Survey for BF moms

[ppshah]

Hello! I'm a pediatrician and work with a group of about 20 other pediatricians. We are a hospitalist group and round on newborns in the hospital ( those babies whose pediatricians don't come to that hospital). I'm working on a conference for our group - the goals of the conference are to promote breastfeeding & to set up practice guidelines based on the latest recommendations. I know little things we say or decisions we make may influence ( although often unintentionally ) mom in their decision to continue BF. Keep in mind we will only see these babies and moms 2-3 days ( never before and never again). Our patient population is generally well educated and motivated to BF. The majority of our moms choose to BF. I'm hoping to have a lactation consultant speak at the conference. At this particular hospital every BF mom gets a visit from the lactation consultant who then gives them names or support groups i.e. LLL.

I'm looking for commments based on your experiences....

What do you wish your pediatrician had told you before you left the hospital?

Any decisions your pediatrician amde influence your decision? ie. supllementation, timing of BF etc.


Thanks in advance......

[Jacksonvol]

This has nothing to do with BF'ing, but it reminded me of my experience with the pediatrician I had at the hospital (not my regular ped.) On the last day of our stay, the ped. comes in my room to give me an update on DD (she had some drainage from one eye, blocked duct or something) I am in the shower and this ped. (female thank goodness for that) comes into the bathroom and starts talking to me about my child. Words cannot express how angry and offended I was. It was so unprofessional. When the ped's group called me to try and schedule a follow up (like I am going to drive an hour each time my child needs to go to the doctor) I was pretty descriptive in why it would be a cold day before I used their group again.

Please remind the peds. to have the courtesy and common sense to discuss things with moms in a manner that affords some measure of dignity to the mother.

That being said, my friend who is a ped. was so supportive by reassuring me that brest-feeding is not always easy, that there is a learning curve, that LC's are helpful, that I should always call my healthcare provider when I have a question or concern and that if it was necessary to occaisionally supplement it would not be the end of the world.

[deenass]

Well, the ped who saw my son in the hospital (not our reg ped) did not make me aware enough of my son's jaundice (the patient asst who walked us out to the car mentioned it) adn THANK G-D she did! My son ended up being hospitalized for 2 days under bili lights and a bili blanket. Because of his jaundice he was very sleepy and wasn't BF nearly enough. I wish the ped had been very specific about waking him to feed (and to contact MY ped earlier) if I couldn't get him to eat.

As it turns out he was supplemented with formula when he was under the lights (despite my being there and trying desperatley to feed him).

I chose the ped practice I go to because they have a lactation consultant on staff who runs a weekly breastfeeding support group. I think the most important thing is to be around other BF moms... despite being natural, it's not easy adn is often overwhelming. My BF friends mean the world to me, even after a year of doing it I still have questions!

[caleymama]

The doctor we chose for DD was a Family Practicioner (not a ped and the same one DH and I used) and he did not have hospital rights at the hospital where we delivered. There were a couple of pediatric practices in the town I was in and the peds (2 of them) that we saw in the hospital were part of one of them. My experience with them only reinforced my decision to use the other doctor we chose, but fortunately it had nothing to do with breastfeeding. I just didn't care for their bedside manner and did not care for the way they dealt with us. One of them completely ignored DH (and he was rooming in with me and right there!) the entire time they were speaking to us. They did not look at him or acknowledge him at all.

I don't recall any mention of BF from either ped - I know DD had the little card in her bassinet that said she was a BF baby so perhaps they didn't need to ask. My OB/GYN (wasn't on call for the delivery) met with me the next day and she and I discussed BF. That's the only conversation about it that I can recall. The hospital nurse had asked while I was in labor if I was planning to BF and that was it. No mention of formula at all.

We were visited by a LC the next morning (I delivered at 10:40pm). BF was going very well and DD was healthy. She roomed in with me, so there were no concerns about her receiving a pacifier or supplemental bottle in the nursery. The LC was good and she gave me her card. I don't remember much of what she said but I remember liking her and thinking I would definitely call her if I had any issues. I received a lot of informational handouts about BF. Overall I feel that I was well informed about BF, both from reading I had done independently and from our childbirth preparation class. Perhaps if I had been ambivalent about BF or if I had difficulties the hospital ped's influence would have been greater. Since DD was nursing (on demand) like a champ from the get-go, there wasn't much need for discussion.

(That was longer than I meant it to be and I'm not sure how helpful to you after all ...)

[farsk]

Hello!

Thanks for being interested in what we say! It's comforting to know that the medical profession is intent to do better as far as breastfeeding is concerned.

We gave birth at a hospital more breastfeeding friendly than the hospital in the town where we live. So my ped was not there after Ellen was born. I met with my ped before Ellen was born for an "interview" where she told me that she was very pro-breastfeeding and asked if I planned to nurse. I said yes. The topic was dropped. However, there are so many who quit nursing at the first tiny sign of an obstacle, I think if the ped had told me more information about BF vs. FF, I would have been more determined than ever to BF (Which I already was....8 months nursing...yay!)

The other comment I have concerns a nurse in the lactation office (NOT my LC) who wanted to supplement Ellen with formula. After weighing her, letting me nurse for 10 minutes, and then weighing her again (she had only gained a minute amoung), she commented on how hard the baby had to work to get that amount of milk. I left in tears. I still harbor ill will toward that woman!

Good Luck!

[jd11365]

To answer your question simply...
If a peditrician came into my room and asked ME questions about my thoughts on breastfeeding...to initiate a brief Q&A...while letting me know the fabulous benefits...without preaching...and then answered my questions with CORRECT information, I might be more inclined to continue.

Personally, I got "Are you going to BF?" and that was it...no additional response...just a question for her notes or whatever. Then when I was having problems the first 2 days with latching, I got misinformation or poorly supportive information...like I HAD to supplement with formula immediately or the baby's glucose would drop and get very ill, or was told to trickle formula on my breast to get things started... I had a lot of pressure to FF.

HTH and I think your conference is going to be fabulous...wish my ped would attend! Please let us know what you decide to present and update us on the conference!



Jamie
Mommy to Kayla
5-1-03

[C99]

Well, I never even *saw* the pediatrician who attended my son. He was in the NICU for 8 days and I was only ever given consults with the nurses. The first doctor who talked to us about him was the pediatrician who was on rounds from our ped group, after I put in a few calls to their office to see if we could get him released from the NICU. So I really wish the peds and the nurses in the NICU would have been more supportive or breastfeeding in general. It was a huge struggle to breastfeed my child and I wish that everyone would have been more supportive of the idea that breastfeeding is always best for the child, even if it's not scientific or measurable.

