Breastfeeding after c-section

JVanRN · Aug 7, 2005

Is yours a high-volume L and D JV?

I don't know if it would be considered that. I guess for this area maybe. We are the busiest hospital in the area. The town has about 150,000 people and this hospital gets patients form surrounding rural areas, but it's certainly not on par with big city hospital, but certainly not rural. I want to say the L/D unit is 22 beds all together.(I work in NICU...don't really know that unit too well yet, except going to deliveries) C-sections go to the gyn floor though. Average census in the nursery is probably about 16-24 babies when we are busy (sometimes more some times less) This is not counting babies in the NICU which on average is about 14 (but we had 22 two weeks ago). Would this be considred high volume?

SmilingBluEyes · Aug 7, 2005

well, it's brisk...but "high volume" not necessarily. Busier than where I work, to be sure. Just was curious....

Zhlake · Aug 7, 2005

I am a lactation consultant at my hospital. We did a process improvement on getting babies to the breast. After some education, our average time for vag deliveries was 28 min from birth until first freeding. For c/s it was 30 min. Only 2 min difference!! I couldn't believe it. Basically as soon as mom leaves OR and gets in the recovery room, they put baby to breast.

Baby only goes to NSY if there is a problem.

allnurses Guide · Aug 7, 2005

Interesting reading . .. . .so many different stories.

As I said, we don't really have a nursery where a baby can "transition" whatever that is. I guess I don't see how babies even need to be in the hospital as they aren't sick, just born and hanging with mom.

Our vag deliveries stay in the L&D for as long as they want (obviously within limits) to bond and breastfeed and then move to a pp room. Our cesarean moms go to Recovery for maybe 1/2 hour . . .sometimes we recover them in their pp rooms. Babies are with Dad or family member. The nursery is just to weigh and bath the baby.

Big differences in hospitals . . . even 22 years ago there was a huge difference between my 1st son's birth and my 2nd son's birth.

steph

SmilingBluEyes · Aug 7, 2005

It's been my experience, that in really LARGE hospitals, where L/D and M/B are separate, there is an increased liklihood of having a "transition" nursery also. There, babies are taken away after birth and baths/meds/admissions done. It need not be that way, but it's a hard-sell concept to "old school" nurses and pediatricians. Fortunately, some of the larger hospitals are even moving away from a "transition nursery" concept, and more to 24/7 rooming-in policies and couplet care.

I have found in smaller hospitals, particularly where LDRP exist, this is not as often done. It just seems to work better to have all staff cross-trained in L/D and mother-baby in the smaller community hospitals. This is why I tend to stay working in such places.

I am not being controversial or trying to annoy anyone, but I would prefer to have a baby in a place where we labor/deliver, recover and stay in one room. I would also question anyone taking my healthy baby away for "tests" or any procedure, when most anything could be done in my room, at my bedside. It's really easier and nicer to have a couplet care concept for all---both staff and families alike, once you get going on it! And, it's easier for mom and dad to learn their infant's cues for feeding, attention, etc if the baby is with them all the time. That first hour of two of life, a baby is often in a "quiet alert" state that no mom should miss out on---she can begin to learn about her amazing newborn and his/her feeding cues in that first hour, if the conditions are right. The sooner they take control in caring for their newborn, the better for everyone.

pink2blue1 · Aug 7, 2005

I'm not sure what our hospital policy is exactly, but as a mom who had 3 sections there I can tell you that after my 1st I was TOTALLY out of it and didn't get baby to breast for 4-5 hours, with #2 it was an hour and a half and with #3 it was right out of the OR practically. AS soon as he was bathed and all that. So if I had to guess I would say that as soon as both baby and mom are ready. With my 3rd apparently he inhaled some fluid on the way out and his resps were high and they had to suction him several times, something that I hadn't experienced with my daughters. Despite this he was still ready to come to me and once he did, he nursed great.

fergus51 · Aug 7, 2005

That's funny Deb, I've actually always thought the opposite. Smaller hospitals (not rural ones) are the ones I've always seen with these types of policies.

SmilingBluEyes · Aug 7, 2005

wow that is funny. I have practiced in two states. Not that many. This has been my observation in both.

allnurses Guide · Aug 7, 2005

Since we don't bath the baby for 4 hours anyway, what would be the point to immediately take the baby to a nursery? Some of the nurses here are very regimented though - they do things so fast after delivery - weigh and measure, footprints, etc., which means taking the baby to the nursery. I like to let the family oh and ah over their new little one and attempt to breastfeed without some nurse interfering. :) Of course I realize that usually we only have one baby at time - makes a big difference.

Also, there is very little chance of getting a baby mixed up with another baby in my hospital.

I actually like the whole idea behind home births . .. . I just want them in the hospital. :)

steph

SmilingBluEyes · Aug 7, 2005

Since we don't bath the baby for 4 hours anyway, what would be the point to immediately take the baby to a nursery? Some of the nurses here are very regimented though - they do things so fast after delivery - weigh and measure, footprints, etc., which means taking the baby to the nursery. I like to let the family oh and ah over their new little one and attempt to breastfeed without some nurse interfering. :) Of course I realize that usually we only have one baby at time - makes a big difference.
Also, there is very little chance of getting a baby mixed up with another baby in my hospital.
I actually like the whole idea behind home births . .. . I just want them in the hospital. :)
steph

why should ANY procedure (other than IV's or other invasive/potentially upsetting treatments---which generally are not done for healthy babies anyhow) be done in a nursery???? I have done PKU in nursery---some moms and dads just prefer it---they are always welcome to join me, if they choose, however.

We bathe, give meds, measure/weigh and can footprint all in mom's room. The scale rolls right in---we have meds and means to measure and bathe all in that scale and its drawers. Moms' rooms have sinks, so baths can be done in the room, too.

Truly.....There is no real need to take a healthy baby from mom's arms or bedside at all. I like the way you do it where you are Steph. I think the policy should be no well babies removed from mom's room unless medically indicated for mom or baby.

Nurse Valium · Aug 7, 2005

I am thrilled to see progressive thinking in the L&D forum. I am not an L&D nurse but am a mom & was overall pleased with the birth of my son though with a few bumps along the way. He was delivered by C-section after 29 hours of unsuccessful laboring & my biggest complaint was that even with apgar scores of 9 & 10 he was wiped down, suctioned, goo-ed (eyes) & wrapped in a blanket before I even laid eyes on him. I had waited 33 years for that very moment of my life & wanted nothing more than to hold him to my chest & "inspect" him. Or at least let my husband hold him close for me.

My husband accompanied him to the nursery where it was discovered that his glucose level was 39. My husband (who is also a nurse) states that the nurse began gathering & assembling a tube feeding when he interrupted saying "he needs to nurse". They then allowed my husband to hold our son to my breast & nurse (my arms were still Jello) while I was in recovery. Bless them!!

SmilingBluEyes · Aug 7, 2005

IN cases of hypoglycemia, we have a clear-cut protocol. Nurse first, then pc (post nurse) supplement w.cup. Most of the time this works well. Just have to be very careful to explain the rationale and gain parental cooperation and trust.