CDC report on lack of breastfeeding support in hospitals

[Swish]

You just described our hospital stay to a tee.

Same here.

We were told DS needed to be taken to the nursery so they could more closely monitor his glucose levels. The hospital was overflowing that day and the nursery was too busy so they transferred him to the NICU, without our knowledge. There he was given an battery of tests, including an x-ray, again without our knowledge. He wasn't brought to me to nurse, I had to wait nearly a day for a breast pump, and even then I had one nurse crank the pump up to the point I ended up with bruising from excessive suction and too small breastshields. On a happy note, I ended up meeting with a LC after discharge, and DS nursed until weaning himself at about 18 months

I had other issues with our delivery there, but it's the nearest hospital with midwives with admitting privileges. About the only good thing I can say is that I avoided a c-section by having a midwife rather than an OB.

[daisymommy]

Add me to the list.
DS was taken to the nursery and not brought back for I don't even know how many hours later. They highly discouraged me from keeping him in the room with me, and being my first, I succumbed to their ideas and agreed.

There was no lactation consultant at all on staff, not just for my stay, but ever.

When they finally did bring him to me, he had a bottle of formula and nipple all ready to go laying next to him. They said it was standard procedure since most moms needed some help! Oh, and he had a pacifier in his mouth, even though the sign on the bassinet--which I made and brought in with me, said "No formula or pacifiers! Breastfeeding only." They said all the babies were crying and he needed some help calming down.

DS was jaundiced by the time we checked out, mostly because he hadn't ever really nursed the entire time, and I couldn't get a good latch. They just kept shoving my breast into his mouth and saying "there." The check-out nurse sent me on my way with a box of the little nursette bottles of formula.

Is it any wonder I quit nursing after 3 weeks (during which time I went back and forth between formula and attempting to breastfeeding)?

It took refusing to have another hospital birth, & hiring a LC to see me the same day as my next child was born to be successful with BF. My next two babies BF until nearly 2 yrs.

[amldaley]

Add me to the list.
DS was taken to the nursery and not brought back for I don't even know how many hours later. They highly discouraged me from keeping him in the room with me, and being my first, I succumbed to their ideas and agreed.

There was no lactation consultant at all on staff, not just for my stay, but ever.

When they finally did bring him to me, he had a bottle of formula and nipple all ready to go laying next to him. They said it was standard procedure since most moms needed some help! Oh, and he had a pacifier in his mouth, even though the sign on the bassinet--which I made and brought in with me, said "No formula or pacifiers! Breastfeeding only." They said all the babies were crying and he needed some help calming down.

DS was jaundiced by the time we checked out, mostly because he hadn't ever really nursed the entire time, and I couldn't get a good latch. They just kept shoving my breast into his mouth and saying "there." The check-out nurse sent me on my way with a box of the little nursette bottles of formula.

Is it any wonder I quit nursing after 3 weeks (during which time I went back and forth between formula and attempting to breastfeeding)?

It took refusing to have another hospital birth, & hiring a LC to see me the same day as my next child was born to be successful with BF. My next two babies BF until nearly 2 yrs.

Way to go! I think, sadly, many women would just write of BFing after a first experience such as that and just say "I tried but we just couldn't do it." There ARE many women who can't, but far fewer than just THINK they can't. I admire your persistence with 2 & 3!

[♥ms.pacman♥]

Okay I'm getting why rooming-in is a good idea in some of the hospitals that you guys are in! Seriously not at all like my own experience with having a nursery. If nurses are breaking the rules, that's totally scary. My nurses CONSTANTLY brought the baby to me to nurse and then promptly whisked them away so I could rest the nights. My hospitals have always had great lactation consultants and been very pro-breastfeeding!

same here! my nurses would constantly bring dd to me in the first couple days when she was in regular nursery. when she was in the NICU, she was tube-fed my breastmilk at every feeding and i would go in at certain times (3x a day) so i could try to nurse her. a couple times the nicu nurses even called me up at home and told me that DD was crying and really hungry so if i could come in right now vs. an hour later as scheduled so i would not miss an opportunity to nurse her. they were very encouraging me of trying to breastfeed her. i imagined this was typical of any hospital, but i guess not!

