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

Nurses Article   (19,032 Views 174 Comments 1,461 Words)
by cjcsoon2bnp cjcsoon2bnp (Member) Writer

cjcsoon2bnp works as a ED NP and Clinical Instructor.

8 Articles; 24,173 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 9 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.

JanetMcFee has 34 years experience and works as a RN.

937 Visitors; 6 Posts

Many of us have personal biases, it's hard not to when we read about dead babies all over social media. But our job as health care providers is to leave those biases in the hall when we enter our patient's room or home. Our priority is to focus on that patient and her needs not compare her to the whole darn world. New moms have already compared themselves to the whole world and have found themselves lacking. What they really need is support and encouragement, to be told, "You've got this, you can do this!"....no matter what their feeding choice is.

After almost 40 years working in health care, raising 10 kids, breastfeeding 8 of them and supporting thousands of women in feeding their babies, I have a LOT of biases. My biggest strength is in understanding that and making sure my own opinion does not interfere with my patient's choice. My opinion is not the most important one in the room when I am teaching a patient!

I work hard to educate myself, including reading lots of opinions. I love to read facebook but I know it is rumor, heresay and conjecture unless it is based on fact. My practice decisions and opinion should be driven by evidence-based research, not facebook.

This is a great topic to be discussed and maybe open our eyes to alternative thinking, to challenge our current beliefs and hopefully improve our patient care.

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140 Visitors; 4 Posts

First of all, thank you for sharing your story. I work in Postpartum as an RN at a Breastfeeding friendly hospital. The goal is to have everyone breastfeed and to keep couplets together 99% of the time. It is interesting to hear what happens after you have gone home. As long as babies are under that 10% weight loss and are voiding and stooling and do not have High Risk TCB (Bilirubin's) the provider will usually sign a discharge order. Some exceptions to that are if the baby is not latching, voiding, stooling, etc. Sometimes we will send great breastfeeding babies home and they will return for phototherapy because breastfeeding babies peak later than a usual postpartum stay. It sounds like your nurses were coaching and stating all the same things that I find myself saying. I know breast is best and I support the facility I work at, but not to go to the lengths to allow my moms feel as if they are failures for not breastfeeding. I make sure I show compassion for the struggles they have and assure them everything they are experiencing is the path to successful breastfeeding. Like cluster feeding and the "second night syndrome". I hope the education and the talks that we have prepares them for the next step so that they are not so overwhelmed when it happens. Like the fact that their babies tummy is the size of a marble and they need only a few drops of colostrum and may not breastfeed the first 24 hours at all, but at least attempt every three hours. Rest while they can, night two will be different. Breastfeeding is hard for more moms than it is easy, I know I struggled with my first two and my twins and never really did get the hang of it and was not successful. If your not in this field, this breastfeeding only initiative is exploding. We pay for all our formula, do not hand it out without a consent form and also offer donated breast milk which we use often, but cannot use a bottle, nipple, or pacifier because of nipple confusion. So add dropper feeding infants to an already busy shift. Its difficult, but I support it. The older nurses however I don't see ever having the patients for this. It easy to hand out formula. It's easy to offer to take the baby to the nursery for checks or for moms to sleep which we shouldn't be doing either. I know I am rambling, these are different times and it used to be "let me tell you why breast is best" and now it's "let me tell you all the risk factors of formula feeding and how to successfully prepare formula". As for your lactation consultant, I almost thought we had the same one reading your post! Not sure what it is with this profession and remembering back to the one I had in a different state, they are all the same. I don't get it, but not very supportive, but very results orientated.

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14,914 Visitors; 630 Posts

I've never given birth and only had experience with new mom's and babies in a very limited way during clinicals so maybe this is why I don't know certain things:

1. I thought that "Breast is Best" was first and foremost about the baby getting breast milk due to the health benefits so pumping the milk and bottle feeding was ok. Clearly I was very wrong according to a lot of LC's.

2. I thought that La Leche League was used a lot by women who could produce milk, or baby wouldn't latch but I didn't see it mentioned in the 3-4 pages that I read. Possibly it was after. Am I wrong that it's used frequently?

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klone has 13 years experience as a MSN, RN and works as a Director of OB Services.

301 Likes; 3 Followers; 112,042 Visitors; 12,926 Posts

2. I thought that La Leche League was used a lot by women who could produce milk, or baby wouldn't latch but I didn't see it mentioned in the 3-4 pages that I read. Possibly it was after. Am I wrong that it's used frequently?

I don't understand what you mean by being used?

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1,997 Visitors; 71 Posts

I was an adoptive mom in 2007 to a newborn baby with HLHS and an intact atrial septum. He was born very sick. I didn't want to induce lactation with him, so I didn't. I was happy to bottle feed him.

