Bottles after 3 hours

[Dayray]

It seems that our lactation nurses and the nursery nurses are at odds with each other. Many of the nursery nurses feel that a baby must eat Q 3- 4 or they will starve. Lactation takes the view (which I share) that babies do not need to be bottle feed, if Mom wants to breast feed, until 24 hours after birth or if the BG is low.

I have had allot new mothers in tears because the nursery nurse made them feel so terrible about breastfeeding.

2 weeks ago the nursery (with the support of our director) changed the feeding policy. Babies will now be bottle-feeding every 3 hours. If the mother is having trouble breastfeeding and is unable to breastfed, the baby will be given formula regardless of mother's wishes. Cup feeding, supplemental feeders, spoon feeding and all other alternative methods of feeding are not allowed unless done by a lactation specialist (of which there are only 2 and none on weekends or evenings) the only expectable feeding methods are bottle or gavage (sp?).

I was called into a meeting with the director, because I am known to be a "problem" when it comes to compliance with these new polices. In other words I take a little extra time to allow mom and baby to learn how to breastfeed. I was told that feeding is nursery's job and that sense I am a post pardom nurse (even though I'm a couplet nurse as well) I am to refer all questions regarding feeding to the nursery.

I know that most hospitals have an "us and them" attitude between NSY and L&D but I don't think my feelings are based on that. Our nursery is continually apathetic toward the mothers, they call them stupid (not to their faces), don't let them hold their babies, shove bottles in their faces and constantly complain about them. They seem to think that they care more about their babies then the mothers do.

I gave my director some examples of the things I have seen and her response was "well as a director what would you do? If everyone except a few people think one way and you, a new LPN think another way what would your decision be" My response was " I would do what was right for the patient". After that she listened to me a little more and admitted that I had some valid points but still said she was going to side with NSY and that I needed to communicate more with them.

I am not a confrontational person and have never argued with the NSY nurses, but I do work with patients and get them breastfeeding after NSY has given up.

I have been more careful but continue to teach my patients how to breast feed.. Iv only had a few rare cases that I was not able to get the baby latched after 1 shift. I know that eventually I will get caught and turned in but I feel I have to do what is in the best interest of my patient.

What do you guys think? Am I just being opinionated and causing problems?

What are your hospitals policies regarding feeding?

[OBNURSEHEATHER]

Good point canoehead. Every 3 hours is a little overkill for a formula feeding.

Heather

[SmilingBluEyes]

I agree w/the others; get lactation consultants and peds in on this. This policy has no value in normal,healthy newborns w/o complications. Don't back down; this is sabotaging the breastfeeding efforts of moms in a needless manner.

[deespoohbear]

Against the parent's wishes?? OMG! I, for one would not want to be on the receiving end of some Mom's fury because of stupid, lame-brained policy. Most Moms can get pretty nasty when it comes to messing with their kids. (Speaking from personal experience! ). Maybe the original poster could let this "leak" out to the breastfeeding.com people. If the name of the facility got out to the breastfeeding adovacates, I bet the policy would be changed in a heartbeat. I don't even work OB-GYN, but I know our lact consultant would have a coronary over this policy. So much sh*t would be flying, you would need a backhole to clean it all up!! Stand up for your patients and fight for their rights and their babies rights!! Keep us posted...

[keeper]

Not a nurse, but a nursing mom.....this is why I homebirth. Even though most hospitals aren't run by idiots, I just can't take the chance of there being some insane policy like this one that flies in the face of solid research.

What about a patient's right to refuse all medical procedures? I would assume that given that legal right, and the legal right of a parent to refuse procedures for her child, that the words "regardless of the mother's wishes" cross the line into illegal territory.

My first baby, born at home, had trouble learning to nurse. He got a little here and there, but it wasn't until day two that he finally got a full feeding...but he fed just fine from there and 12 days after birth, he had regained his birthweight plus 8 ounces. I credit lots of support from my midwife and Bradley instructor and knowing that giving him a bottle would only make the problem worse.

[SmilingBluEyes]

oh boy here we goooooooo.....................................................let's keep this clean if it gets ugly now.

[OBNURSEHEATHER]

Originally posted by SmilingBluEyes

oh boy here we goooooooo.....................................................

:chair:

[emily_mom]

I'd be pissed if someone gave my baby a bottle against my wishes. And that's all I'm gonna say b/c I see it's getting a little testy in here and I'm bailing out...(did someone say test? crap, i gotta go...feel the "ain't studying for finals guilt setting in)

Kristy

[babynurselsa, RN]

Do they have any facts to back up this decision?!?!?!?! I think not.

We have individuals at our Nursery that have that mindset. But, they are morons who are not especially pro-breastfeeding. It is very normal for a breastfed infant to not nurse well in the first 24 hours. THEY ARE TIRED! If you had just had your head nearly squeezed off you might want a little rest too!!!!!.

collect your own research to show that this is fine for these babies to eat on demand. Your hospital Library can do an article search for you, or check out Le LEche, they have a web site.

[imenid37]

i'd hate to see administration's face when one of these moms gets to them and for sure they will. this is lunacy!!! i get concerned if baby has not eaten for 10-12 hrs., i know they can go w/o for 1st 24 and usually be o.k..

i'd never give a baby a bottle aginst mom's wishes, unless it was life/death hypoglycemia. you must have some of those nursery nurses of old from the badilax(?) days when i had my kids. the ones who turned all the bright lights on and woke up my bottlefeeding room-mate, when they brought my breast-feeding baby in, w/ the the familiar..."you're child is hungry AGAIN, wake up mrs.___! perhaps you should give a bottle, it's only been 3 hrs(doesn't sound too bad for breastfed baby)!" i tried to joke and say maybe she just missed me and the one mean nurse, told me "she doesn't have a good temperament."

actually, i do what i do because as a cardiac nurse at the time, i knew i could do a better job than these meanies! it really is a sin when we're supposed to be here to help people along in a joyful moment and we ruin it for them.

[canoehead, BSN, RN]

"she doesn't have a good temperament"

Really. She just went through hours of labor, got shot out into a cold bright world, someone stuck needles in her, and all she wants is to be cuddled a little. Who could blame the poor thing. Sheesh.

[SmilingBluEyes]

exactly, lisa, i see all the time---- infants who don't nurse well for 24 hours or so...they are sleepy and have energy reserves leftover from mom.....i tell my families all this and not to worry...

now, here is where i stand against early discharge unless they have GOOD, thorough followup and support at home.........we need to see these couplets breastfeeding well, or at least help them along the way. not always possible in just 24 hours' time......

[vashka25]

Oy.... we'd be thrown out of the hospital if we put formula or even a plastic nipple in the mouth of a babe without consent from the mother first. I can't tell you as a student how many cup feedings I do, or how many mom's I do S&S on with pumped breast milk if need be...or finger feeding....anything to make sure that babe is feeding well and to avoid bottle-feeding unless absolutely necessary. And like most hospitals up here, the Mom may be d/c after 24-48 hrs... but the Pedi's wont let the baby leave the hospital until they are satisfied that proper feeding is established first...(breast or bottle). (*pardon my inexperience as I'm only a student*)

Oy what a row this will create when I bring it up in conference on Sat....