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"Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms

Nurses Article   (19,063 Views 174 Comments 1,461 Words)
by cjcsoon2bnp cjcsoon2bnp (Member) Writer

cjcsoon2bnp works as a ED NP and Clinical Instructor.

8 Articles; 24,175 Visitors; 1,156 Posts

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In my last article “Becoming Dad: A Humbling Birth Experience of a New Father and Nurse,” I discussed my journey to becoming a first-time parent and included some of the challenges that being a nurse and a parent present when it comes to the health of your children. This article continues on my journey with the battle we fought against the “breast is best” movement, which advocates that mothers exclusive breastfeeding babies for the first six months of life. You are reading page 13 of "Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms. If you want to start from the beginning Go to First Page.

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Has anyone studied if there is a rise in readmission rates to hosptials for exclusively breast fed infants. I am seeing hyperbilirubinemia and dehydration. This is not healthy for infants and quite costly. I have not seen if the rates have actually changed. I believe in breast milk. Who cares if it is pumped or directly from the breast. Some families are so adamant about breastfeeding that their anxiety gets in the way.

Fathers that advocate for their infants and moms should be congratulated. Having a baby should not be such a noxious event. And again, I believe in breastfeeding, but enough is enough.

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NickiLaughs has 8 years experience and works as a RN, ER-Trauma/Critical Care.

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Thank you! This was me 6 1/2 years ago with my first. The lactation consultant was borderline cruel in her encouragement, I felt like a failure. The exhaustion took over ND had it not been for my step mom telling my husband to "give the baby some damn formula and your wife is going to sleep right now as n long as she needs." I'm not really sure what would have happened. I admire the women who rock it,but I couldnt. Good for you for telling her to back off. I wish I had done it sooner with the first one.

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bathrobemom has 3 years experience.

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I breastfed my kids and also supplemented with formula. My first two had issues latching on and breastfeeding was difficult initially with both. A little formula helped them until my milk came in and they got the hang of breastfeeding. Plus I had no interest in getting up in the middle of night to pump milk. Sleep is precious. With my second child for whatever reason I had one breast that didn't seem to make much milk. It was painful to pump from that side. I called a lactation consultant and nothing she suggested worked. I saw a doctor and she had no answers. If there's going to be an emphasis on breastfeeding, then there needs to be solutions to problems that occur with it.

I think breastmilk is pretty cool, but I don't understand why some women make it out to be the end all and be all of nutrition. Blood is very important, we absolutely must have it, it has unique properties and does amazing things when you think about it, but at the end of the day it's still just blood. The mania that surrounds breastfeeding is a real turn off.

Breastmilk is best, but it's not like formula is the equivalent of a bag of chips and a Coke. There isn't a stigma associated with TPN, is there really a difference? People accept that so much easier for some reason. My dad's generation (born in the 50s) questioned breast milk, no one knew what was in it, there wasn't a way to measure it, so formula was deemed better than breastmilk. I don't see any difference in that generation as far as health issues, longevity, or intelligence. I don't have studies to back up my opinion, but if the difference is that slight that a study needs to be conducted then I'm not going to get excited about it.

What really bugs me is that I don't understand the concern about a child's first year, but the rest of childhood seems to be forgotten. Child obesity is a real problem as well as adult obesity. It doesn't make any sense to me why anyone would be so concerned about breastmilk and then basically not care about nutrition after the first year. Diabetes is a real problem in the United States, there should be a lot more concern about that.

If we want women to breastfeed then we need to allow them space to do it. Once again I don't understand what people are thinking, they want visitors to wash their hands before touching their baby, but if it's a breastfed baby, it's ok to take it into a public restroom and let it eat on a toilet. There are people that don't want their toothbrushes near the toilet, but it's ok to feed a baby on the toilet? Huh?

Women need help with breastfeeding- not guilt trips. Breastfeeding should be encouraged, not thrust on women and there should be real support for it. We need to acknowledge that not all women are able to breastfeed and we shouldn't shame moms that don't want to.

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Thank you for sharing. It's so important that medical professionals share these stories as well as other parents, because it really drives home how insane the "breast is best" policies have gotten. My son also wouldn't latch, despite copious support (that also verged on bullying) in the "baby-friendly" hospital. I also didn't produce much milk. Somehow my son escaped jaundice but was dehydrated and had lost 11% of his birth weight by day 3, so we were also readmitted. We "triple-fed" him, a schedule that drove me bonkers, and saw several lactation consultants. We finally switched to exclusively formula when he was two months, though not without tons of guilt on my part. In all that time, though, NO ONE told me that my breasts had nearly every physical marker for insufficient glandular tissue, which meant I couldn't have exclusively breastfed no matter what I did. The hospital kept me in the dark and allowed me to struggle and my son to starve either out of ignorance or a near-religious devotion to breastfeeding (or a twisted combination of both). It is just maddening.

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Yes, readmission is on the rise. A large Hospital system in Utah that is certified by the BFHI released data recently that within their system, a large percentage of newborn readmissions are due to feeding issues or complications from exclusive breastfeeding. I recently saw some studies in the UK and Europe that pointed to similar issues and dangers. It's not your imagination.

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Yes, readmission is on the rise. A large Hospital system in Utah that is certified by the BFHI released data recently that within their system, a large percentage of newborn readmissions are due to feeding issues or complications from exclusive breastfeeding. I recently saw some studies in the UK and Europe that pointed to similar issues and dangers. It's not your imagination.

