Baby Friendly- getting a tad over the top

Published

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!

Elle23,

lmao!

I was just thinking that was how most of my German Parents and their parents were feed! Most lived very healthy well into their 80s & 90s. Out of my 3 children, the child that I nursed has health issues....autoimmune in fact:(

On another note I know the studies say breast is best and it is a good thing that we are educating parents on how healthy breast milk is but how about when mom goes home? In some areas there is very little support when and if mom has problems with latch on(most common problem r/t sore nipples) or any of the other issues that may come up. I hope there are good and available resources for these moms that choose to nurse.

Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.

I can't believe I'm hearing the tired old "well, I was fed xyz and I turned out fine" HERE of all places. What happened to EBP and research to guide our care?

It's clear that this is a hot button issue for many people.

Up Vote Up Vote ×

not me, I was breast feed, unusual in my age group. it was the attitude coming off the page that turned me off. BEFORE you go into educate, you need to know a little background on your patient, one size doesn't fit all. referring to my previous commet, not so much to klone's comment.

I can't believe I'm hearing the tired old "well, I was fed xyz and I turned out fine" HERE of all places. What happened to EBP and research to guide our care?

It's clear that this is a hot button issue for many people.

Up Vote Up Vote ×
Specializes in Maternal - Child Health.
It isn't lecture.

I can't understand why we are okay with people making uneducated decisions with this aspect of healthcare.

How do you know that any family's decision to use formula is an uneducated one? How do you assess parents' knowledge of the risks versus benefits of formula use before providing teaching and objective resources (that I 'd like for you to share with us)?

Up Vote Up Vote ×
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
How do you know that any family's decision to use formula is an uneducated one? How do you assess parents' knowledge of the risks versus benefits of formula use before providing teaching and objective resources (that I 'd like for you to share with us)?

Just like with anything else in nursing...you ask the patient in a conversation. This isn't any different then other areas of nursing.

Up Vote Up Vote ×
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Woah woah. Let's break this down another way... It's fact that prenatal care reduces infant mortality. Is it a coincidence that places with better prenatal care have higher incomes? Or that mothers with access to more financial resources get better prenatal care and thus have healthier infants? And that those same mothers are more likely to breastfeed for a longer period of time? I'm not saying breastmilk isn't the best option (it is). I am saying that studies frequently tie a direct link to breastfeeding and healthy babies when there are many many other factors in play. As nurses we have to look at our patients as whole people and not push our perfect world scenario on them when those ideals are unrealistic for their situation or when our agendas just aren't the same as theirs. Also, I'd be very interested to read more studies on these big bad risks of formula if you happen to have any handy.[/quote']

You work L&D and NICU and are unaware of the studies? Here's the deal...go so some research. I'm not going to sit here and post the endless evidence based research articles when you should have them at our finger tips. The benefits of breastmilk aren't debated. The risks of formula are not debated in the literature. These risks and benefits and very clearly stated in any number of places. Go do some research because if you are unaware of these risks and benefits...you need to make the effort to learn about them. I don't need to know them....this is my profession and I made sure I did the research.

Up Vote Up Vote ×

Yup right there with ya, jolie. per my post above yours....you have to know where the mom and family are coming from, before you can ASK them to go where you think they should be. I think all minds should be open...including nurses.

How do you know that any family's decision to use formula is an uneducated one? How do you assess parents' knowledge of the risks versus benefits of formula use before providing teaching and objective resources (that I 'd like for you to share with us)?
Up Vote Up Vote ×
Specializes in Med-Surg.

You work L&D and NICU and are unaware of the studies? Here's the deal...go so some research. I'm not going to sit here and post the endless evidence based research articles when you should have them at our finger tips. The benefits of breastmilk aren't debated. The risks of formula are not debated in the literature. These risks and benefits and very clearly stated in any number of places. Go do some research because if you are unaware of these risks and benefits...you need to make the effort to learn about them. I don't need to know them....this is my profession and I made sure I did the research.

Just to play devils advocate...I'm sure there are people on here reading this thread who are not employed in NICU or L&D. Could you post some of these articles about the risks of formula? Because personally, the baby friendly hospitals I worked in focused on the benefits of breast milk rather than beating down the big bad formula.

And FWiW, I very much support breast feeding and nursed my daughter for almost a year. I only stopped because she lost interest.

