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

[jd11365]

Her doctor, who I dislike, said the baby will be taken immediately after her c-section and brought to the nursery while she recovers and won't come back until she can feel her legs. He said they wouldn't feed the baby (we've all head that one) and would probably "only" be a couple of hours. She would like to nurse right awayand is very unhappy about this...needless to say...but is not much of an advocate for herself. So, I need some links to send to her (she said she would love them) so she can print it out for her doctor and feel more empowered. Who better to ask than you gals?

TIA!

[kijip]

Well, they CAN'T take her baby unless her and her husband consent, no? I just would not consent. I did not feel my legs for almost a day after my c-section. Not seeing Toby for 24 hours would have been OUT of the question. He was in the NICU but I was there in my wheelchair.

[mommyoftwo]

I can't point you to any links, but that's rediculous. I had to have a c-section with Linnea because she was breech and was bf within minutes of being in recovery. I started nursing as soon as they had taken care of getting me situated. I can't imagine why she would need to wait. My nurse in recovery was wonderful about helping me. Maybe the nurse would be a good advocate? Linnea wasn't taken to the nursery until I was in a room and they needed to check her over (hours later). Then they brought her right back. I hope she can convince her doctor to let her stay with the baby.

[kfcboston]

FWIW, I wasn't groggy or having to be horizontal after my scheduled section. I nursed the twins right away and often!

http://www.kellymom.com/bf/start/concerns/c-section.html

[EllasMum]

I ended up having a c-section (DD decided to come out ear first, of all things...) and as soon as I was in recovery the nurse brought her to me and helped me BF for the first time. I was fairly out of it so they took the baby to the nursery after that, but I was able to BF her immediately upon arriving in recovery, just like a PP said. I would ask prior to the c-section starting - make sure they are all aware that your friend wants to BF right away. Shouldn't be a problem.

[daniele_ut]

I agree with the PPs, that is absurd. Since they have to consent to baby being taken from their sight, they need to just say no. My c/s wasn't scheduled, I went in to PTL and DS was frank breech, but when they asked me if there was anything that I wanted, I made it clear that I wanted DS to stay with me unless it was medically necesary and they were more than happy to oblige. Unfortunately he had breathing problems and had to go to the NICU so that didn't happen. The delivery nurses said I could go see him within a couple of hours, but the post partum nurses on duty that day were overworked and obnoxious and I didn't get to see DS for almost 8 hours. I am still angry at myself for not being a better advocate for myself.

FWIW, I could feel my legs about an hour after my CS was over.

[kellyotn]

That's odd. My doc was too busy performing her next section, or returning to her packed office practice, or delivering a vaginal to know what happened to me or my babies post-surgery. :)

With both of my sections, the baby was in daddy's arms immediately. He didn't let go until HE put them into my arms in recovery maybe 30 min to an hour later. My doc was LOOOONG gone by this point, I was totally in the care of the nurses and maybe the "drug doc" (can't spell that one). The nurse immediately helped me to breastfeed, it was wonderful. I couldn't yet feel my legs, but the nurse and DH helped me to sit up. Baby staying in the nursery was totally optional, and upon our request alone. They weren't whisked away.

She should call the nurses that do the hospital visits. Have THEM go through the procedure check-in to recovery with her. I wonder if he really knows what happens after he leaves! If this is the way the hospital operates, then they need to catch up with the rest of the world.

[octmom]

That sounds nutty to me! I had a c/s with DS and he was brought to the nursery (DH went with him) while they finished sewing me up, after I was able to see him and touch him. He needed super-suctioning and had to have his heel pricked to test sugar levels since he was very large. It took something like an hour (what seemed like an eternity to me) for them to meet up with me in the recovery room, but I started nursing him right there, before I could feel my legs. I was really worried while they were gone, but at the same time, I am glad DH didn't leave DS to come fill me in. I wanted DS in (at least one of) our sight.

I haven't looked, but I imagine that kellymom and the La Leche web site would probably have some good information.

Jerilyn
DS, Sean 10/03
DD is scheduled to arrive via c/s on March 21! :)

"Baby makes days shorter, nights longer, home happier, and love stronger."

