Alright BFing gals...need some help for a friend.

[tarahsolazy]

That's probably a hospital policy issue. The policy makes things easier for the NURSES AND DOCTORS. Not the families. This is a danger sign in a hospital, IMO. 29% of kids in the US were born by CS in 2004 (mine, included, sigh), and there is no reason for maternal/infant separation outside of severe illness in one or the other (other than someone else's convenience).

If its a hospital policy, she needs to talk to the head of nursing in OB, and her OB doc, and her ped. Or, change hospitals if its important ot her and she can't be assertive with the staff. Its hard to stand up for yourself when you've just had surgery.

But, as you probably know, Jamie, your state is one of the most family-unfriendly in the US as far as birth practices is concerned. Very high CS rate, too.

At the very least: NO Bath, Dad holds skin to skin in nursery and they can assess the babe from that position. Being who I am ;) I'd also make it clear that I DO NOT CONSENT to any formula, unless a doctor has explained the risks and benefits personally to me, and I then agree. I'd sue, if my kid got "routine" formula for being a c-section baby, or being "big", both of which are hospital policy in some places. There are no medical data to support such things.

[dogmom]

I'm probably going to voice an unpopular opinion here. I'm not saying that the policy isn't stupid, or that you should not have say in you baby's life, But....

I think we get so wrapped up in those first few days, the labor, the hospital stay it's easy to think one thing out of place will be a disaster. I was definatly going to breastfeed, new I was committed to it, but didn't think one formula feed in the hospital was going to change that. I know there are dire warnings, one bottle and your child will never latch, but studies don't bare that out as a direct causal link. What seems to matter more is that there is a consertive effort on the part of the hospital and healthcare workers to encourage breastfeeding. A hospital can make sure they plunk the baby on your breast right away, but that doesn't necessarily translate into a lacation friendly place that improves breastfeeding.

Having said that, I think the most direct course of action for your friend is to call the post-partum floor of the hospital she is delivering at and find out if she can talk to the lactaction consultant about this issue. It may be the doctor, not the hospital. The LC should be her ally in helping her with this issue. She might also find out how long the baby will be in the delivery room before being taken away. It might be she has some time then the baby will be moved the nursery. Of course, unless I was dying, literally, I wouldn't let that happen.

Here's a good article I found.
http://pdf.dec.org/pdf_docs/Pnach559.pdf


Jeanne
Mom to Harvey
1/16/03
& Eve
EDC 6/18/06

[lmcnabbkv]

I just wanted to chime in and say that in most hospitals it is routine policy for C/S babies to be taken to nursery for a full assessment while mom is being stitched up or for up to 24 hours. In part this is due to the fact that C/s babies retain more fluid in their lungs after birth and are therefore at a higher risk for breathing problems.
That being said, there should be no reason that after she is closed up, if there are no complications (bleeding etc) that she should be able to have her baby and nurse. If the hospital is strict on this policy she can ask if she can waive her right to 24 observation in the nursery (which will mean signing a legal waiver that if there was a complication she was fully aware of the risks). The whole leg part is crazy...my one leg didn't wake up for over a month after my deliver (vag with epidural) due to nerve damage.
I think everyone needs to take a step back and see that yes it is your right and privilage in this country to be an advocate for yourself and your family but that there are ways to do this without threatening to sue etc, which is one of the reasons that healthcare in this country is taking a turn for the worse. Policies like 24 hour observation come into play because people are threatening and filing lawuits and all it takes is one lawsuit to ruin things for everyone. The best way to get what you want is not to be standoffish but to compromise and speak to someone and let them know that you understand the need for the baby to be checked out but that after you are closed up and if everythings is fine with baby, you would like to have your baby right away so that she can nurse because this is important to you. Nurses on docs have things that are important to them too...like the mother and baby's health and welfare and you have to see things from their side of the fence. No matter what happens, the most important thing for successful breastfeeding is her commitment to making it work even if she cannot breastfeed immediately post-delivery.
Good for you for helping her get her points of reference together so she has facts to go on...that is what doctors will listen to...not what someone else did and what worked for them but what the studies show or from credible places (not that we are not credible...lol!! :) )
http://www.lalecheleague.org/FAQ/cesarean.html

[muskiesusan]

Here's a link that goes over the benefits to nursing after c/s that she might find interesting.