[papal]

Let see...
Two different peds from the clinic I go to visited us on the 2 days we were in hospital. It was a very brief visit (5 mins) and they always seemed like they were in a hurry. If you are going to bill it for a regular visit then imo you should SIT down next to the mom/dad and relax and listen to what they have to say. I just got the 'how is the bfing going' and 'it takes a while to get the hang of it). Oh, and when i returned to the clinic 4 days later because my nipples were cracked and bleeding, i got the 'that happens, it will get better.. keep at it'. How about some empathy, something like 'i have seen this before, it happens..'. Also, i don't think my ped recommended that i consult an LC. I did that on my own.
If i was not hell bent on bfing then i would have been put off with this non-caring attitude.

[ppshah]

Well the conference is only one hour long so we won't have time to go over a lot of information. I haven't really decided on what to present - that's why I posted this survey. I'm so much more pro-BF as a pediatrician after BF DS for 9 months. Alot of the peds in this group are women who have BF so I think that is helpful.

Believe it or not...I never suggest supplementation except for 2 sitiuations:

1. Low blood glucose- and we usually have the mom nurse first and if it still stays low we can give the baby formula ( with a syringe if mom is again bottles )

2. Baby has lost a lot of weight ( >15% of birth weight ) and is jaundiced. But we have the mom always BF at every feed first and then offer the formula.

I also emphasize that the supplementation is a TEMPORARY measure.

I think since time is limited I want to make several handouts and just go over them briefly.

1. The first hand-out will review the medical literature and set up medical practice guidelines. Since the mom will talk to a different doc every day I think it's important for us to be consistent. For exmple someone mentioned jaundice- well the new AAP guideline ( based on recent literature) say all BF babies should have follow-up within 48-72 hours to access weight gain, jaundice and to address any BF difficulties.

2. Maybe the 2nd will be about "Myths" about breastfeeding.

3. I also want to make one for the nurses. Believe it or not I feel a lot of pressure form the nurses to supplement. I often get calls "This baby need to supplement b/c ..... is that okay???"

As far as my personal experience, I did not like th LC who met with me. She asked me if I had read any books on BF or taken any classes. When I said no- she was very rude. Basically she implied I wasn't very serious about BF. Well she hadn't been 9 months pregnant, working 80 hours a week, and moving into a new house all the same time!!!. When exactly was I to fit a BF class into that? I wish someone had told me to expect little bumps along the way and give it a full month before quitting. I almost quit several times- but each time I'm glad I stuck to it. I founda message board of other BF moms which was a life saver!!!

[ericajosh]

Thank you so much for your interest in helping moms BF. My ped. did not discuss the baby's eating at all at the hospital. It was only when I went for a check up with the baby that the ped asked about my plans in terms of feeding him. (By that time I switched to a ped with a nicer bedside manner, who was happy to hear that I planned on nursing for a while). However, most of the ped from the office that I met with did not push BF enough, IMO, especially since the AAP does.

I was lucky to have a supportive staff of LC at the hospital in which I delivered. They helped with latching on the baby and positioning. However, once you get home, it isn't as easy...therefore, I would suggest giving the moms a heads up as to what to expect when they get home and how to deal with BF issues (such as engorgement). Also, giving some information on baby's eating habits in the beginning will help the mom's with BF. I never realized how often DS would have to nurse in those first few weeks.

I did have a LC visit me at home (after calling many ped. to try to get info on BF and not getting any help). I found it hard to get BF advice from doctors (the response was "Call LLL") It would have been nice if the ped had more info. on BF too. Luckily, I was devoted to BF, but I could easily have waivered because of the ambivilance of one ped. who told me that there was no difference between the health benefits of bf and bottles!

What kept me BF was hearing how good it is for the baby. To this day, when I get tired of nursing, I remember how healthy my DS is and will be because of BF. That really was the greatest influence. Also, my husbands support was really helpful. Don't forget to include dads in on the benefits as they are good cheerleaders when the mom's want to give up. (Oh, you can also add how much it helps a mom get back into shape...not sure if that is a rumor or not...but it worked for me and will definitely motivate new moms..lol)

Good luck. Keep us updated. :)
-Erica

[COElizabeth]

I think the idea of doing one for the nurses is great. I don't remember the peds ever discussing nursing in the hospital, but I do remember one nurse telling me that if DS's glucose was low he'd have to have formula. As far as I know, there was no reason to suspect that his glucose would be low (he wasn't big, only 6 pounds, 6 ounces), so I don't know why she had to "threaten" me with formula. The nurses also told me I'd have to supplement if DS lost more than 10% of his body weight.

It bothers me that there seems to be a lot of variation in the "thresholds" at which peds (or nurses) insist on supplementation. Can you suggest any good references for info on what weight loss percentage and what glucose level are considered dangerous? I will probably have my next child at a hospital where my ped doesn't have privileges, and I can't guarantee the hospitalist will be as supportive of BF as you! :)

Elizabeth, Mom to James, 9-20-02

[lizamann]

ITA about the nurses being the sticking point. My MD's were behind the bf'ing, but the nurses made me feel guilty that dd was "crying because she's hungry because your milk hasn't come in." I wasn't about to let them bully me into supplementing, but it just seems so wrong to have to advocate for yourself and baby at such a vulnerable time. Not to mention how furious it made me that these women didn't seem to know the first thing about bf'ing that I'd picked up by reading a stupid book! It's their job, for crying out loud! The lack of nursing help and support was appalling and by far the worst part of my whole hospital experience.

Sorry to rant there, but you get the picture...

[jubilee]

With my 1st son I was told by the ped that I would have to supplement because of how big he was (9#13oz), and I think a lot of people think that big babies can't breastfeed- so please tell your patients that it IS possible!

Also, tell them about nipple confusion, so they don't end up with a baby that wants the bottle because it is so much easier.

And explain about jaundice makes the baby so sleepy he won't wake up to breastfeed. My 2nd son had to be on the biliblanket for 4 days while I finger-fed him breastmilk because he wouldn't wake up to even suck. I wish I knew sooner the warning signs of jaundice because I delayed treatment 2 days because I thought the yellow would "go away" and that his sleepiness was normal.

Thanks for asking!!

[sirensrise]

thanks for taking the time!
i wish the pedi would tell me how normal it is for a newborn to eat
ALL the time!i wish they told me all babies are different, as a first time mom, all i had to go by was the books nad did not expect that. i also wish they would tell me more about just stick with it even if it is not easy.
the nurses, oh boy! i think some of them might need some more education. no offense, MIL is a nurse. i had nurses in the pedi's office tell me all sorts of things. they esp. PRESSURED me to give dd solids when she turned 4 month. by 6 month, i was told that she was starving. (no, her is BIG for her height, and i had a LOTS of milk, i mean a lot)i wish the pedi would have educate the nurses about the new aap about the new guidelines. it is one thing that they are unfriendly to breastfeeding, it is another that they gave parents wrong info. they insisted that solids would make dd sleep through the night. solids solids solids! MIL was asking me about solids when dd was WEEKS old!she was not rude or anything, but still, the mis information!my pedi is great, but his associate informed me that there is absolutely no reason to feed my baby less than 2 hours, since the breat would not have been filled.
sorry, i dont mean to be ranting about all this. i believe a woman should be able choose whatever is best for their baby.breast or formula.