When he graduated from PICU to NICU, I distinctly remember the looks and comments I got after I told the nurse I wouldn't need the fridge in the room for breast milk. I explained that I was his adoptive mom, and she still made comments that implied I should have tried. And the ironic part, because he was so tiny and SO weak, he ended up a tube feeder. I bottle fed him about 2 weeks. And I missed it! Tube feeding just wasn't the same. But you know, I had to report his weight every day to his CT surgeon and I remember the struggle to get him to gain .1kg!

10 years later, and I still remember the guilt that a nurse tried to place on me when my baby didn't even have the strength to eat.

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68 Likes; 5,439 Visitors; 393 Posts

My child was born premature and had to have a feeding tube inserted in the NICU, she was too small to even fathom trying to have her latch and would become exhausted after just minutes of suckling on nipple, hence the feeding tube. Anyhow, I was encouraged in the hospital to pump while the NICU also supplemented her with formula. Even though I knew this was necessary and there was no physical way my child could breastfeed, I felt the stigma of "breast is best". I felt like a failure as a mother and it depressed & guilted me. In hindsight and after being able to breastfeed in addition to formula another child, the thought of the guilt I felt about this is upsetting to me. How mother's are shamed for not doing what is "natural" is terrible. To be able to breastfeed your child is a wonderful thing, I was fortunate enough to be able to do it with my second, but for many of us for various reasons it isn't always possible. Breast is great, but fed is best!

Edited by MiladyMalarkey

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161 Visitors; 2 Posts

omg somebody shoot me....i cant believe this topic is even necessary. nurses please get out of the judging business...no matter what your good intentions.......can we please remember the golden rule and treat others as we would like to be treated??!!!

this is when you know you have been a nurse too long and have seen way too much crap to put up with this kind of BS anymore...

Families please follow this dad's lead and advocate rather than humiliate your wife who just bore your offspring. What a wonderful gesture he showed his wife by putting her and the baby before the ego of a lac consultant....which i am judging now as i type, to be not a real nurse but a lackey or a failed out/burned out nurse who really has no control and weilds her power only in the area she can....so moms please put a breast or a bottle in that baby's mouth and feed it for crying out loud!!! and don't let other people TELL you what you will and wont do with your body and your kid!!

Just my opinion after 20 something years of critical care nursing of big people, little people and people who chose not to breast feed....

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161 Visitors; 2 Posts

well that doesnt happen at lots of hospitals bc its all about the bottom line....and alot of formula is given free to hospitals by the formula companies.....by the way......i have never had anyone sign a consent form for formula...EVER...in many hospitals i've worked in over the years.....see this book perfect world of nursing and medicine that some nurses learn and are fortunate enough to practice isn't reality for most of the hospital world. much as i support breast feeding etc...if im a new mom and you come at me with that scripted crap im already feeling hormonal and blah blah blah....all you have done with that is tell me that what i am feeling is wrong but you do it in a professional manner so that makes it NOT condescending.....as a nurse and female it pains me to see how women undermine other women and not bc we mean to but bc as a society we decide who should and shouldnt be accepted and what behavior women should and shouldnt display and if someone steps out of that line, GOD forbid, we find systematic ways of controlling the masses....i say stop it.....quit telling women they just have to keep trying and that this is all normal.....its not normal to them in that moment and saying it doesnt make it so.....you invalidate their very real feelings in that moment...maybe later they will look back and thank you for the education but when they are frustrated and overwhelmed and just need someone to understand...well if you don[t have the patience for that, find an OLDER nursel......(you see the age bias you put in your little speech...you probably didn't even recognize it....)

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OrganizedChaos has 10 years experience and works as a LVN.

7 Likes; 1 Follower; 63,802 Visitors; 6,876 Posts

I just had my baby last night & it was such a great experience. Even when asked if I was gonna bottle or breast feed I never felt pressured or guilty for not breast feeding. All of the nurses have been amazing. From the triage nurse to post partum, it has been an amazing experience. But maybe I'm still on the post baby high.

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140 Visitors; 4 Posts

There is a theory that pacifiers and bottles are "easy nipples" to latch onto and if a mother has flat or inverted nipples than the baby won't work to latch properly. This can delay mother's milk coming in because the baby is not latching or is frustrated. Most EBP shows not to use artificial nipples/pacifiers for 6 months. However, this doesn't fit for everyone so if we have the option to do hand expression and dropper feed until we can get a successful latch that is our first choice. Time consuming so not all nurses are willing to do this. Pumping doesn't work with colostrum because of negative/positive pressure the pump gives off the mom is lucky to get a few drops of liquid gold and this adds to frustration and the feeling of failure. Hand expression until her milk comes in is my go to if possible. I'm not sure about La Leche League.

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Cococure has 7 years experience and works as a RN on a mother/baby unit.

4 Likes; 1 Follower; 6,155 Visitors; 345 Posts

I just had my baby last night & it was such a great experience. Even when asked if I was gonna bottle or breast feed I never felt pressured or guilty for not breast feeding. All of the nurses have been amazing. From the triage nurse to post partum, it has been an amazing experience. But maybe I'm still on the post baby high.

Congratulations :up:

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