http://www.obgyn.net/pb/pb.asp?page=...es/bf_cesarean


Susan
Mom to Nick 10/01
& Alex 04/04

[tarahsolazy]

I am a doctor, who works with sick newborns as a career. These policies are not for the safety of the baby, when applied to a blanket population like "all CS babies". Babies can be assessed by trained nurses or doctors after birth in the presence of the parents. If the baby is breathing rapidly, grunting, retracting, or having other symptoms of problems, the baby should be rapid removed to the NICU for intensive monitoring. BUT, if the baby is normal, removing him or her from her parents, regardless of the feeding method chosen, has no benefit for the baby. There are nationwide perinatal care guidelines about monitoring babies after birth, hourly at first, then every four hours, etc. That can be done in the parent's presence and room, if all those evaluations are normal. Baby and family all lose out if the baby is taken away for those for convenience.

Regardless of BF or FF, a hospital that does this routinely, especially the 24 hour thing, which is archaic, BTW, is not following current standard-of-care. They are not providing family-centered care, and that would concern me, regarding how up-to-date their medical care is.

I think that many physicians, including me at times, lose track of the importance of these events in people's lives. In my world, babies are born daily, I see births, I see critical illness, I see death. Its hard to remember that this "routine" to me is a life-changing experience for someone else. I try as hard as I can to step back, to acknowlege that, and to work with people to make the experience the best it can be. And I try to always look at data to make medical decisions about how to treat my patients, not what's easier for me.

[lmcnabbkv]

As a nicu nurse I definately agree with you but these are things that we as medical professionals see daily and many hospitals still have policies like this in place (proud to say I don't work at one that does the 24 hour hold).
I will say that I do work at one of the consistently top ranked hospitals in the nation and it is policy to transfer every c/s baby to our well-baby nursery (accompanied by dad of course) for an initial assessment no matter what their gfr status. This gives the docs enough time to stitch up mom and place her into recovery, after which the baby is returned to mom if there are no issues.

[o_mom]

Just out of curiosity - when you say "accompanied by dad" does that mean he comes in the nursery? Our nursery doesn't allow anyone in if there are other babies, so they would have to watch through the window. DH was under strict orders if that was necessary to have them take the baby to a room for any assessment so that he could be in the same room. (Didn't need it, but just in case.)

[lmcnabbkv]

Mothers and fathers are always allowed in at any time all we ask is that they are not sick and that they wash their hands of course. I can't imagine parents not being allowed in...from your post I'm picturing back in the day when people would walk by the nursery and peer in the windows, lol!! :)

[muskiesusan]

Tarah, I was hoping you would respond and you did so beautifully. I think your last paragraph really hits the the nail on the head for a lot of these issues. You must be a wonderful doctor (not that you haven't already shown that in other posts. :) ).

I guess I really don't understand the need to evaulate the baby other than in the presence of the mom. I fortunate that this was all done in the OR while I was being stitched up in my view. I was also lucky that my recovery was in my room with a nurse present for a couple of hours to monitor us and help me feed.

It was hard enough for me not to be able to hold the baby while they were sewing me up and, quite honestly, I was pretty bitter that my husband got to hold the baby first (I am the one who carried the baby for nine months after all :)). I cannot imagine having the baby wisked away for these so-called routine procedures.

Susan
Mom to Nick 10/01
& Alex 04/04

[o_mom]

Actually, our hospital is set up so that babies room-in all the time. You can request they go to the nursery at night, but it is expected that they will stay in your room during the day. Almost all procedures are done in the room - they bring in a scale and warmer for birth, for example, and your nurse stays with you for the first hour after to do all the checks, the pediatrician comes to the room, etc. Oh, and they are all LDRP rooms, so there is no room change at all if you have a VB.

As a consequence, the nursery is very small and there are rarely more than one or two babies in there. For legal/liability reasons, they don't allow parents in the nursery if there are other babies in there. It is completely surrounded by windows, so you can see everything that goes on from the hallway.

I don't know what they do for c-section, since I didn't need one, but since you are set up for a room when you come in, I don't know why they wouldn't just take the baby back there for all the checks, KWIM?.

ETA: Compared to the other major hospitals here, the policies at ours were great. One has the standard "send 'em to the nursery for a few hours after birth" policy. The other, while supporting rooming-in has LDR rooms that you are booted out of an hour or less after birth.