moms and babies staying together

BETSRN · Dec 20, 2003

We encourage rooming in and it has nothing to do with saving money and getting rid of nursery nurses. It's important for new parents to learn to care for their babies and learn, for instance, to read feeding cues in their newborn. It's a waste of staff to have nurses tied up in a nursery unless the circumstances warrant it (sick baby). We do LDRP and whoever is assigned to the nursery floats out to the floor and does her assessments at the bedside and helps out where ever necessary. There is very little that cannot be done at the bedside as opposed to in the nursery.

PegRNBSN · Dec 20, 2003

Thanks for all the input. As usual it helps to have a view from outside our little world.

The biggest problem I forsee is that this isn't the standard in our community, so if women really want their babies taken care of at night it will be a dissatisfier.

Also, how do you sell it to the multip who doesn't need the learning and wants the sleep?

fergus51 · Dec 20, 2003

Again, we don't have to sell it, it just is. I think if women know BEFORE delivery it isn't a problem. The problem would be if no one informed them beforehand. Even the multips I look after are generally happier to have the baby with them. Every baby is different, and just because they had an easy time with their other kids doesn't mean they will be able to breastfeed problem free with this one, and the nurses need the time to assess that. Mom can sleep when baby sleeps.

BRANDY LPN · Dec 21, 2003

"Brandy, I know where you are coming from, and I am not trying to be blunt, but don't know any other way to say it..... No, it isn't mom's choice. Where I work, we do not have a well baby nursery. The NICU is not for well babies, it's for the sick ones. We aren't going to transfer out a premie because the mom of a healthy baby wants uninterrupted sleep.

It would be nice if we had the resources to provide everything our patients wanted, but most days I am satisfied in being able to provide simply what they need. It would also be nice if we could have moms stay in longer, but it just isn't the reality where I am, so until then I'll just keep dreaming"-qoute

In the hospital I work at we only have well babies and ship the rest, our nursery is staffed by aides with the RN to do assessments we only have had about 400 del this year and so we have plenty of staff to keep a baby for a few hours if mom needs to rest, we have private rooms with an extra bed for S/O, but some of these girls dont have one or FOB has to care for other children at home. I can see where if staffing is a problem and you cant safely care for these babies in the nsy unless absolutely needed where you would have no choice but I still stand by the fact that it is not good for the bonding process to "force" an exhausted mother to have her baby in the room with her. Also its hard to learn to breastfeed when you cant keep your eyes open.

That being said I wont condone a mom who is unwilling to care for her own baby at all. If the case is that she is just too lazy to keep her baby at all then I would inform the doctor that there is a bonding prob. and let him/her handle it, while encouraging mom to become more involved in babies care.

After hearing your stories I am glad that I'm working somewhere where our moms DO have these resources if needed.

fergus51 · Dec 21, 2003

The benefits of rooming in have been proven. The nursery model is well meant, but outdated. When women are being discharged 24 hours after delivery, we can't waste one night. It just isn't practical or helpful to anyone. Babies often sleep 3 or 4 hours straight after breastfeeding, and that's when moms can sleep as well. Sending them to the nursery for the nurses to look after and bottle isn't helpful with breastfeeding. I suppose I am glad that most of our moms want to breastfeed, so they expect rooming in. I can't imagine working somewhere that moms always expected to send baby away for the night.

Luvmedicine · Dec 22, 2003

I am not an ob nurse either, so my opinion or question may not count for much...but here goes...

I agree with rooming in for the most part. I think healthy babies need to be with their mothers. My concern are the mothers who are sick or especially the mothers who are post-op c-section. I've had 2 sections, with my first I was in a hospital with a nursery and the first night I got a whole nights rest. It did wonders for me! After that first night, I didn't want my baby to be out of my sight. My recovery was also fairly quick....I believe because I got some rest. My second child was born in a hospital without a nursery and I was forced to keep a newborn which I felt I could not properly take care of. I was exhausted, sick from the meds, and in a lot of pain, it is major surgery, after all. Needless to say, my recovery took much longer....I think because of lack of rest...after having major surgery. I just feel that hospitals need to accomodate these types of moms. Once they have the baby, does that make them no longer a pt. who needs care? :confused:

SmilingBluEyes · Dec 22, 2003

had a section w/dd. she never left my room, and I recovered quickly, never foisting my daughter on the nurses for one minute. she WAS MY BABY, not theirs. Amazing how quickly I was on my feet, as much out of necessity to care for my daughter as for my own recoveryl. Sure, those first several hours, I needed a hand getting her out of the basinette, but did not demand more than that ...I fed her, I changed her, I slept when she did.

that is how it needs to be with HEALTHY moms and babies. csection while major surgery, it no reason to send a baby out for a whole NIGHT....when does breastfeeding and/or bonding take place then????? Who takes the kid for you at home when you are tired of it all? I knew the nurses were NOT going home with me.

and I did all this w/o a support person in my room....I live 2000 miles from family and my dh needed to be home w/our then-7 year old. But somehow I managed. I guess I figured it was MY responsiblity, not that of the staff.