Up Vote Up Vote ×
Specializes in OB.
Also, I'd be very interested to read more studies on these big bad risks of formula if you happen to have any handy.

Really??? A two second search came up with this, and I didn't even have to sign in to PubMed:

The Risks of Not Breastfeeding for Mothers and Infants

It is honestly making me feel like I'm in the Twilight Zone reading this thread. There seem to be posters who are actually trying to argue that formula does not have health risks or is just as good as breastfeeding.

I worked in a Baby Friendly institution. OF COURSE there are patients who can't breastfeed for unique reasons, such as breast cancer, transgender status, etc. But in general that is quite rare. Most issues that moms have with breastfeeding that cause them to give up, feel guilty, say "Well not everyone is Mary Milkmaid!" are really due to a lack of support and education. The point of BF is to give mothers and babies the best start possible towards an optimal breastfeeding relationship.

As others have stated multiple times, if someone wants to formula feed for non-medical reasons, we briefly assess the reason why. For example, some patients take medications that they have been erroneously told are not safe with breastfeeding, and with a quick assessment and reeducation, that person could then go on to successfully breastfeed. If the patient is not interested, no one "lectures" for ages on end to try to convince them to change their minds. If that is happening in other institutions, it's not because Baby Friendly status actually requires it. As klone said, that is a warped, incorrect interpretation of Baby Friendly. But it absolutely the nurse's right and responsibility to have a conversation with the patient about their feeding choices. If we just ask "Yes or no?" many patients could fall through the cracks.

Up Vote Up Vote ×
Specializes in L&D/Maternity nursing.
Just to play devils advocate...I'm sure there are people on here reading this thread who are not employed in NICU or L&D. Could you post some of these articles about the risks of formula? Because personally the baby friendly hospitals I worked in focused on the benefits of breast milk rather than beating down the big bad formula. And FWiW, I very much support breast feeding and nursed my daughter for almost a year. I only stopped because she lost interest.[/quote'] Just a few on hand: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/ http://www.sciencedaily.com/releases/2013/06/130605133710.htm http://www.aacr.org/home/public--media/aacr-press-releases.aspx?d=2898 I work at a BFHI and we are not at all what is described by the OP. We are supportive of all mothers, regardless if how they choose to feed their babies. But yes, we do educate them on formula feeding, and part of that is risks associated with doing so. We also teach them on safe preparation and handling of formulas. All our formula must be signed out and accounted for. We must document on admission a mother'a feeding preference. The only consent she signs is when the baby needs supplementation (medically indicated) and with what means...either human donor milk or formula. We have mom and baby room in. We have no "well nursery" (just a SCN). We don't encourage sending your baby out at night for sleep, but if it's a safety issue where mom (and partner if there is one in the room) are too exhausted to appropriately care for babe, then we will take the infant our for a few hours. We delay baths, we have babes skin to skin for at least the first hr after birth or more. We don't give out pacis, but it's fine if the pt brings in their own for the babe (though we do educate the risks of pacis on breastfeeding initiation). These are all practice based on evidence and there is NO reason as to WHY everyone SHOULND'T be doing this.
Up Vote Up Vote ×

I just want to add one risk of formula that I didn't catch stated here (sorry if this is a repeat):

Formula has a (albeit small chance) of being contaminated. Several formulas have been recalled at various times over the last decade. Please encourage mothers who do choose formula to sign up for recall alerts (or keep an eye out for them on the news/internet) and educate them where to look for lot numbers, and to never use formula that looks like it was opened before they bought it (remind them a store will exchange these.)

Up Vote Up Vote ×
Specializes in ER.

Big breast feeding advocate here. But, unfortunately, breast milk has sadly been found to be contaminated with lead, mercury, orificenic and other heavy metals. If nurses educate mothers regarding the proven advantages, they also should be educating them as to how to make the healthiest breastmilk possible through healthier diets and lifestyles.

Unfortunately, though, some contaminants in our environment are difficult to avoid.

I just want to add one risk of formula that I didn't catch stated here (sorry if this is a repeat):

Formula has a (albeit small chance) of being contaminated. Several formulas have been recalled at various times over the last decade. Please encourage mothers who do choose formula to sign up for recall alerts (or keep an eye out for them on the news/internet) and educate them where to look for lot numbers, and to never use formula that looks like it was opened before they bought it (remind them a store will exchange these.)

Up Vote Up Vote ×
+ Join the Discussion