[cinrein]

I don't have much to add to what others have said. I just wanted to share that my practice did something that I thought was so great and I don't know if it's commonplace or not. A nurse called me around 9:00 the first morning we were home after our first full night home with a new baby. The purpose of her call was to find out how things were going, especially feeding. We chatted a bit and then she gave me her direct line and urged us to call if anything at all came up. I love them for that! I think it's a great way for a pro-breastfeeding practice to encourage Moms to continue breastfeeding when you hit the inevitable rough patch.

Cindy and Anna 2/11/03

[sntm]

I think one thing is to assume breastfeeding is the norm in the way in which you refer to it. Don't ask "are you going to breastfeed?" ask "you are going to breastfeed, right?"
Praise moms for their decision. Reinforce to them that they are doing the right thing. Warn them that it might be hard and that they may feel pressured to use formula, but tell them that the need to supplement is rare. Tell them before they give formula or consider giving up breastfeeding, they need to talk to their ped at least or an LC.

And definitely educate the nurses. That seems to be the weak link in most cases (not an insult to the nurses -- just a reflection of how medical education occurs). Tell them that they are the key to a mom's breastfeeding success. Latch techiniques are essential. Make sure they are comfortable handling a mom's breast (if you have a very willing patient, see if she and her baby will come in for your talk to demonstrate.)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03

[KGoes]

I wish my ped had discussed breastfeeding a jaundiced baby (due to ABO incompatibility). There were several issues. First, the jaundice. DD was treated aggressively with bili lights to make sure that her count never went near 17. I wholeheartedly supported this since it enabled us to go home in two days. But. . . . The lights made her sleepy because she did nothing but fuss while she was naked and under them. This made nursing more of a challenge, since once she got to me, all she wanted to do was cuddle and sleep. The nurses scared me with warnings of low blood sugar, etc. If it had not been for a rather militant LC on staff, I would have been quite discouraged. Now, I am not faulting the nurses because I truly believe that they had DD's best interest at heart, but breastfeeding support was left to the LC, who I had to ask for. Here's my point to a ped - with my child ill (and I know it was not that serious, but to me at the time it was extremely serious and traumatic) any time that the ped can spend with me talking about breastfeeding issues would have been time valued beyond measure. Even hypothetical - you may find that your DD is sleepy with jaundice; here's what you can do, etc. Second, DD was also on antibiotics due to an increased white blood cell count that was ultimately linked to birth trauma as opposed to infection. The antibiotics led to a nasty, nasty case of thrush. I personally believe it was so nasty because it took me awhile to realize that the pain in breastfeeding wasn't "normal." I had never heard of thrush, and if it hadn't been for an off-hand comment by a maternity store owner, I would have suffered much longer before seeking medical attention. I would have been eternally grateful if the ped had mentioned this as a possibility when DD and I were on antibiotics.
In short, information and support can be in short supply with new moms and breastfeeding. The cure is time and information from the ped. A specific list of possible things to watch for - like sleepy babies who will latch better in a few days once they are less jaundiced (remember, it is in these few days that well-meaning family members often push formula to "help" the exhausted and overwhelmed new mom)and symptoms to look for that may be thrush would be invaluable.
Kelley
DD born 7/03

[lynettefrancois]

I know a couple people who did not breastfeed for personal reasons that were perfectly legitimate, so I would be wary of imposing BF on anyone. Why not ask patients if they have received any information on the benefits of BF? Or if they have received enough information to make an informed decision on whether they will breast or formula feed? I would hope anyone who is presented with a little info will make the best choice, and in this format, would seem less threatening to all.
Also, I wanted to add that I spent the first two months with a bad latch (it didn't happen in the hospital or during the first visits with 2 different LCs, only after I went back, knowing that I surely wasn't supposed to have terrible nipple pain at 2 months). I also spent the first two months diagnosing silent reflux, which made her scream while eating (my husband thought maybe my milk was "bad" so I went on nearly a total elimination diet for awhile), and then the last 2 months with thrush. I couldn't get my pediatricians to prescribe anything but nystatin, so I switched offices finally, this week. Why? They were condescending, which REALLY ticked me off, on top of not giving it the attention needed- they only saw it in her mouth once, but my symptoms persisted. I've been trapped in my own home to air out my breasts! The nurses INSISTED that if there were no white patches, she didn't need to be treated! If I hadn't been so committed to BF, I would have given up at least 2 dozen times. If I hadn't done any research, I would never have figured out anything (and would have quit), since our old pediatricians' office were not up to date on their information (nurses and doctors included). And how would I have know the difference if I hadn't looked it up myself? Plus, EVERYONE around wants you to formula feed- if you mention any problems with BF to someone who didn't, they will immediately tell you to formula feed because BF is a pain and formula is fine. I hadn't expected that; nobody told me of the resistance to BF I would encounter. I guess what I'm saying is to tell patients to keep asking for help and information until they get what they need- maybe even tell them that some people are not up to date with their info, so they'll have to be persistent about getting the best information if problems arise. Also tell patients to connect with other BF mothers so they have a safe place to voice concerns without getting attacked for BF in the first place! HTH...

[HelenD]

1) Ask the patient if they have any questions about BF and PATIENTLY answer them....
I know that Drs. have very little time and are extremely busy, but you can't imagine how immensely wonderful it is to have a Dr. who doesn't, literally or figuratively, have their hand on the door knob the entire time they are speaking to you. I think this is the number one impediment to patients (BF or not) asking the questions they really have. So, my number one comment is to check your body language for "ready to bolt" signals when you ask the patient (as I assume a good Pediatrician would) if they have any questions about BF (or anything else).

2) Ask the patient if they are aware of local support for BF after they leave the hospital…
Personally, the one thing that prevented me from giving up all together on BF was the local support group of moms hosted by a lactation specialist. This group offered support, education, and information that was just LIFESAVING for me. For the first 9 weeks, I lived for that Wednesday group so I could go and ask all the tons of questions I collected over the week. It was just VITAL for me in terms of the BF relationship surviving. You can’t imagine how much it helps to have some other mother who just had a baby say, “Yup, my DD nursed every hour and a half for week too, but they don’t keep that up forever – it’s just a growth spurt, and it will pass”. I think it’s very important for a doctor to understand that it’s not the questions they can think of at the hospital, when a patients just been through this mind, body, and heart (emotional) blowing experience. It’s the questions they’ll have tomorrow and over the next really hard few weeks. It would be WONDERFUL for a doctor to acknowledge this and to advise a patient of their options for support over the next weeks. It’s one thing to have a nurse tell you about something like this, but if the doctor can tell the patients about these groups in the area and explain how much it helps maintain this important BF relationship to have others with first hand experience and expertise to talk with – it really means something.

