What is your hospital's policy on supplemental feeding?

RN Rotten Nurse · Nov 11, 2004

I have never been able to figure out what the big deal about breastfeeding is all about anyway. There are claims that it is healthier for the baby but I certainly haven't seen any proof of that given the breast fed infants I see in the ER. For one thing, formula is fortified with vitamins and minerals whereas breast milk contains the mothers and what she eats which is usually not well balanced.

mitchsmom · Nov 11, 2004

I have never been able to figure out what the big deal about breastfeeding is all about anyway. There are claims that it is healthier for the baby but I certainly haven't seen any proof of that given the breast fed infants I see in the ER. For one thing, formula is fortified with vitamins and minerals whereas breast milk contains the mothers and what she eats which is usually not well balanced.

RN rotten nurse, I can help you figure out the big deal about breastfeeding. :) It is actually considered a well-proven fact at this point that breastmilk is healthier for the baby, it's not mearly claims or theories. It really never has been, as a matter of fact. Did you know that back in the olden days, doctors discouraged (and mothers avoided) weaning in the summer months because that's when disease was more rampant, and it was well known that their babies would be more likely to get sick if they were weaned in the germy season? Not to mention, humans thrived for thousands of years before formula ever existed, and most of that time was with much more limited diets than we have available to us nowadays :)

Entire books could be written on the ways that it is healthier for babies, and essentially have been. Two that I would recommend for nurses are Breastfeeding: a guide for the medical profession

http://www.amazon.com/exec/obidos/tg/detail/-/0815126158/qid=1100139941/sr=8-1/ref=sr_8_xs_ap_i1_xgl14/103-5770771-8152636?v=glance&s=books&n=507846

and Breastfeeding and Human Lactation at

http://www.amazon.com/exec/obidos/ASIN/0763705454/qid=1100140022/sr=2-1/ref=pd_ka_b_2_1/103-5770771-8152636

If you aren't in the mood to read a textbook, here is also a page with some evidenced-based bf nutrition information: http://www.kellymom.com/nutrition/vitamins/mom-vitamins.html

The whole site is really good and offers references.

The production of mother's milk is not that simple... a mother would have to be malnurished in a way that women rarely are in the U.S. to not have milk that is complete with all nutrients and vitamins needed, as well as many other things like antibodies that are completely missing from formula (even in countries with famine, the mother will generally suffer nutritionally before the mother's milk will). Because of this, and because we still don't even know all the substances in mother's milk, formula will never be able to replicate mother's milk. Remember, mother's milk has always been the gold standard by which all other infant nutrition is measured... every since baby milk formulas were invented in the 1800's, they have strived to make it like mother's milk, not the other way around. :)

Because a mother nurses doesn't mean that her baby will never go to the ER. Of course some bf babies will still get sick, but the incidence is less and the severity is reduced.

I am actually writing an article for publication in the spring on how the breast works, mother's milk is made, and how substances enter breastmilk... I would be happy to discuss more if your are really interested in understanding why breastfeeding is so important. [email protected]

It is very fascinating stuff!!!

klone, MSN, RN · Nov 11, 2004

Forget it, Mitch's mom pretty much covered it.

Fiona59 · Nov 11, 2004

When I had my kids, in the 90's, it was assumed you would breastfeed and you were a BAD mummy if you didn't. But guess what, even with all the post natal classes, the total help I had on the maternity ward was a nurse saying, here's your baby, feed it. No help with positioning, no monitoring of the latch. NADA. The 20's with no birth experience of their own where the worst, "You really should try harder, your milk is best for the little guy". Well, I'm on morphine, and have stitches up the yingyang and my 'roids are the size of golf balls, my nipples are cracked and I should try harder!!!

When I became a nurse, the hospital where I wound up working had the attitude that "breast is best BUT its the mother's choice". They felt it was more important for us to promote a good experience for the mother and baby. Help was there for anyone having difficulty with bf but for those that chose to bottle feed we emphasized the importance of holding the baby close and bonding.

