIFIES a crying child. Sucking is an INSTINCT that babies are born with and the pacifiers soothe that when they're not hungry or wet or cold or uncomfortable. I compltely understand asking a new mom breast or bottle, and why they pick one over the other, but stop lecturing and nagging and berating. Trust me, the entire 40 weeks of pregnancy we've been bombarded with "breast is best" literature and posters and our decision has been made way before the delivery room.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
If the hospital had refused to let me bottle feed my baby then my husband would be driving to the pharmacy across the street and buying some. It's the mother's CHOICE to breastfeed or bottle feed and to use a pacifier or not. I bottle-fed both my kids and they're just fine. Moms who don't breastfeed are almost bullied by those who do breastfeed, yet the breastfeeding moms can't feed in public or else they're ridiculed for public indecency. Nurses and moms need to respect each other's decisions regarding feeding our own children. And who in their right mind would refuse to give a pacifier for a screaming newborn? It's called a PACIFIER because it PACIFIES a crying child. Sucking is an INSTINCT that babies are born with and the pacifiers soothe that when they're not hungry or wet or cold or uncomfortable. I compltely understand asking a new mom breast or bottle, and why they pick one over the other, but stop lecturing and nagging and berating. Trust me, the entire 40 weeks of pregnancy we've been bombarded with "breast is best" literature and posters and our decision has been made way before the delivery room.
Bombarding and berating and belittling isn't what Baby Friendly is about. Baby Friendly is about encouraging breastfeeding and increasing the success rates. It is your choice to formula feed or bottle feed and the formula isn't locked up and never given out. The formula is given when mom states that is what she wants and she have received the education necessary for her to sign for informed consent. Many moms have no clue that formula have risks. They hear about stuff during their pregnancy about both sides that are negatives and positives...they need a detailed accurate education before they make their choice.
At a Baby Friendly hospital the formula is there and the pacifiers are there...they just aren't going to be handed out like they are nothing because they do have risks and they do decrease breastfeeding success. Don't want to breastfeed...sign the form stating you are aware of the risks and move on. It really isn't a big deal to just sign the form which is fact based risks. If seeing the risks is an issue...then you should be thinking twice about what you are doing. But if a mom says I want formula and she received the needed education and she can then sign the informed consent and she will be handed formula. Mom still has her choice...but now they will make an educated choice.
I really won't get deep into the argument of "my kid is fine" because a kid here and there with no issues doesn't mean anything. Also, some issues that have been linked with formula do not come up until adulthood. And fine...in comparison to what? They could have been healthier but they are fine? Okay. That is fine if you are okay with it. But it isn't worth arguing because "fine" works for you and many.
What difference does it make? I was formula fed. I am now an IBCLC and a strong proponent of educating mothers about the risks of formula.
The difference is a mother should not be made to feel guilty about not breastfeeding her baby. There maybe risks from formula use but who are we to judge someone on how they choose to feed THEIR baby? It is our jobs to educate the parents about different feeding options. If they choose not to bf then so be it.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
The difference is a mother should not be made to feel guilty about not breastfeeding her baby. There maybe risks from formula use but who are we to judge someone on how they choose to feed THEIR baby? It is our jobs to educate the parents about different feeding options. If they choose not to bf then so be it.
Sent from my iPhone using allnurses.com
A mom feeling guilty isn't really a reason to not educate. So we educate about formula, they sign saying we did...and they formula feed. It is that simple. If mom feels guilt...that is her own feeling that we have no control over. We can't stop educating because somebody might feel guilty. They are making the choice...if there is guilt maybe they should reconsider their choice.
WoW, I could have written the question asked. We are 3/4 through becoming Baby Friendly, how I hate that term though.We just went back to doing couplet care, which I love when we have the proper staff. I agree the education needs to begin during prenatal care. We allow one person to spend the nite with mom and have changed our introduction form they receive in L&D to explain what is expected of the person staying with mom. We are not a hotel for them to sleep all nite. I really enjoy reading what others are doing with this change. I have worked in OB for over 32 years, so I am close to retiring.
All you want to do is list the risks just like you list the risks with medications or surgery. You do not talk about them being a bad mom or negligent or anything like that. You want to simple state the risks. Very fact based...leave opinion out of it.
Fact based can sound hard and uncaring and result in parents feeling inadequate. If a parent is unsure about breast or bottle I'm more than happy to provide information on BOTH. If they have made up their mind I don't go in and tell them all the risks of bottle feeding.
Also, I have found that many lactation studies are VERY biased. Think about where breastfeeding rates are higher (at least in the US)....upper middle class. Of course an upper middle class family is on the whole going to have fewer medical costs - it's very likely not the breastfeeding but preventative care, access to nutritious foods, etc. that's skewing these results.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Fact based can sound hard and uncaring and result in parents feeling inadequate. If a parent is unsure about breast or bottle I'm more than happy to provide information on BOTH. If they have made up their mind I don't go in and tell them all the risks of bottle feeding.
Also, I have found that many lactation studies are VERY biased. Think about where breastfeeding rates are higher (at least in the US)....upper middle class. Of course an upper middle class family is on the whole going to have fewer medical costs - it's very likely not the breastfeeding but preventative care, access to nutritious foods, etc. that's skewing these results.
So we shouldn't educate when somebody has made up their mind? In what other field of medicine or nursing do we not educate a patient just because they have already made up their mind? That just isn't a good reason to not do our job of educating. We can't control their feelings but we can ensure they make an educating decision after we present factual information without bias.
Seriously? So because you think that some of the studies are biased and that healthcare is cheaper for upper middle class that maybe breastfeeding doesn't have the benefits? Seriously? Plus, this isn't just about the benefits of breastmilk but also about the risks that are associated with formula feeding. We know these risks are valid.
Jolie, BSN
6,375 Posts
Please give an example of a counseling session with new parents and how you educate them on the dangers of formula use.