3) Tell the patient what’s normal for a BF baby…
Someone else mentioned this, but I do think it’s important for the doctor to acknowledge how hard those first weeks are; how the baby will want to nurse all the time AND why that is – ie not because they are starving or anything else horrific. Tell the mother what the poop should look like (all the variables and the loose consistency that are normal), how to know if the child it getting enough milk (suggest counting diapers if they’re worried, etc), how often the child will nurse at first and how it does get better, and any other general, basic things a new BF mom should know. It would be great if in a positive manner, the Dr. could dispel many of the BF myths all the well meaning neighbors, aunts, and grannies will give them over the next weeks about BF.

4) Tell the patient what’s not normal for a BF baby…
Give the parents guidelines or things to watch for that warrant a call to their pediatrician.

5) Encourage, Support, and Praise…
Tell the patient in terms of the health of the baby as well as their own health how GREAT what they have chosen to do is. It would take 2 minutes for a doctor to just run down very quickly some of the advantages of BF in a very congratulatory, praising manner. I think this kind of encouragement on the healthy choice they have made for their baby will help in the hard weeks ahead.

Sorry this is so long winded. I hope it helps some.

Helen

[lfp2n]

I just wanted to agree with other people. I think its important to emphasize that most people don't make much milk for the first 2-3 days and thats normal and the baby will be OK.

I think nurses need to be educated, you see them far more than peds and they are the ones who make you feel bad by saying they are crying because they are hungry- you could give a little formula.

People kept asking me whether my milk had 'come in', to this day I didn't know when it happened and I found the question very stressful. I didn't get engorged and it wasn't obvious what was happening.

I had to deal first with jaundice and bili lights and then with slow/no weight gain. I think that reassurance that both are fairly normal and it is completely possible to get through both without supplementation would be good. Just to take away the guilt that you might be doing something 'selfish' and harmful to the child by zealously sticking to BFing.

The other thing I think I learnt from these boards which seems obvious now is that most BFing supply problems are solved by more Bfing.

Hope the conference is good

Lucy (DD 3/27/03)

[jerseygirl07067]

We had hospitalists follow DD at the hospital where she was born and they were terrific. I have to honestly say that I did not speak with them too much about BF since I was asking so many other questions. (I was directing my BF questions to the nurses and LC's - more about that below) I do think though, that it is important to educate moms on the health benefits both to baby AND mom without being preachy. I know sometimes it is not even what is said, but how it is said. Also, let moms know of signs to be aware of regarding baby getting/not getting enough. Also, I believe encouragement from an MD is golden. Especially one who has been through it! If it is a mom's decision to BF, explain that it is hard at first but definitely gets easier! Hearing that from an MD might help with the perseverance during that first week when your nipples are too darn sore and painful and you're wondering how much longer you can continue.

I have to say that at the hospital I delivered at, the nurses have a lot of training regarding breastfeeding. In fact, they were the most helpful! We did have a visit from a lactation educator and a consultant too. But since it was the nurses that we had the most interaction with, training them too made a lot of sense. It was my RN on the night shift who initially helped me to get DD latched on once DD returned from the nursery - at two in the morning! And during subsequent shifts, I always got helpful and accurate information, which really helped to reinforce what I already knew. They were also really good about "keeping on top of me" every two to three hours, asking how many wet/poopy diapers DD had, and when she fed and for how long, etc. and asking if I had any questions or problems during the feeding.

I am not sure how helpful this post was but if you have any influence at all at your hospital, educate the nurses on breastfeeding. It made all of the difference for me.

HTH,
Marcy

[deborah_r]

I second that - my biggest problems were from the nurses. Also my hospital has lactation consultants in the breastfeeding center, but those are outpatient only - the ones you see in the hospital were called something like lactation specialists and only one of them was helpful, the others seemed pretty clueless. The nurse on my last night tried to get me to stop using the nipple shield, so DS didn't eat at all the night before we left (maybe he had some formula, I don't remember) I was a wreck from him screaming and the nurse pressing on my engorged breasts and trying to force my screaming son onto them. It is by far the experience I worry about the most as far as having done permanent damage to him because it is so obvious to me NOW how wrong it was to do that to him. But she scared me by saying if I didn't get him off the nipple shield before I went home, I never would. (I did, 2 weeks later)

So then I saw a different ped the next day than the one who had seen us the previous 3 days, and he thought the baby looked jaundiced. He tested him and he was completely not jaundiced - he scored very well on the test. The doctor was wearing a YELLOW smock, could that have had anything to do with it? He still said to supplement with formula after each BFing session "until mother's milk comes in" - umm, apparently he hadn't noticed my huge engorged breasts, my milk was as in as it could be. I don't know why I didn't tell him that, or tell him that the baby hadn't really eaten the night before (although baby would have eaten just fine from the nipple shield) - I was intimidated by him and I was emotionally exhausted from the night before, and I was upset that I had failed to get him to stop using the nipple shield (I finally fed him with the shield when that night nurse went off duty and my DH got there).

Anyway, recently I was talking to the LC I used and she is familiar with most of the peds and OBs and she said that particular ped is kind of "old school" and he says ALL of HIS babies are supplemented with formula (his being all of his patients babies, not his biologically). And I bet there are a lot of peds out there who feel that way.

Interesting to me that I always choose female doctors, but in this situation I had this male doctor thrust upon me and he was in charge of deciding whether we could leave the hospital, and he was my worst experience with doctors during this whole experience. I now use the female ped in his same practice, the one that had checked on us the first 3 days in the hospital. Not saying all male docs are bad, but in my experience, they do NOT LISTEN! In this case, granted I should have told him some things, but he didn't ask the right questions, IMO.

Done ranting, this is making me mad all over again!!!

[emilyr]

First, thank you for the interest!

Apparently, my hospital is different in that the nurses do not push formula or supplementing ( at least in my two experiences there) and I know a few of them personally and know that one breast fed and one never would. However, I never got an "attitude" from either one of them. I think that educating the nurses would be great as they are who the mothers and babies are seeing the most. Although I LOVE my ped and she is the one who visited me in the hospital, for my second baby she simply asked if I was breastfeeding, said "great. She looks perfect!" I do think that she asked if I had any questions but with her body language acted like she was ready to get out of there.

With my son, he had a medical condition and it benefited him greatly that he was breastfed so both my ped and the surgeon we were referred to were very encouraging (although I was adamant that I was going to breastfeed as long as possible). However, again, it was the nurses that were there in the middle of the night helping me to pump (he couldn't be fed the first 24 hrs), try to get him to latch on once I could feed him, etc. I delivered on a Friday afternoon so the LCs were not there for the weekend. The ped on call for the weekend was not my regular ped and he did not even mention how I was feeding him, although I don't know if this was because we were more concerned about the other condition or because he knew that my regular ped had been there the night before.

