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!
I refuse to berate or lecture anyone on their infant feeding choices. Formula is not poison, and I will not make a mother feel guilty for using it. They have their reasons. Educating is one thing, forcing them to sign a form saying they are a bad mother for giving it opens a whole new can of worms.
I'm certain that consent form doesn't say anything akin to formula is poison and you are a bad mother for giving it.
Parents deserve the right to informed consent. How can they have informed consent if they don't have the information?
Specializes in Nurse Leader specializing in Labor & Delivery.
You stated in a previous post that educating parents on the benefits of BF is not enough, that the risks of formula must be presented also. .
Every "benefit to breastfeeding" is actually a "risk of not breastfeeding" since breastfeeding is the biological norm by which we measure health and health risks when it comes to infant health and nutrition.
It would be like calling "risks of smoking" as "benefits of not smoking".
The article I linked to in my very first post on this thread addresses this very issue.
If people are having to consent about formula if they choose to not BF, do the moms who can't due to various reasons have to sign also? Not all hospitals have access to donor milk. I am not going to get into the argument since we all, as educated professionals, know EBM is best, but I wouldn't go as far as to say formula is poison, etc.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
If people are having to consent about formula if they choose to not BF do the moms who can't due to various reasons have to sign also? Not all hospitals have access to donor milk. I am not going to get into the argument since we all, as educated professionals, know EBM is best, but I wouldn't go as far as to say formula is poison, etc.[/quote']
Nobody said formula is poison. If somebody said "I can't breastfeed because of...." I would first assess if they truly couldn't breastfeed or if they just need some education and support. If they needed to use formula they are still owed the education of knowing the risks. We don't ignore risks of other things because it is medically necessary. We still provide education.
Specializes in Nurse Leader specializing in Labor & Delivery.
And as an IBCLC, I just want to say that I recognize (and I believe my cohorts do as well) That formula definitely has its place and can be very helpful. My last son was in the NICU for 10 days and I had lactation failure with him. If it wasn't for formula, we would've really been in a bad situation until I was able to arrange for donor breastmilk. So, yeah, even though there are risks to not breast-feeding, even I recognize that formula has its place and can be very helpful and even life saving.
Nobody said formula is poison. If somebody said "I can't breastfeed because of...." I would first assess if they truly couldn't breastfeed or if they just need some education and support. If they needed to use formula they are still owed the education of knowing the risks. We don't ignore risks of other things because it is medically necessary. We still provide education.
Playing devils advocate in a sense...
What if someone says "I don't want to breastfeed?" Do you give it up or do you try and educate?
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
Playing devils advocate in a sense... What if someone says "I don't want to breastfeed?" Do you give it up or do you try and educate?
You provide the education needed to say you educated, ask them to sign the form and move on. This isn't any different than anything else we have to deal with.
Specializes in Nurse Leader specializing in Labor & Delivery.
Yes, I would approach it the same way we would approach parents in OB who say they don't want to vaccinate. We don't continue to ask them or berate them for their choice. We educate them, provide informed consent, and move on.
As long as they're making informed choices (and it's my job as their nurse to provide the education so they can do that), my only care is that their baby is fed. I don't have the time or mental resources to hound/berate/guilt parents who have made an informed choice. I'm too busy helping the women who WANT to breastfeed and need help.
You provide the education needed to say you educated ask them to sign the form and move on. This isn't any different than anything else we have to deal with.[/quote']
And this is a great example of breastfeeding issues...an 11 ounce loss isn't a meaningful piece of information. The baby's initial weight needs to be know, the amount of fluids given to mom in labor needs to be considered before looking at weight loss.
Also, "topping off" is a great way to ruin the breastfeeding relationship. If she wants to use formula...that's fine. If she wants to have continued to success with breastfeeding she needs to be careful with "topping off" because you can over-feed a baby and you can stretch their small stomachs. The baby should be able to get all the baby needs at the breast...if baby can't it is important to try and determine the issue whether it be a supply issue or an anatomical issue with either mom or baby.
That fact that the kid is fine isn't a reason to not educate parents. This is all about ensuring parents are making an educated decision.
The reality is that moms should be given more information at their OB appointments about breastfeeding and formula feeding...but sadly they aren't. So many moms come to the labor floor with a decision they made based off of information from a friend or a relative or something they found on google. These moms haven't been told the risks of formula. They also haven't been told ways to support their breastfeeding relationship if they decide to breastfeed. There is a lot of sabotage at the hospital level for breastfeeding moms and that is another key to the BFI...remove the barriers and the sabotage so that we can have more breastfeeding success.
Formula is still there. Moms just get to make an educated decision...just like every other medical issue they will be faced with in their life or their child's life. We do need to make sure the information is presented as factual and not biased. We need to make sure that after mom is given the information and she has signed the consent form that we then support her with formula feeding and give her the tools to use the formula properly.
The key is we are working towards educating these moms so they make an informed decision and also supporting and encouraging breastfeeding because we know the benefits.
Baby was 9 pounds, 10 ounces.
My son and daughter-in-law have access to a wonderful lactation department that is open on weekends here. So, anytime they have issues, they can drive over and sit and chat. They also make housecalls.
There was careful consideration from the pediatrician and lactation consultant about adding formula. Remember, my daughter-in-law had breast reduction surgery and while she was encouraged to try and she wanted to try, there were some troubles with milk production.
Baby is 2 months old now and mom has a double pump. She breastfeeds and pumps milk and gives that in a bottle and also gives formula.
I highly doubt my granddaughter will turn into a mutant due to formula.
I breastfed my kids to toddlerhood so remember, I'm a huge proponent!
As Jolie has stated, I'm interested in scientific studies regarding dangers of formula feeding.
IrishIzCPNP, MSN, RN, APRN, NP
1,344 Posts
And as nurses we don't assume anyone knows anything...we educate.