[nd93]

Well, she should get this straightened out with her doctor because this does sound ridiculous, but she should also check with her HOSPITAL on what their policy is. Have her put in writing what she wants done (like a birth plan), have her or her DH tell every nurse they see when they get there. Most hospitals nowadays have babies room in, it's unusual to have babies sent to a nursery if delivery is routine. Does her hospital have lactation consultants on staff? They would also be someone to talk to ahead of time. Tell them what her OB said, see if they can help.

Good luck. Please keep us posted, this is wacky IMO.

[hez]

Wow. Payton was in my arms as they wheeled my bed out of the OR-- basically the second I was done being sewn up. I thought they were crazy for giving him to me to hold so soon ;) but I gotta tell you, it was absolutely wonderful. I nursed him once before we called my mom and girlfriend down to recovery to meet him.

You've already got the kellymom link-- that's what I'd have searched out, too.

[MonicaH]

I agree with the previous suggestions to check on the hospital policy and to ask the hospital's lactation consultants. I would also suggest discussing it with her pediatrician and seeing if s/he will go to bat for her. After all, the baby will be the pediatrician's responsibilty as soon as the baby is born.

Also the AAP policy statement on breastfeeding states that the first feeding should occur immediately in the delivery room and that "Except under unusual circumstances, the newborn infant should remain with the mother throughout the recovery period." I do not think that numb legs after a scheduled c-section constitutes unusual circumstances!

I guess one concern on the doctor's part is if the mom is going to be alone with the baby (no other adults present) with numb legs, and I can see that that might be a risk in terms of her falling out of bed or something if she tried to get up to change the diaper etc. But as long as another adult is present I think there should be absolutely no problem.

Monica

[o_mom]

I was numb for over 8 hours after a VAGINAL delivery - no way I would have waited that long.

If for some reason they do go through with this, tell her to have her DH stay with the baby the entire time - do not leave the baby alone for a minute. If they try to supplement at all - he needs to be ready to refuse it and tell them to get the baby to the mother.

ITA with PP that you need to talk to the hospital, not the doctor - get any policies in writing. Have her talk with the pediatrican too - once the baby is born, they are under the ped's care. Have a big note attached to the chart to say no supplements w/o parents approval.

[deborah_r]

Well, can't say I'd recommend it, but this IS what happened to me and DS. I had an emergency c-section, and had no idea that I should not let them take him; I was still so shocked and scared, it didn't occur to me that it was strange. We dealt with it, and he's still nursing now (gosh, how I wish he would stop!!!) but like I said I wouldn't recommend it. In hindsight, I wish I had not let them take him. I kept asking and asking when they were bringing him and it took hours. But I just wasn't being very assertive, with the shock and the drugs and all. If I have another c-section in the future, I will plan ahead of time and make sure DH has his thinking cap on enough to make sure they do what we want!

[mommy_someday]

>
>If for some reason they do go through with this, tell her to
>have her DH stay with the baby the entire time - do not leave
>the baby alone for a minute. If they try to supplement at all
>- he needs to be ready to refuse it and tell them to get the
>baby to the mother.

ITA! I had a natural vaginal delivery with no complications and they took DS to the nursery because his blood sugar was a bit low. We had a birthplan and his hospital basinette had a sign on it that said he was being BF. I told DH to go with DS and not to leave him. Good thing, too, because the nursery nurses tried to give him a bottle of FORMULA! DH literally had to bang on the glass window and shake his head NO. I was so ticked off.

OP, I hope that your friend is able to advocate for herself. It's so hard to do when you don't know what your rights and limitations are. Kudos to you for helping her figure this out beforehand.

[dowlinal]

Jamie,

This is a major issue for me. With Madeline, after assuring me that she would be brought to recovery, they instead took her to the nursery and I didn't get to hold her for almost 7 hours. With Sabrina, I actually changed hospitals to ensure that I would have her in recovery. At the last minute, the nurse on duty told me that she didn't feel comfortable with that and I would have to wait until I was in my room to nurse. I went nuts and actually withdrew my consent to the surgery and threatened to leave. The head of nursing was brought to my room and the compromise we reached was that while I was being stitched the baby would be brought to the nursery with DH to be weighed etc, but not bathed and then she would be brought back once I reached recovery. It was the most amazing moment for me. Sabrina knew my scent and latched on by herself. I don't think it's a coincidence that Madeline was a horrible nurser while Sabrina nurses like a champ.