We're not there to judge, just to assist.

kmrmom42 · Nov 11, 2004

Those Asian mothers could not be scared into thinking that bottle feeding would wreck their chances of breastfeeding (and trust me some of the nurses tried to convince them!). They know they can do it, they have seen their mothers, sister, aunts and friends do it. They know that breastfeeding is not something you need a degree from MIT to do.

This is also something I see with many of our Hispanic Mom's (mostly those who have recently come from Mexico and have not been "Americanized"). They do not want to breastfeed until their milk comes in. They bottlefeed (oftentimes to excess) and then seem to successfully transition to the breast. I would like to see some good studies on this to see whether my experience bears out statistically. However, I do feel that there is something to just BELIEVING you and your baby can do it. Believing it in your heart and soul. Doubt can be a very powerful thing. That is why I hate formula reps and all of their doubt producing propagana. Yes, we need formula. But we do not need their powerful media machine creating doubt for us all. (But that is another story).

Another thing that I see is these wonderful Mexican women believing (again in their heart and soul and with the support of their entire extended family) that giving birth is a natural event that does not require epidurals to make it better. They labor without fear and without fighting it and give birth the way women were meant to give birth, without the interference of medical intervention. It is a wonderful thing to see and an honor to be part of!

mitchsmom · Nov 11, 2004

We're not there to judge, just to assist.

Amen to that. I'm sorry you didn't have a good experience, Fiona. There is a fine art to being encouraging instead of pressuring - they are not the same thing.

kmrmom42, I agree with the things you said.

This discussion (and others; about the other cultures bottling until lactogenesis II then transitioning to breast) makes me wonder what has been said about it on Lactnet.

CHATSDALE · Nov 11, 2004

I logged off this tread when i became angry and didn't want to say anything but i had to return and vent a bit.....how can you as nurses see only the outside of the patients...ie all chinese and hispanic women do this and everyone else are individuals who respond in a variety of different ways.....nurses should above all see the people who come to them for help, who put their lives in your hands should see them as individuals and not as cookies stamped out of the same mold

SmilingBluEyes · Nov 11, 2004

where do you see this Chatsdale? Can you be more specific? I see the posts regarding Asian and Hispanic women, but fail to see where anyone refers to them in a cookie-cutter fashion. Could you be a bit more specific on what bothers you most? Thank you.

fergus51 · Nov 11, 2004

I don't only see the outside of patients and I am not trying to imply every Chinese woman will do the same thing. I am telling you my experience in dealing with women from China who gave birth at my hospital (and I am talking about women from China, not those of Chinese descent who are Canadian/American). Obviously they are not all the same. Please try not to read more into it.

CHATSDALE · Nov 11, 2004

the point i was making was that labor/delivery and breastfeeding are not significantly differant in one woman from another d/t race...some individuals have high risk pregnancies and some individuals cannot or choose not to breastfeed depending on issues not related to ancesyty...look at your patients and the people you meet on a day to day basis as individuals...aren't we all individuals with our own strengths, weaknesses, talents and hangups...

i think i was still angry when i posted the reply...should have slept on it.. it would have come out differant

kmrmom42 · Nov 11, 2004

Chatsdale,

I am sorry you were offended but if you knew me you would know how very far off-base you are with this. There is nothing wrong with identifying that the cultural beliefs of a specific group seem to, "on average", effect the healthcare choices that they make. If that were not true then why should we have those cultural reference books on each unit or the mandatory educational classes on cultural differences?

As an L&D nurse and lactation counselor I look at not only the mother's as individuals but also the babies! Their little personalities and unique differences can effect the breastfeeding process as well as the mother's. Not being sensitive to these unique differences would make me terribly unsuccessful as a lactation counselor.

And again, please don't misunderstand, I am only discussing women who have CHOSEN To breasfeed and not those who have made the choice not to. Those Mom's have no need for a lactation counselor.

This can be such a sensitive subject at times and the interenet can be a difficult medium to make youself understood in, all we can do is try our best!

fergus51 · Nov 11, 2004

I second that. It isn't about race, it's about culture. Are there differences between people from the same culture? Sure. Of course. But there are also bound to be some similarities and I don't have trouble discussing those that I've seen. It doesn't mean I don't see people as individuals.