I am LOVING the changes that were implemented in the past year as we grow to becoming more Mother-Baby Friendly!
ALL babies go skin to skin from birth with mom at vaginal births, unless mom refuses to do it. Families are educated on this as a standard of care (prior to the birth), and I'd say that 95-99% of them agree with it and love it. I also educate families before the birth that baby stays skin to skin with mom for AT LEAST the first hour, or until after the first successful breastfeeding. Whichever one is longer. I go on to explain the benefits of the uninterrupted time of skin to skin from birth, and how it benefits both mom and baby. Dads do get a little upset because they either: want to hold their new baby too, or they want to know the baby's weight.
I also explain that knowing the baby's weight isn't the utmost important thing in this "Golden Hour", and point out that the rest of the family can wait to see/hold the baby until after that first hour -- because you as the new parents will NEVER get that first hour back again.
As for c-section births -- we are trying to get baby skin to skin with mom within the first five minutes of the birth. However, it's a different story in the OR. If mom is vomiting, shivering, or her arms are too weak (as is often the case with some of the spinal/epidural blocks), it's a safety issue over the skin to skin issue. In that case, we offer skin to skin with dad/significant other in the OR. Some dads/SO's love it, while others are just totally turned off by it. So, if mom/dad doesn't do skin to skin in the OR, I make sure that baby is skin to skin with mom in the PACU as soon as she gets there. (Medical stability of mom comes first, so sometimes it's delayed.) Breastfeeding attempts are made in the PACU as well. Not always as successful as with a vaginal birth, because of mom having to remain relatively flat after a spinal (risk of spinal headache if her HOB is elevated too soon).
Another change that we have implemented is that if your baby is going to the NICU, it is no longer an option to NOT choose to breastfeed/pump. You simply must start pumping for the colostrum for your baby's health and well-being. The NICU providers are insisting that all NICU babies get that colostrum/breastmilk for the health benefits. So far, moms are ok with this. This is where it gets sticky for me --- I don't feel that it should be forced on those who are adamant about not breastfeeding/pumping. But at the same time, I understand the health rationale for colostrum (at the very least), especially for the premature infants. Formula will never, ever take the place of the nutrients found only in mom's breastmilk. I do know that our NICU staff are excellent at providing the education to the parents about why colostrum/breastmilk is so important for their premature baby.
Anyway, we are on our way to truly becoming Mother-Baby Friendly!! YEAH!!!!
14 comments:
While it's great that mom's are able to breastfeed immediately, your NICU needs to calm the heck down. I understand that breastmilk is important for preemies. And likely, most women are going to be just fine with pumping. However, there is eventually going to be someone who doesn't want to pump or can't produce milk. What's going to happen then? Are they going to kick the baby out?
We are baby friendly, and while we encourage women to pump/express for their NICU babies, it is still ultimately the mother's choice. I'm not sure what your hospital is going to do if the mom refuses. I believe that would be called assault.
What I meant was, attempting to force a woman to pump if she has expressly declined would be assault. Her body, her choice.
I'm curious about your hospital's policies for reuniting sick moms and nicu babies. I had severe pre-e and an early/small preemie. I read a lot of stories from moms who had babies in similar circumstances and it seems that many of them 1) wait a very long time to see their babies 2) are never given clear information about when they can expect to see their babies. I don't have a medical background, so while I can imagine their are legitimate reasons for keeping a woman in bed when she's quite sick, I can't really tease out the lines between medical need/staffing/convenience/liability/general policy.
The NICU where I work is lucky enough to have access to a donor milk bank, so our preemies can get breast milk no matter what.
The NICU has overstepped its' bounds in a big way. You simply cannot force someone to bf if they choose not too. Physically forcing the issue will result in Bad Things happening to the nurse/doctor involved. The reasons someone chooses not to bf are varied and many, and no one should be forced to bf if they choose not to do so.
I love baby friendly hospitals. I am supporting breastfeeding on each and every level and am fully aware of its benefits.
However, I think forcing mothers to do so is going too far. Has anyone ever thought about the psychological impact this can have on sexual trauma survivors amongst others? Nursing (pumping) can be highly triggering and having devastating impact (PTSD flaring up, flashbacks, etc). The people who made this decision might want to talk to some trauma therapists for a change or read 'When survivors give birth' by Penny Simkin. That might open their eyes.
Educating about the benefits of breastfeeding is one thing, FORCING someone to do so a completely different. This is going too far.
I'm all happy with this until.....I get to the "must pump". I had one of the most pro-breastfeeding neonatalogists I've ever heard of and I can never imagine her FORCING women to pump.
Pumping is hard and unpleasant for the most motivated mom. It is exhausting to pump multiple times in the night, get up, walk down to the NICU....and to make it mandatory? Yes it is in the best interest of the baby but sometimes it really may not be in the best interest of the mother. I remember watching post C-section moms shuffle into the NICU.
How healthy is it for a NICU baby if their mom is unrecovered from childbirth and exhausted when that baby is discharged?
How does being forced to pump on a woman who really doesn't want to affect her perception of her birth, her providers, her trust in the NICU personnel etc....
Wow. What an incredible boundary violation. How wonderful that YOU feel good about it, regardless of the parents who, for whatever reason, do not.
I think it is fantastic what your NICU is doing, and my guess is that if mom was not willing to pump/breastfeed, then they would bring in donor milk. Breastmilk is less risk than formula. Period.
I am a huge supporter of breastfeeding, and nursed my son for 21 months. I'm not a fan, though, of coercion, or of interfering with parents' right to choose what they believe to be best for their child/ren, whether other people share their perspective or not. I absolutely support breastfeeding, but I find that policy intrusive.
What NICU does is really great and people who needs it can only understand it better!! Keep up all the good work.
Regards,
Valleyobcare
OMG!! What happens when mom is unable to breastfeed? I had severe preeclampsia and hellp syndrome with my first. I spent 4 days in the ICU. It never came in. I wasn't a big fan of it anyway. All the drugs I was on to help me would have been passed on. it never came in. What a way to make mom feel like a failure!!! BTW, all three of my preemie severe pre e babies were formula fed and are fine today.
Your hospital, and any other that prides itself for similar policies, needs to make a full stop and consider the implications of imposing their value system on all patients. Where is the respect for individual patients-- their values, backgrounds, and best interests? More and more, the people who work in maternity-related fields subscribe to dogmatic philosophies about what kind of process and outcome is best (natural, etc.), but these beliefs are often not in the best interests of their patients and they often infringe upon and/or violate the patient's rights to make decisions about her care.
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