My doula gave me some article on this stuff and the importance of it but I don't know where they are from. If you want PM me your address and I'll mail them to you. Also, I bet LLL would be able to provide her with literature.

HTH,
A

[pritchettzoo]

WTF? I would have freaked if I couldn't have my baby right afterwards. I probably would have dragged my numb butt to the nursery and grabbed them myself! I had c/s in two different hospitals. With Gracie, they took her back to our room and did the weighing and measuring there while I was stitched up. I went straight from the OR to that room to recover. I held her and tried to nurse her while they were doing who-all-knows-what on the bottom half. With Eli, he went to the nursery (with Bryan following) to be weighed and measured while I was stitched up. As soon as I went to the recovery area, he was brought to me. He nursed while they did who-all-knows-what on the bottom half. Then we both went to our room when I was ready.

Tell her husband to follow the baby. Do not let them bathe the baby--the scent really does help. As soon as they're done weighing and measuring, the husband can take the baby to the recovery area or wherever she will be. If they won't let babies in the recovery area, I would seriously switch hospitals.

It's not about being an advocate for yourself once you become a parent. You're an advocate for your child. Tell her to kick some ass.

Anna
Mama to Gracie (Sept '03) and Eli (July '05)

[muskiesusan]

In some cases where I've read the baby can't be with the mom after the c/s, it is because the recovery room is not private. She should call the hospital and find out what the normal procedure is regarding babies and recovery/rooming in w/ c/s. If it different than what the dr says, she should question him. If it's the same, I would personally think about switching care.

I have had two c/s and both times the baby never left my sight the entire stay and I was nursing w/in 30 minutes of delivery.


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

[eb1]

I, too, had an emergency c-section with my DS, and I was put in a private recovery room for about an hour while my baby was taken to the nursery (on another floor) for measuring, testing, and yes, bathing. I didn't get to hold DS until I was moved out of recovery, into my normal hospital room. I don't recall any guideline about feeling my legs.

DS had no problems BFing despite the hour-long separation, but I found it agonizing and maddening to be that long without holding/seeing him (I had a quick peek when he was delivered, but then he was whisked out of the surgery room). I really didn't know I had any alternative at the time.

I'm so glad to read this thread and realize that I probably can be a better advocate for myself next time.

Good luck to your friend. I really hope that her doctor will honor her request.

[kimbe]

After my unplanned c-section, they did take DD into the nursery while they put me back together. DH went with her. (Although we would have let her go alone - our hospital was wonderful and there was NO worry that they would supplement. Really PRO Bf hospital.) They cleaned her up, weighed her, etc. They moved me to recovery for about an hour. DD remained in the nursery getting her spa treatments! DH ran back and forth between us. As soon as I got back to my room, I held DD for about 1 second and then the 2 nurses said with me said "Let's get nursing!" I was still groggy, so they actually did all the work, got DD latched and she then held DD while she nursed. (I think that we both fell asleep!)

I don't think that she should have to wait until she can feel her legs! I didn't feel mine for ahwile. And last I checked, you don't need to stand while you are nursing.

What does her doctor care? He isn't going to be there! And TECHNICALLY he ISN'T in charge of that baby once it is delivered. (Mama, the nurses, and the ped! Mama being #1!) He will do the c-section and probably go home! I would have her call the hospital and her ped and ask them what the common practice is after a c-section. I would take the word of the maternity nurses and the ped over the OB.

I sure do hope that everything works out for her! Power hugs to her.

[jamsmu]

Vaginal delivery, but I was holding and bfing Carson ALL THE TIME. And I didn't get my legs back for about 36 hours.

[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=/pb/articles/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.

[m448]

See for me the issue was not what formula would do for our nursing relationship (vaginal birth but dead set against supplementing for any avoidable issues) but what one bottle of formula could do to the intestinal flora of a baby as well as the unsealed fissures in their bowels. That's the one thing that kept me going with breastfeeding and alert the whole time I was in the hospital (both times the baby never left my side for anything).