I don't know if you're responding to my question, but your answer if quite interesting and needs to be taken seriously. This a great educational topic for all perinatal nurses and physicians, as well as administrators. Baby Friendly should involve more than exclusive breast feeding. I once saw an infant who had nothing to eat for 48 hours and was crying constantly. Parents, physicians and nurses all knew that the mother did not have a drop of even collostrum yet, but agreed not to feed this child formula. That was the only time in my life that I felt like a partner in abuse and I told them I will not be assigned to this infant again unless i could feed. By the end of my shift, mother asked me to give the infant a bottle and she would continue to put him to breast for stimulation. You don't have to give 2 ounces, but supplement with a little formula to support the baby.

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6 Likes; 3 Followers; 17 Articles; 65,646 Visitors; 5,259 Posts

The issue is not with the BFHI, though; the BFHI steps are not that earth-shattering. The problem is when managers or admins or someone with an agenda misinterprets. The bit about rooming in? It says "allow mothers and infants to remain together 24 hours a day." Allow is the operative word. It doesn't say force, and unfortunately it gets taken that way. Nurseries get taken away completely and sore, exhausted mothers who can barely see straight are up for 48-72 hours straight caring for their babies.

The part about giving infants no other food/drink except mother's milk unless medically indicated? Well, that doesn't mean you can never give it. If the baby is hungry or jaundiced above light level or dehydrated or losing too much weight or is hypoglycemic, that is a medical indication to feed them something. All the best reference texts, even the ones LCs have to study to pass LC boards, will say that rule #1 is feed the baby. Unfortunately - again - that has gotten twisted to mean that formula = poison and has no place in the hospital. Admittedly, it is 3rd best on the WHO preference list for maternal milk substitutions, behind pasteurized donor milk and then unpasteurized donor milk. But it is still considered an acceptable substitute and it can save lives. If I've got a newborn with a sugar of 25 who's already breastfed, God knows I'm not going to wait around for the pasteurized donor milk to thaw out before I feed that kid. I'll pop a bottle of formula and get him on his way.

The whole point of the BFHI is to help mothers who want to breastfeed without undermining their efforts. It just means that hospitals can't do what used to be standard, which was take all the babies to the nursery all night and feed them formula...which definitely works against what we've plainly seen here can be a tenuous relationship, esp at first. It makes me sad that people hear baby-friendly and roll their eyes, because it doesn't have to be that way, but poor implementation and bad examples have made it that way.

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LibraSunCNM has 10 years experience and works as a CNM.

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Also, the BFHI only goes as far as the hospital. All of those readmissions say to me that moms are completely without support when they get home, from pediatricians, family members, spouses, and community resources. That is a huge problem, and not the fault of the BFHI.

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Also, the BFHI only goes as far as the hospital. All of those readmissions say to me that moms are completely without support when they get home, from pediatricians, family members, spouses, and community resources. That is a huge problem, and not the fault of the BFHI.

We have to careful about placing blame. Many people do not have family members, family members don't know what to look for, spouses have inadequate knowledge, baby sees pediatrician 2-3 days after discharge and at that time pediatrician sees something is wrong. That's what my experience has been. Many families and nurses have been indoctrinated that the baby is getting something and that something is enought. The wet diaper standard is not enough. Also, the quiet, sleeping baby may be suffering from hypoglycemia. I've seen that too, but medical care came too late.

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LibraSunCNM has 10 years experience and works as a CNM.

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We have to careful about placing blame. Many people do not have family members, family members don't know what to look for, spouses have inadequate knowledge, baby sees pediatrician 2-3 days after discharge and at that time pediatrician sees something is wrong. That's what my experience has been. Many families and nurses have been indoctrinated that the baby is getting something and that something is enought. The wet diaper standard is not enough. Also, the quiet, sleeping baby may be suffering from hypoglycemia. I've seen that too, but medical care came too late.

Totally agree. This is exactly my point---there is no safety net in those first few weeks. Other countries have nurses doing home visits multiple times a day in the early days and weeks postpartum, so that moms aren't left to their own devices with breastfeeding, to the detriment of the baby. The point of the BFHI is to get moms (who want to breastfeed) off to the best start, but it's not enough, and it's not to blame for all of the babies who have ever had feeding issues.

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1,742 Likes; 4 Followers; 17,046 Visitors; 2,529 Posts

Also, the BFHI only goes as far as the hospital. All of those readmissions say to me that moms are completely without support when they get home, from pediatricians, family members, spouses, and community resources. That is a huge problem, and not the fault of the BFHI.

That's kind of a broad leap Libra. I kind of think the BFHI should include comprehensive follow up and links to community resources. Finish what they've started. For most new moms it's all they can do to manage a shower let alone advocate for themselves when they are having difficulty. Indeed I would speculate that most of them don't know their babies are in trouble until it's late in the game. And new dads? They aren't in much better shape and even less-educated.

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LibraSunCNM has 10 years experience and works as a CNM.

83 Likes; 24,385 Visitors; 1,069 Posts

That's kind of a broad leap Libra. I kind of think the BFHI should include comprehensive follow up and links to community resources. Finish what they've started. For most new moms it's all they can do to manage a shower let alone advocate for themselves when they are having difficulty. Indeed I would speculate that most of them don't know their babies are in trouble until it's late in the game. And new dads? They aren't in much better shape and even less-educated.

I absolutely agree with everything you're saying. I just don't know that the BFHI can be responsible for all that, in that it's an initiative aimed at changing the hospital process to implement recommendations from the WHO, not an actual government program or something. But I agree that all of the problems you listed above, are real, serious problems.

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