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?

[SmilingBluEyes]

Originally posted by Cheerio

My 2nd DS was given a bottle in the nursery. He was rushed there after birth, and I was bedridden. However, I had told the NICU nurse and my PP nurse that I wanted to breastfeed, no nurse would take me down to see him They claimed that I should rest and that my BP was still too high to get up and walk around. He was born at 03:40, and I didn't get to see him until 10:30 when my Mom came and wheeled me down. I even asked for a pump, and they dismissed me. When I finally got him, he refused to latch on, even the LC freaked when she heard he was given bottles. I worked at trying to bf him for 2 weeks, and gave up too easily. Our hospital is supposed to be 'breastfeeding friendly'

I am truly sorry to hear this. In a case such as yours, we offer to take the mommie in a wheelchair to the nursery so she may hold/feed the newborn if possible. If the baby is too sick, we certainly encourage her and the family to visit and bond as soon as feasible as well as begin PUMPING milk IMMEDIATELY. Breastfeeding success is important to me and I will do everything humanly possible to help ensure this success for those who are dedicated to it! I am sorry this was not the case for you!

[SmilingBluEyes]

Originally posted by mother/babyRN

. It isn't up to me or anyone else to attempt to change someone's point of view. Mine is as educated as anyone elses....It takes courage to stand up for patients, and that is what I intend to continue to do....But, it pleases me that all of you are so devoted to the well fare of these moms and patients. What you fail to see and understand, is so do I....Thanks for the discussion...Anything more heated would just be an argument, would it not? Lets agree to disagree and continue our spectactular care of our patients! {{}}:)

I could not agree more w/this part of your post. I agree to respect all points of view here, even if we don't agree on principle.

[SmilingBluEyes]

sorry duplicate post..

[mother/babyRN, RN]

I have to say that whatever anyone says, no man has any idea exactly how tired, sore or anything else a breast feeding person gets. And, as both men and women can get MIs, I think that example is totally off base...I am not simply talking about the physical component. Sitting next to me while I am breast feeding every two hours does not a similar experience to my husband make. But, I wouldn't make that even an iota of an argument since, once said, it really doesn't make for much more than voilitile discussion between men and women.

Hey, I check out the nutrative suck, audible swallow and work out there in the trenches just like all of you to achieve a great breast feeding experience...Truly, I do. But, babies, though rarely, do get dehydrated and have low blood sugars. Their health comes first. I am happy that doesn't happen too often.. And why doesn't anyone ( although there are a few studies out) consider that babies can get thirsty? I recall when I was in nursing school, the general belief was that newborns didn't experience pain, so weren't medicated after surgical procedures, in my case, repair of mylomeningoceles.) I am not arguing with any ones points here. I am just saying, as I have mentioned, there is no such thing as black and white in the area of nursing (either definition), and sometimes you have to work with the grey.....

[SmilingBluEyes]

like I said, we may agree to disagree. I will leave this thread w/that thought.

[Cheerio]

Originally posted by SmilingBluEyes

I am truly sorry to hear this. In a case such as yours, we offer to take the mommie in a wheelchair to the nursery so she may hold/feed the newborn if possible. If the baby is too sick, we certainly encourage her and the family to visit and bond as soon as feasible as well as begin PUMPING milk IMMEDIATELY. Breastfeeding success is important to me and I will do everything humanly possible to help ensure this success for those who are dedicated to it! I am sorry this was not the case for you!

Thank you Deb. I wish I had given birth at your hospital. It tears me up when I think about it, and some people don't think breastfeeding is a big deal, but they took the choice away from me. For my third, I will birth there again, but *I* will be calling the shots. They're actually thinking of implementing bands for the babies, so you can tell if they are breast/bottlefed much easier.

Good idea? Possibly.

[SmilingBluEyes]

Originally posted by Cheerio

Thank you Deb. I wish I had given birth at your hospital. It tears me up when I think about it, and some people don't think breastfeeding is a big deal, but they took the choice away from me. For my third, I will birth there again, but *I* will be calling the shots. They're actually thinking of implementing bands for the babies, so you can tell if they are breast/bottlefed much easier.

Good idea? Possibly.

I think that idea is ok, but if nurses/staff are not supportive of breastfeeding in the first place, a band will not do too much good. I say, try making a birth plan and including the desire to be the first to hold the baby and be able to breastfeed immediately after birth.

In the event the baby must be transferred to the nursery, request you be allowed to go there to bond/feed as soon as possible, even if it means by wheelchair. Be VERY assertive from the start and don't take NO for answer unless truly, medical conditions make it impossible. Also, it may help if you can get hold of a lactation consultant or La Leche League if there are ANY issues that prevent normal breastfeeding after delivery. Ask if your hospital employs a lactation consultant and if so, know his/her name and how to contact this person ahead of time. Unless your blood pressure is dangerously high, or you are hemorrhaging, you SHOULD be able to feed your baby immediately (or at least upon recovery).

They have no right to take that choice away from you and no bottles, nipples, pacifiers or formula should be used unless SPECIFICALLY ordered for MEDICAL purposes by your pediatrician. IF this is the case, make it clear to the pediatrician your STRONG desire to initiate breastfeeding ASAP---- and reiterate your commitment to this goal as a family to all personnel involved in the care of you and your baby. I wish you luck! Hopefully things go much better this time around!

[mark_LD_RN]

MotherbabyRN-- i think you may have taken some of what isaid the wrong way, i tried to clarify it the besy i could. We may disagree on the male thing but i do know how tired and exhausted a BF can get and feel for them.

my points and issues are with doing things against the mothers wishes. it is not the nurses place to take it upon them self to decide for the patient if she should supplement or not. we can suggest it but never force it. that is the points i am tring to make.

I hate to see a patient in tears for any reason but really can not stand it when it was caused by someone doing something against their wishes.

everyone is intitled to their beliefs nurses as well as patients. and i am not trying to change ones view.

I hope me asking the question about ever seeing a baby given a bottle and it affecting BF adversely was not taken in the wrong way. if it was I am sorry> I was just honestly asking a question:)

[mother/babyRN, RN]

No one should EVER take the choice away! I agree 100 percent. And thanks for clarifying things guys.....