ETA: that when they tested Ryan blood sugar post birth the pedi nurse TOLD me that they'd have to give him a bottle of formula if it came back too low. Knowing they need my consent for anything I TOLD her no. I have a pair of perfectly working breasts right here and he would get no formula low sugar or not. She was taken aback and then when she turned around I saw she was expecting - #2.

Oh and one more thing, having friends & family that FF I'm not saying formula is poison but it's a choice that should be made by the mother & father, not a heavy handed hospital. If I'd decided to FF then as a BBBer I would have been heavily researching formula and shown up with my own brand/can at the hospital instead of letting them choose for me.


Marielle


Ian - born 10/03
&
Ryan - born 01/06

[o_mom]

Not to mention interference with the absorobtion of iron in BM....

[jd11365]

You are all just the best...I knew I could find help here. I forwarded your responses to my friend and she was thrilled to have this information. Yes, she was told hospital policy, but now she has some information as to how to empower herself better and doesn't feel like she's the only one who thinks this was not right. She's going to follow your directions about bathing, and have directions written, and I believe she's going to call the hospital ahead of time to try and talk with the nursing staff and LC. You guys are great!

[tarahsolazy]

I'm a neonatologist at a university ECMO center, also one of the most highly ranked for survival and outcomes.

I STILL think these policies are NOT for the well-being of the babies. They are just to make it easier for the staff. There is no medical reason to take a well baby away from its parents, ever. Babies do not require bathing after birth, and bathing actually makes them more likely to be cold and need a warmer bed and have respiratory distress. Bathing the baby protects the hospital staff from anything the baby has, but does absolutely nothing for the baby. Weighing and measuring typically do not impact infant health, so postponing that for hours is not a huge deal. You need to know a weight so you can monitor feeding, of course, but those scales can be placed on carts and rolled from room to room.

If a family really has concerns about this, they are not being difficult to be difficult. And since letting the father or support person keep the baby with mom, if its important to her, is not a big deal, IMO, why not be flexible? Seems like at that point its a power thing: the staff can "make" the family do it their way. If the parents are fine with the nursery time, then its no big deal, and the staff's preferred routine can take place.

[amp]

No links, but I had 2 CS and was able to hold both Jake and Kate right after we got to recovery after they sewed me up. I wouldn't tolerate not seeing my baby, especially to try BF'ing, right away!

[calebsmama03]

Tarah, Very well said! I agree with you 100% on the staff convenience issue. It's so unfortunate that many new moms are led to believe that is "has" to be this way or their baby might become seriously ill or die. It just feeds into the unfortunately all-too-common way of thought that hospitals/nurses/doctors know baby better than the parents do :( WHY can't more pediatricians/neonatologists be like you??? You need to become a professor and teach the next generation of docs - or better yet, write the new pediatrics/neonatology textbooks!!

And not to seriously rock the boat but I've read some lactation articles about uber-progressive hospitals that are letting c/s moms immediately hold and sometimes even BF on the table (with help from a doula, LC or nurse holding the baby) so long as baby is healthy.
Lynne
Mommy to C 3/03
http://www.gynosaur.com/assets/ribbons/ribbon_emerald_18m.gif[/img][/url]
And Miss Purple, 5/05

[tarahsolazy]

I am a profesor ;), trying to subvert all the residents to my pro-bf, pro-family ways. Quite the unusual type in staid academia.

[hez]

Did you deliver at B-N? I did-- and that was pretty much exactly my experience.

[Radosti]

I had a vaaginal, but my legs were numb for a while because they gave me a bolus epidural to give me more pain relief). I tried to nurse Aaron for an hour after delivery with no success. Then, he spent time meeting the family. Then he went to the nursery for a bath. However, they came in at 2am and asked me if I wanted to feed him or if they should give him formula. I don't remember this at all. Apparently, in my sleep induced state, I told them to give him formula.

It's ok, he is nursing quite well and has been since a day after coming home from the hospital.

[calebsmama03]

>I am a profesor ;), trying to subvert all the residents to my
>pro-bf, pro-family ways. Quite the unusual type in staid
>academia.
You go girlfriend!!!

Lynne
Mommy to C 3/03
http://www.gynosaur.com/assets/ribbons/ribbon_emerald_18m.gif[/img][/url]
And Miss Purple, 5/05