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

Published
by cjcsoon2bnp cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing.

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 14 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.

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,293 Posts

Oh, I have so many things to say about this!! Don't have a ton of time right now, but wanted to mention that one of the things that HUGELY drew me to the hospital where I work now is that they have a comprehensive case management program for pregnant/new moms, which includes postpartum home visits within a day or two after hospital discharge for all women in the program (which is 90+% of all the women who deliver). What I would love to see is a program like this for ALL hospitals, in all communities. I would also like to see the postpartum home visits expanded to include another visit at a week, and/or two weeks.

One of the things the nurses do, standard, at these visits, is a bilirubin check. They've caught SO many in-crisis breastfeeding pairs through this program, intervened early to help get breastfeeding onto a better path, and yes, even readmitted babies who required phototherapy.

Wuzzie

4,847 Posts

Oh, I have so many things to say about this!! Don't have a ton of time right now, but wanted to mention that one of the things that HUGELY drew me to the hospital where I work now is that they have a comprehensive case management program for pregnant/new moms, which includes postpartum home visits within a day or two after hospital discharge for all women in the program (which is 90+% of all the women who deliver). What I would love to see is a program like this for ALL hospitals, in all communities. I would also like to see the postpartum home visits expanded to include another visit at a week, and/or two weeks.

One of the things the nurses do, standard, at these visits, is a bilirubin check. They've caught SO many in-crisis breastfeeding pairs through this program, intervened early to help get breastfeeding onto a better path, and yes, even readmitted babies who required phototherapy.

Wish I could give this post more than one like. I think for as advanced as the U.S. is in medicine we are really dropping the ball when it comes to perinatal/postnatal care. The Europeans do it so much better.

sanakruz, ADN

735 Posts

Breast is best.

Of course, use a pump! Who is stopping you?

Call La Leche league. (Talk to other moms.) DOZENS of resources available.

No, we havent gone overboard. Breast is best.

jodyangel, RN

Specializes in L&D. 687 Posts

Klone,

Tell us more about this. HOW did this program get started and where does the funding come from?

...comprehensive case management program for pregnant/new moms, which includes postpartum home visits within a day or two after hospital discharge for all women in the program (which is 90+% of all the women who deliver).

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,293 Posts

Klone,

Tell us more about this. HOW did this program get started and where does the funding come from?

...comprehensive case management program for pregnant/new moms, which includes postpartum home visits within a day or two after hospital discharge for all women in the program (which is 90+% of all the women who deliver).

Funny you should ask, because this is currently my VERY FAVORITE TOPIC and I could chat anyone up about it for days if they ask! The program has been in our rural community (population 20,000) for over 25 years. We have a 100% referral rate from the OB care providers, and 100% buy-in from the community's pediatricians. Over 90% of the women who deliver at our hospital has at least one visit from our OB case managers, and most of the women have multiple visits, which take place prenatally in the home and on the unit, various formal education classes that are free, visits while inpatient after delivery (all of our maternity case managers are also IBCLCs), and postpartum home visits, as well as follow-up check-in calls for as long as the mother wants.

The funding comes from the hospital - it's considered a "community benefits" program. It does not earn revenue of any kind. As a result, we have a shoestring budget and have to do lots with little. Luckily, the nurses who work in the program are used to that and are very fiscally minded.

What's REALLY cool is that a large Oregon non-profit approached us this past summer because they recognize that the program is so incredibly awesome and they've given us a sizeable grant and have hired a researcher to spend the next year with us to document what we do, and this will be published, in order to provide a blueprint of the program for other communities that wish to replicate the program. SO SO EXCITED!!

cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing. 8 Articles; 1,156 Posts

Breast is best.

Of course, use a pump! Who is stopping you?

Call La Leche league. (Talk to other moms.) DOZENS of resources available.

No, we havent gone overboard. Breast is best.

With all due respect, your response comes across as dismissive and is exactly the reason why I wrote this article in the first place

!Chris :specs:

flowerpowerntx

flowerpowerntx

76 Posts

Thank you! Yes, I agree with you 100% and am so glad you wrote this article. For many reasons, breast might not be best. We need to examine those reasons and talk honestly about them. For example, breast feeding is an added stress on mom during a very vulnerable time. And it often times means less sleep as well. Unfortunately, added stress and less sleep for a woman at risk for post-partum depression/psychosis can be a life threatening combination.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience. 8,058 Posts

Thank you! Yes, I agree with you 100% and am so glad you wrote this article. For many reasons, breast might not be best. We need to examine those reasons and talk honestly about them. For example, breast feeding is an added stress on mom during a very vulnerable time. And it often times means less sleep as well. Unfortunately, added stress and less sleep for a woman at risk for post-partum depression/psychosis can be a life threatening combination.

Except the incidence of post-partum depression is generally lower in breastfeeding women.

nehneh14

nehneh14

107 Posts

Thank you! Yes, I agree with you 100% and am so glad you wrote this article. For many reasons, breast might not be best. We need to examine those reasons and talk honestly about them. For example, breast feeding is an added stress on mom during a very vulnerable time. And it often times means less sleep as well. Unfortunately, added stress and less sleep for a woman at risk for post-partum depression/psychosis can be a life threatening combination.

Absolutely! In fact, my PPD didn't alleviate until I stopped breastfeeding. My OB felt it was a likely contributor and thought stopping was worth a try. I wish I could have all that time back during which I was suffering thinking I had to power through. Little did I know that breastfeeding was making my situation worse. We all, baby and husband included, were much more content once the BF stopped. My hormones were all out of whack, and when I stopped, the ship righted itself! :)

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,293 Posts

Unfortunately, added stress and less sleep for a woman at risk for post-partum depression/psychosis can be a life threatening combination.

Research has shown that women who breastfeed are at less risk for PPD/PPP due to the hormonal effects of lactation.

flowerpowerntx

flowerpowerntx

76 Posts

Research has shown that women who breastfeed are at less risk for PPD/PPP due to the hormonal effects of lactation.

If you could point me to that study it would be greatly appreciated.