NicuGal, MSN, RN · Dec 22, 2003

I have a question about moms and babies staying together...do you all have a nursery open at all times...we have to have an RN in the nursery 24/7 because when the moms shower the babies have to go to the nursery. They aren't to be left unattended for a milllisecond and have to come back if there is no mom or dad to watch them. I'm just curious.

I know that my daughter was an absolutely horrible feeder and I was soooo thankful for the nursery nurse to come in and get her and I begged her to give her a bottle so I could get just an hour of sleep! (I had worked nights, went to bed at 10am, woke up at 12n with broken water and was up for the next year LOL). I wish she had been one of those kids that slept for 3-4 hours after nursing...she could go an hour and I was sick for the lack of sleep! Not to mention not very nice LOL Each baby and mom are different, if baby comes to our nursery at night, it goes out to the mom to eat, but we will take it back if mom is very tired or doesn't feel well.

SmilingBluEyes · Dec 22, 2003

No our nursery is NOT open 24/7 unless there is a sick babe in there. BUT I have NO problem with helping w/poor feeders or frantic babes .....moms do need respite.

MY THING is there is NO reason to send a baby out to a nursery for an entire NIGHT.........just "because"---- a mom visited all day long and did not sleep, despite my recommendations. Or because she has had a csection. Our rooms are LDRP and can accomodate 2 support persons...like fergus said, we encourage people to stay over night to help out. This is what they do at home, anyhow. That said:

yes, I have rocked babies who were inconsolable....and fed babies cups of formula at mom's request so her sore breasts can get a rest....Oh yea--- case by case, I will bend backward to help out. But I will not take a baby to a nursery for 8, 12 hours in a row. I can't...I have other patients, too. And there is NO nurse in the nursery unless there is a sick baby in it.

unikuelady, RN · Dec 23, 2003

TraumaRUs

You brought back memories. My first 2 children were born in a military hospital in GA in 1980 & 1982 by C/S. The first 24 hours the nurse would come in and help me care for the baby, change my linens etc. But come day 3, I got moved to a 8 pt ward. The beds were the old hand crank at the end of the bed. We also were required to change our own linens, completely care for our babies and even line-up at the nurses station with water containers in hand to be given our medications! lol. Everything was "Olive Drab Green(the army color)". When I was in my private room, I got bored. When they moved me to the "ward" I had opportunity to meet new moms, learn baby care from each other, someone to talk to. I was able to make lasting friendships with 2 of the women. This may have been due to the fact that we were all military wives, far from home, limited ties to the community (ie few visitors). We had each other for support. Where I work currently we only do mother/baby care unless their is a problem. The reason I see for the complaints of tiredness is the unlimited visitors policy that we have. Moms are able to get 2-4 hours of sleep between baby feedings if they don't feel like they have to entertain the visitors. We nurses try to cluster our care as to cause minimal disruption to the couplet dyad. We can observe the bonding between mother/baby, moms knowledge and ability to care for the baby. We intervene as necessary. I don't feel comfortable discharging a baby home unless I am confident that the mother is able to care/bond with her baby. This is very difficult to observe when the baby is in the nursery:confused: I work with a predominately low-income, high risk population. A large amount of teaching is needed in all areas, we can NEVER assume that just because this is moms 4th child, that she knows how to care for it:eek: My vote is couplet care when both are healthy. Very Limited visitation time.

panda_181 · Dec 23, 2003

Well...in our hospital...if they want them in the nursery for the night and we're able to accomodate, they stay in the nursery. If it gets really busy, then we wheel them back to their mothers. I haven't heard any complaints personally...they obviously know what a delivery is like.

For the amount of time they're in the hospital...1 to 2 nights...get all the rest you have because you won't get any at home! Especially if you have more kids at home. The babies are in with their mothers all day long, even if they're in phototherapy. Get the rest when you can.

Amanda :)

BRANDY LPN · Dec 23, 2003

Smilingblueyes-

IF you had the staff and say a mom had been up all day, then all night laboring, then all day pushing, then bonding with baby, breastfeeding, ect. and asked to have the baby in the nsy. and be woken up for feedings. Would you still have a problem with it?

OR if the above scenario resulted in a c-section?

I kept both of my first two babies in the room with me as much as I was allowed (the first had trob. stabilizing a temp and the second was 35 wks. and was observed for several hours), but with the third I had been without sleep approx. 36 hours and received 50 mg demerol and was not able to stay awake I literally fell asleep trying to eat a cheeseburger with food in my mouth. I luckily had my hubby there and I guess he took care of the baby but I honestly cant remember, if I had had no support there is NO WAY I could have safely cared for a newborn.

I do not mean this to be a flame but you sound as if you feel that these mothers who ask for a little rest are just lazy, which is not always the case.

I also know that exhaustion can be very bad for the bonding experience as I was also awake with the second one for 48 hours plus then had to return to nursing school when she was 5 days old and was breastfeeding and had a two y/o who still wasnt sleeping through the night and I had trouble bonding until she was about 7 mo old developed RSV was dx with congenital heart defects and I thought that I might lose her.

That being said I dont know why IF you had the staff you would still feel that a mother asking for a little rest or even a whole night IF baby is bottlefeed is burdening YOU with HER baby.

Again I do not mean this to be a flame its just my .02 cents worth.