I do wish someone had told me that some days I would feel that I was feeding my baby ALL day long! I also like the idea of giving the info on LLL, the LC phone numbers, etc. My hospital gives a little booklet with these numbers, info on how often the baby should nurse from days 1-4, 5-10, etc and it also had charts to monitor when baby eats, how long on each breast, number of wet/dirty diapers... There is also a page with info on where to buy breastfeeding supplies, pumps, etc. I found this to be very helpful but it was given to me the first night with all of the other paperwork and no one ever mentioned it again. If this hospital gives out something like this, maybe it would also help if the peds showed an interest in it, or encourage the mother to refer to it.

Again, thanks for the interest, good luck on your conference!

Emily

[quikeye]

I'm not sure if your hospital has "rooming in" for new moms and babies, but that was one of the best things that I had done to help establish breastfeeding. I had a hard time trying to figure out how to get baby to latch (even though I came w/ my well-read copies of the nursing companion and sears' breastfeeding book!) -- but having so many different ped nurses coming by while I was nursing and trying to nurse really helped me with learning how to nurse (and I was still not very good at it when ew left, but I felt confident that it would get better with the advice I received while rooming in. The nurses really made a difference in being really proactive about helping me bf -- they came up and helped me, and I didn't have to ask (I can't believe how embarassed I was that I couldn't get baby on...)

I think one of the mot important lessons I learned was of baby's early hunger cues (learned from a nurse as well as a lecture given in the hospital by a LC)-- without knowing the cues or reading them, baby goes crazy by the time he's crying w/ hunger and makes it near to impossible for new moms to get a good latch on... and nothing is more discouraging than having a baby cry at your breast.

Also, the lack of formula @ hand or pacifiers made breastfeeding my "only" choice (though it already was upon entering the hospital, there was no easy way for me to change my mind in regards to that). Plus, the staff @ the hospital was very pro-bf'ing (one nurse gave me some glucose water to make my nipple less dry & make latching easier, and another nurse saw the used "enfamil" cap and said "where did this formula come from?!"-- she didn't want to see baby supplemented either, since I didn't.

Finally, my baby lost close to the 10% birthweight, and it did scare me into thinking about supplementation (esp. since the nurses were like, "wow! can that be right?" when baby was weighed...) My ped (after being checked out) just had us come in for weight checks until baby got back to his birthweight and kept reminding me that the loss was normal... Although he did say that supplementation may be necessary if baby lost more weight, he didn't and so it didn't become an issue. (I do wish that my ped had told me that babies lose a lot of the weight b/c of the purging of the IV fluid from their bodies that was given to mom during labor-- I kept thinking he was starving or wasting away, but if I had known it was just a water-weight loss, I would not ahve felt soooo anxious about his weight loss).

Basically, for me bf'ing was my 1st choice but I wish that my ped had given me more practical advice and support to amke my decision easier-- specifically, making sure I had help in getting a good latch/bf'ing started @ the hospital (the nurses were great at that), letting me know baby's cues to make feeding easier, etc.

[AngelaS]

My ped is a friend of mine and I called her from my hospital bed with both births and she came right up to give my girls their assessments. So, I'm a bit biased, since I knew my ped nursed and totally supported my plans to nurse. :D

My experience with hospitals and BF was that it was the NURSES who needed to be more trained/helpful/supportive. It's the nurses who say, "if she won't calm down, we can give her formula" and they're the ones who raised a stink about my insisting my baby be cupfed instead of bottle fed (only the nurses are allowed to cupfeed a baby and they really don't want to cupfeed in front of the parents, but I also don't let my babies leave my room.....). So, it was the nurses who were pushing the formula and being detrimental to a happy nursing environment, IMHO....

[leanng]

First- thanks for pushing BFing. My pediatrician said he was 'pro' BFing but that was the first and last we heard about it. At our hospital (prominant hospital in Atlanta), I had to throw a hissy fit in order for the nurses to NOT feed my son formula during the 10 minutes a day they had him in the nursery. I also was told a lactation consultant would be by but it was 48 hours before she showed up. Luckily, I was extremely determined and had my own books and just struggled through on my own.

Second- I think one of the main problems women I know have with BGing is that noone seems to tell you quite how difficult it will be at the beginning. I remember feeling like a cow every time my son was put in my arms to feed. It HURT for weeks and I was just soo tired that it was tempting to listen to my formula friends who told me to share the work and supplement so I could sleep. I think it would have been very helpful to have been told that things get easier after the first few weeks. I know I have told friends not to think about BFing for an entire year or even an entire 6 weeks. Just make the commitment for a few weeks and vow to rethink things at that point. It makes things MUCH easier.

Hope this helped.
LeAnn

[Jeanne]

Just wanted to add that the most important thing that made a huge difference for me was a LC that was willing to look into my insurance plan options to see if a LC was covered for my first day home. It was an option on my plan and from what I understand, a benefit offered by many plans although never publicized. Of course this all depends on your employer choices, but in the several conversations I had with my insurance provider, they never once mentioned it as an option. And I would have not known to ask as first time mom.
I was fortunate that I had several nurses that were pro BF and a committed LC who wouldn't let me leave the hospital until she felt comfortable the I wasn't going to give up. She also scheduled the visiting LC for the very next day that I was home. That kind of support ensured my success in BF.
My Ped only casually mentioned it, although my group is very pro BF as well as my OBGYN. The nurses spend the most time with you and they need to be onboard and well informed. They need to take the time with you to ensure your comfort and success.
HTH and thanks for asking!

[C99]

I know. Our situation was different because Nate was in the NICU, but it was still pretty difficult.

I was breastfeeding Nate at a family function a few weeks ago, and my husband's cousin was giving me raised eyebrows over it. She's also just gotten work as a nurse on the post-partum floor (and is 8 weeks pregnant!), so I shudder to think what is going to happen with the BFing moms when she had such a negative reaction to it at the dinner table!

[redhookmom]

I have not read the the other replies...

Breastfeeding hurts, and you are not doing it wrong if it hurts.

[jbowman]

I gave birth at a "breastfeeding friendly"/pro-breastfeeding hospital. I, like so many other women, was resolute about my decision to breastfeed, but at the same time I was nervous (since I had never done it before and didn't know what to expect!). I attended a breastfeeding class prior to the birth of my daughter, which increased my confidence.

Once my daughter was born, formula/supplementation was never mentioned. An LC visited me several times and gave me the best advice. She said, "if you can get past the first week or two, you'll be fine!" She also helped show me the proper latch, position for the baby, etc. Additionally the nurses kept a log of how long and how often Ellie fed. And they never once implied that Ellie wasn't getting enough. Although I had a relatively easy time with breastfeeding, I believe that it was at least partially due to my experience at the hospital.

My ped. is supportive of breastfeeding and really helped when my milk took a bit longer than usual to "arrive." It would have been easy at that point for him to say, "throw in the towel, your daughter's lost a pound since birth, bring on the formula!" Instead he supported me and monitored my daughter closely. Luckily my milk came in soon after, and everything went well. I appreciated everyone's patience and support!

Ultimately I think the best thing that a ped. can do is to support the wishes of the patient whether her decision is to BF or to FF.

[luvtoshop]

Hello.

I wish that someone would have told me that due to my C-sect my milk would be delayed so much that I would need to supplement my 8lb, 5 oz baby. I was so determined to BF that I didn't want to supplement. I ended up having to supplement after my baby got jaundice and was severely dehydrated. My baby was born on a Friday morning and my milk didn't come in until Tuesday. We started supplementing on Monday after a trip to the ped. My baby never had nipple confusion and as soon as my milk came in I BF 100%.

I also had the luxury of a LC at my fingertips. There is a local service that has LC on call. They return you page within 30 min. It was fabulous! I also attended a weekly Lactation Support Group for the first 12 weeks. Support, support, support is what every mother who attempts bfing needs.

Good luck!

[lizajane]

i am very opinionated, so if my ped tried to get me to supplement, i would have left that ped. but i had a friend who were told to supplement la de da like it was no big deal. she quit breastfeeding at 8 days. she was also told to feed her baby for 15 minutes per side and then offer formula. ACK!!! my son ate for 45 minutes per side and my milk still didn't come in for 5 days.

so my comments:

everyone loves a compliment.

everyone hates a criticism.

everyone needs information about where to get help.

i think it would be GREAT if peds offered some phone numbers for lactation consultants, along with a little info about what they do and how they can help. not only with how to latch on, but with reassurance that you WILL get it and you CAN make it work and you DO have enough milk and it is OK if you feel overwhelmed and sad and like you need a break.

and i just WISH WISH WISH that peds would STOP STOP STOP telling moms to supplement like it is just the best idea ever for anyone. (i do recognize that it is the best idea for many moms/babies who really need it.)

[stillplayswithbarbies]

The first night after Jake was born, the nurses brought him to me to feed him, and told me to ring for them when he was done. (rooming in wasn't available back then) I was feeding him, as best I could since I didn't really know what I was doing and wasn't even sure he was eating, and I feel asleep with him in my arms. Sometime later, the nurse came back in to check on us, and said to me:

"What a good momma you are, you're doing a great job feeding him"

I still remember that statement today. I am an awesome breastfeeder. I'm good at it. And that one statement started it all. It validated my choice and gave me the confidence to stick with it no matter what happened.

So, my advice is to compliment the mothers. Build up their confidence by telling them they are doing a good job, and don't undermine their confidence by telling them you'll have to supplement, or saying things like "if your milk doesn't come in soon". Women should feel empowered at a time like this, especially by other women.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[hellosmiletoday]

I cannot say anything from experience, other than I plan on BF for my baby coming in May because I have researched the benefits. Yet, as with the pregnancy books I have read, I think you can go a little overboard...my pregnancy books stressed diet and nutrition to the point that I felt awful when I had morning sickness and could not ingest any vegetables. My mom did not BF me b/c back then she was told that formula was better, and I turned out just fine. I think as important it is to encourage BF and state the facts, we need to keep in mind that not everyone can do it for medical reasons.

[wagner36]

I completely agree with Karen. My milk came in very early - while I was still in the hospital, and I still smile everytime I remember the nurse saying to me "you're a breastfeeding natural!" I barely remember anything else about the hospital stay, but I will remember that forever!

If your hospital has a "What-to-bring" list, I would also recommend putting a Boppy or another nursing pillow on there, referencing that they are very helpful for moms who plan to breastfeed.

A friend had recommended that I bring one, but in our haste to leave for the hospital with what seemed like too much stuff, we left it behind. I was SO HAPPY when DH ran home to get it the next day - trying to get the right positioning with those crappy hospital pillows was a nightmare!

[tamipayne]

My pediatrician was on vacation when I gave birth, and I saw an on-call pediatrician. He didn't really give me any information on BF, just asked me if I was BF. Even the nurses on staff were not very helpful. They would just drop Delia off and expected me to know what to do. When I asked for help, they told me to keep trying and gave me a nipple shield (which I did not know was not a good thing to use at the time). It was very frustrating, once I got home, all of my information on BF came from a video I saw in childbirth class and some books and articles. Living in a small town, there are no lactation consultants and the nearest LLL group is 40 minutes away. The only help I've gotten with BF was from LLL by calling a leader.

I definitely think more education on BF before leaving the hospital would be helpful. I can see why people would easily give up and go to formula w/o the right information. Delia latched on wrong for the first few days and this caused a lot of pain. She's now got a better latch, but I'm still recovering from the mis-latch.

It would be great if either the ped or RN would sit with you and watch you BF to tell you what you're doing right/wrong and give tips on how to make it better. Also some resources to call if you have questions once you leave the hospital.

[babymama]

Had my son in a pro-breast feeding, pro-mother/baby hospital. One important topic that I wish *someone* had discussed with me (I saw 3 lactation consultants, my pediatrician, a neonatal specialist, my ob/gyn, and dozens of nurses all while still in the hospital) is the symptoms of breast infestion. My left breast got infected soon after I got home from the hospital. The pain felt like being stabbed by a sharp knife everytime my son BF on that side - worse pain than childbirth (and I had a medication-free birth). This further delayed our getting BF established. I had no idea what the pain was, and thank god I talked to a friend about it who experienced the same thing. She made me promise to call my ob/gyn the next morning. I was able to treat it right away. IMO, it's VERY important to educate new moms about potential infection.

I think one contributing factor to my infection was that my breasts weren't being drained because my son had to spend 3 days in the NICU because of a high bilirubin level (caused by bloodtype incompatibility) - nurses fed him formula and encouraged me to pump. I feel like I pumped and pumped and pumped to no avail (to this day I'm not sure if I was even using the pump right). One lactation consultant told me the phalanges on the pump were too small for my breasts, so she got me another (bigger) set. Then another LC came and told me those phalanges were too big. I tried to get my son to latch (once he was able to come out from under the lights and I could hold him and feed him again), but he was too used to the quick gratification of the bottle by then. I absolutely hated that drip feeder (can't think of the name) with the tiny tube that gets taped to the breast and drips formula in the baby's mouth while he BFs. The LCs seemed to be in a big rush all the time and they seemed to be forcing my son to eat instead of teaching me techniques. It was a very stressful time. Overall, I don't remember anyone working to build up my confidence with BFing. I think it's SO important to do that with new moms - ideally, the mom would see one BFing mentor over a couple of days (seems like I saw a new person everytime - sometimes that person would contradict what the previous person said). So please work on building CONFIDENCE with new moms.

We finally established BFing at about 2 1/2 months (yay!) and I exclusively BF for the following month before I had to return to work.
Now I'm BFing while at home and baby drinks formula and/or EBM during the day.

During the hospital follow up visits in the first 10 weeks, my son's ped said "it's no big deal that he's not breast feeding. the baby's gaining weight and that's all that matters." I know she was just trying to be nice and comfort me during my obvious disappointment that I couldn't get the hang of BFing, but I found her comments to be discouraging.

[missmelis01]

I didn't get any advice from the hospital pediatrician (my ped didn't have hospital rights), but I got great advice from my OB. He said BF was the best thing I could do, but to be prepared because it could also be one of the hardest things to do.

When I did meet with my pediatrician, my son was very jaundice and was not gaining weight adequately. She didn't tell me I had to supplement with formula, and instead suggested I pump and give my son a bottle of breastmilk. That was very comforting to know she supported my decision to BF even when it could have been just as easy to tell me to give my son formula.

All the other advice I got for BF was from a BF support group the hospital where I delivered hosts every week. It was the support group and the wonderful contacts I made in the group that helped be get through the first 6-7 weeks, which I thought were by far the hardest. The group was so wonderful and I feel so strongly about the group, I think every hospital should have one!

Cudos to you in your efforts to promote BF.
-Melissa

[Puddy73]

DD's ped is great and has been very supportive of breastfeeding from the beginning. However, the nursing staff was another story. I was having problems getting DD to nurse for more than 10 minutes at a time because she was slightly jaundiced and a little sleepy. Rather than giving me any suggestions or encouragement, the night nurse insisted that we give DD formula. When I protested, she brought a pump into my room and told me to pump while DH fed DD a bottle. She didn't offer any help with the pump or explain why DD needed formula. I was in tears and I wasn't able to pump anything. The nurse took that as a sign that I would not be able to breastfeed and told me to continue giving DD formula instead. Luckily, the next morning I had a visit from the LC, who was very helpful and reassuring. I had read several books about breastfeeding and was very determined to continue, but I can see how even one bad nurse could cause someone to give up.

Best of luck with your conference - hope it goes well!

Jennifer
Mommy to Annabelle Mae 9/8/03

"Life is not measured by the number of breaths we take, but by the moments that take our breath away."

[psophia17]

As a PP was, I was also hellbent on BF. But it was a big struggle, and I wasn't prepared for that.

If I hadn't been as hellbent on BF, then I think a lot of the info I was given in the hospital would've caused me to FF. The nurses all had different ideas on how to get DS to latch, and in the 4 days I dealt with them (I had a c-section), only one really helped. Some of them were horrible. I got yelled at at 2am by one old harpy because DS hadn't BF long enough (10 min per side) and that I should be able to do 1/2 an hour per side by that point. I was so proud that for the first time I hadn't had someone in there helping to get DS latched on right. My roommate, who was FF, came over to get me to stop crying. As far as I know, she went down to the nurse's station and filed a complaint about the treatment I got.

The ped we chose was great - he had a 3 month old and his wife was having real problems with BF, so he was incredibly supportive of it, and even asked me for tips when things started to go well. I told him about the nurses in the hospital, and that really made him mad. It was nice to know he was 100% on our side, you know?

About BF info from the ped - the only thing I would've liked was more info on jaundice. DS was jaundiced, and we were told that it was not something to worry about unless the yellow went below the bellybutton. It did, a month later, but by then we had moved and had a new doctor. He told us to go to the ER to get DS's bili checked, and they wouldn't let me BF or FF for 9 hours. That was when we found our new, BF-supportive ped, who let the ER drs. have it for subjecting a new mother and an infant to that torture.

Make sure you have your doc's tell patients that BF is best and why, that it's not easy at the beginning but worth it, and that ____ are the things to look for because they will signal a problem.

-Petra

DS - Nathan, 12/29/03

[psophia17]

ITA - I would've been so thrilled if anyone had said that to me in the hospital!

-Petra

DS - Nathan, 12/29/03

[Cassandra27]

I was hooked up to two bags of IV magnesium sulfate due to PIH for 3 days in the hospital. On the third day, the staff pediatrician informed me that I shouldn't be bf'ing my baby while on the mag, and that it would make her sleepy. This was extremely upsetting to me for various reasons:

1. Jenna was 5 weeks premature with an immature sucking reflex, and I had been unknowingly "putting her to sleep" every time I nursed (or attempted to--not sure how much she really ingested). She lost 25% of her birthweight in those 3 days, which I have to attribute partially to being too sleepy to nurse.
2. It took him THREE days of visiting her before he told me this.
3. My OB and none of the nurses thought to inform me
4. And the ped didn't stop to explain anything beyond "you shouldn't have been nursing her while on the mag". I felt so guilty, yet I couldn't figure out what the alternative would have been--bottles of formula, I guess?

Anyway, that's my wish. That he would have been more forthcoming and speedy in his advice, and actually counseled me a little rather than dropping that bomb on me and then leaving. To top it off, he discharged her at 4lb 12oz with severe jaundice, even though I hadn't even been cleared for discharge yet and we knew it would be at least another day before I could leave. (She ended up being readmitted by a different staff ped, and we filed a complaint.)

A second suggestion would be to provide some kind of counseling or literature on caring for preemies. I had no idea what I was in store for, and weeks after coming home, I was still bf'ing her every 45-60 minutes round the clock. I was a wreck--mentally, physically, and hygenically. We did make it through in the end, but I almost resent that they sent me home with this 4lb bundle of a thing with no real instructions or pamphelet or at least helping to set my expectations (as far as the difference between caring for a preemie vs a full-term baby).

Cassandra
mom to Jenna, born 02/03/04

[ellies mom]

What a wonderful idea. I had DD at a kaiser hospital that is very pro-breastfeeding. That said, looking back there were a few things I wish were done differently.

Each nurse had different way of trying to get the baby to latch on and hold the baby. That is fine in itself. But instead of saying "this is THE right way to do it", it would have been better if they had said something like "this is what works for me. let's see if it works for you" The different ideas were great but not when presented as "the other ways are wrong".

The first LC I saw was completely unknowledgeable about any pump other than what Kaiser sells (medela), including the very popular Isis (strongly discouraged it). She was also the worst about doing it her way. The second LC I saw was much more helpful.

If a mother is planning on breatfeeding, I think someone needs to say that it is hard at first, but it will get better. I think too many new mothers feel as though they must be doing something wrong because it hurts or that the baby isn't doing what the book says.I think some more honest information would be helpful. Luckily I had my Mom to tell me that it will get better, to give it three weeks. She was right and 11 months later we are still going strong and I still love my Isis. :)

[squimp]

The best thing the ped could do is to find a way to have a LC visit moms every day while in the hospital and then do a follow up home visit for free within a week of returning home (preferably 5 days). Fantasyland? Nope - standard practice at my hospital.

The LC spent at least 30 minutes talking with us every day in the hospital, and was like a goddess to me. I looked forward to her visit, and that's not just because she said I had great breasts (for BF, of course :D). The home visit was several hours and really built our confidence.

My experience was that the pediatricians were extremely busy. The best they can do is say how beautiful and wonderful the baby is, share all the pertinent baby health info and not say something offensive because it will stick with the parent for months. I also agree that the nurses are really key - they are the ones there with the moms at 2 a.m. when the baby is hungry and won't sleep, and you need sleep so formula starts to sound like a good option.

[jacksmomtobe]

It's nice to see someone in the medical profession looking for this type of feedback. I had a tough time in the beginning but guess I am pretty determined so I persevered. I had a c-section. My son was a barracuda baby so he did some damage early that made it difficult to keep on trying. He also had jaundice and was partially supplemented. My advice would be:

*Explain to the mother (&Dad)that bf'ing is a learning process for both baby & Mom. It takes time to figure out what works. You don't want the Mom to think this naturally occurs otherwise she may feel like a failure. Tell them that it gets so much easier as time goes on and Mom & baby get to know each other.
*Encourage the Dads to be supportive of bf'ing.
*Educate the nurses so the message/advice given is consistent. I got conflicting info from the nurses while in the hospital which was frustrating. A LC who later came to my home laughed at some of the misinformation I was given.
*Let the nurses know that new Moms have feelings and need support. I got the feeling that some of the nurses were just trying to check off that I was breastfeeding successfuly rather than really hearing what I was saying or experiencing.
*Explain to a nurse that when a Mom brings a baby to the nursery so she can take a quick nap bringing the baby back to her in 5 min because he/she is crying so he/she must be hungry is preventing the Mom from having a break that she desperately needs and can make them feel like a failure.
*Tell the Moms to seek out an LC right away if they start to have problems. I was 80% there but still experiencing some painful latches and I had an LC come to my home. She helped me find positions that worked for me in my home and was so supportive that she really helped my confidence and put me over the edge to being 100% successful. Even if their insurance does not pay it is money well spent.
*Educate new Moms about when their milk should come in ie for a c-section it is usually later and let them know that the baby is getting nourishment from colustrum. I think many Moms worry that their baby will starve in the beg and feel a lot of pressure & stress because their milk has not come in yet.
*Let the new Moms know if they have to supplement either for medical or sanity reasons it does not mean that they must give up bf'ng or won't be successful bf'ing

As you can see most of my gripes were with the nurses. They interact with the patient the most. If you can add a little consistency to the information they supply the Moms with and help them realize that new Moms are feeling a lot of pressure and worry about failing so the way they treat the Moms can have significant impact on the Mom's success with bf. I have a great Pediatrician. The whole practice is pro bf'ing. They always make me feel good leaving their office because they are supportive. Overall what you & other Peds can do is to educate and be supportive.

Thanks for listening & trying to make things easier for New Moms!
Kim

[audys]

Dear PPS,

I would not have succeeded at BF without my LC - she was instrumental in the learning process for me. The nurses at my hospital were positive but some gave me downright wrong advise about latching, technique, etc.

For the pediatrician (or nurses), additional helpful comments to your patient's mother would be:

- drink a glass of water during or after EACH feeding

- the best advise I received in the hospital was that "growth spurts" occur and just hang in there through them - these periods were difficult but that little bit of knowledge to just feed-on-demand was helpful

- info on a good latch and how to deal with painful nipples

- LC (one you LIKE - people vary so much...) that mothers can contact immediately if there are any problems. I was hesitant to do this initially but WOW, did it help me!

- breast pump discussion - I think that having one (rental or purchase) can make all the difference in starting off that milk supply if the baby isn't nursing well initially. My son took formula after BF for jaundice and my supply was not affected for those first 6 months thanks to the breastpump

- how to wake up the baby for feedings - my nurse incorrectly had me wait until the baby woke up (sometimes after 6 or more hours) and I quickly learned from the hospital LC to wake him and feed him

- how to tell if the baby is getting enough (# wet diapers per day, etc)

Audrey, mother to Graham

http://lilypie.com/baby1/050210/3/15/1/+10/.png (http://lilypie.com)

[Ksinglet]

I wish the ped would have told me that it is going to hurt a bit but to keep at it. It is a learning process for mom and baby. All the books seem to give the message that it only hurts if you are doing it wrong. Nonsense. I do not know one breatfeeding mom who had a totally pain free experience.

As to the nurses, I think it is important to make sure that the new mom is not getting mixed messages. The hospital I delivered at is "pro-bf" and the LC are pretty militant about it. Kinda intimidating. On the other hand the nurses were not really that supportive. My son developed jaundice and had to stay at the hospital an extra night. The nurses seem to blame the jaundice on breast feeding. They told me that he had jaundice because he was not having a bm (untrue, he had a bm his first day) and he was not having a bm because he was not getting enough to eat. They told me ff would help fix the problem (along with a session under the lights).

At the same time the LC made me feel just awful for being unwilling and unable to shuttle back and forth between the hospital and my house every two hours to bf the night we were apart. She made it seem that once a bottle nipple touched my boy's lips, it was all over with - he would be unable to bf. I would have happily stayed in the hospital another night but that was not an option and there was no place in the nursery for me to rest between feedings.

The nurses seem to not want me in their hair hanging around the nursery. There was no place to sit next to the incubator thingee they had him in. I was expected to stand there all night if I wanted to stay with him. I could only sit down to use the rocker they set up for bf-ing when I actually fed my son. When they took him away to put back in the lights they would give me the strong hint that I should disappear until his next feeding - where was I supposed to go? I turned to the ped for reassurance that bf was not the problem and that one or two ff were not going to be the end of bfing and she was not very helpful.

Happily, in the end, I did manage to feed him for all but 2 feedings by making a nuisance of myself in the nursery. Despite the 2 ff he got, we eventually figured out how to bf and we are still going strong 7 months later.

[hellosmiletoday]

Update.

I've been BFing 5 months and counting...and its going well so I'm aiming for 12-24 months. However, I attribute my success to perserverance, and advice on these boards rather than any aid from the hospital staff or books.

I wish the nurses, OBs, and pediatricians would have been more encouraging about pain during BFing. NO ONE told me that pain was normal or customary, and that it would likely subside. I took it one day at a time...I guess my mindset helped alot...that I would give it my 100% effort, but if I still failed I knew my baby would be fine, as I was not BF as an infant and am healthy and obtained a graduate degree. Thus I was focused on getting BF to succeed, but not to the point that it stressed me out (which could hurt my milk supply). My mom helped me as much as she could, but she was sad that she could not provide me advice and mad that she was not properly informed by her own pediatrician when I was born.

I delivered on weekend and was NEVER seen by an LC. There were no boppys to help hold DD, no lansinoh at the hospital. I could not BF DD until 6-7 hrs after delivery until I could walk to wheelchair and be transfered from the labor/delivery to the "baby" floor.

Just a few simple actions would have helped immensely in encouraging moms to Bf!




Mommy to baby girl 5.8.04