[hellokitty]

Yeah, count me in as another person who isn't surprised. We live in an area with an extremely low BF rate. It isn't even that moms are failing at BFing, a lot of them don't even TRY to BF, that's how bad it is! As for those who want to BF, IMHO, unless you really prepare yourself BEFORE the birth for BFing and/or you have an amazingly pro-BF hospital with competent LCs, RNs and docs that are willing to bend over backwards to be BF supportive, it's an uphill battle. I always HIGHLY recommend to mothers-to-be who want to BF, even those who failed with their first baby, but want to try to BF again with their subsequent babies, the importance of attending LLL mtgs. You find out so much info, are in the know about which docs are pro-BF, the best LCs, and are able to prepare yourself for what to expect at local hospital for your birth, it's invaluable. I had to be super diligent with DS1 with my determination to BF, and if I weren't so stubborn, I would have quit. I had EVERYTHING going against me, a baby who didn't want to nurse, who had a severe undiagnosed tongue tie, that FOUR doctors all refused to diagnosis or even suggest clipping, until my LC hooked me up with a ped who was willing to do it when baby was 6 wks old and I was ready to throw in the towel from the pain. I also had ductal thrush, I TRIED to take a BF class at the hospital while pregnant, I was the ONLY one signed up for 3 sesions in a row, all which were cancelled, because I was the ONLY one who was interested! I don't know why I didn't just demand that they give me a private session! It pisses me off now that I think about it. If it weren't for a LC worth her wt in gold and a ped who is probably one of the most BF-supportive in our area (both an accident on my part of finding these two, I got very lucky), I would have failed. Plus, both my mil and my mother were pushing formula and not supportive of BFing. It was an awful experience to not only have to struggle so much to be able to figure out how to BF, but also to deal with a completely LACK of support. I was lucky that when DS1 was a few months old, I introduced myself to another mom in our neighborhood who had a baby a month older. The two of us were the ONLY BF moms that we both knew, until we started attending our local LLL, which consisted of 5 members.

The only good thing that came out of this is that, b/c of my experience I'm now a LLL leader myself. However, I am so frustrated that even though we are available as a FREE service to the public, we are rarely utilized the way we should be and worse yet, the lack of knowledge and BF ignorance the HCP in our display just kills me. They need to start drilling BF education into HCPs at the nursing/med school/residency level if there is to be any change When it comes down to it, ppl say, "well, my doctor/nurse told me I HAD to give the baby formula, and they are the experts, so I listened to them," is our #1 problem. These moms don't even have a chance, and I don't blame them, b/c our society tells us that docs and nurse (and I'm an RN myself, so I'm not just ripping on HCP w/o knowing the other side of it) know the best, so listen to them, even if they don't know WTF they are talking about. I usually feel like docs/nurses are not our allies in BF promotion, but our enemies, b/c finding one who actually KNOWS a smidge of correct BF info in our area is so extremely difficult.

[sste]

Brittone I def. agree that our experiences are not representative . . . I know within my city BFing support varies greatly between hospitals.

Anyway, my hospital was always above average but in the three years between DS and DD I think they improved things and I would describe them as excellent. They have a policy of training most (all?) of the nurses on the maternity floor in lactation support and they have a lactation counselor. They have optional rooming in but as someone who used the nursery twice they did not supplement and were very insistent about waking me up frequently during the night (I am not an easy riser!!). They encourage rooming in and they are phasing out the formula samples (I think they just allowed the companies to give baby diaper bags but not formula samples).

The NICU was not so great but their mindset is different and they have so many other fish to fry. For whatever reason the NICU did not want to discharge DD until she had taken a formula-size serving versus the very small amounts of collustrum I was able to pump. We went around this issue for a day and it did not seem worth it to have a huge conflict over one serving. DH and I both thought springing DD from the NICU was our top goal! At least they asked and to be fair DD was previously on IV nutrition so it was a little different.

Overall, what I thought was exceptional is that the hospital policies became very oriented toward trying to ensure all moms left the hospital BFing. So, I had a complicated delivery, didn't see DD for three days, had blood transfusions myself and all the nurses were super positive and supportive that BFing would work . . . none of this you have violated the XIX Commandment of BFing by not nursing for 48 hours or because of the blood loss or whatever. In fact, they were bragging that the week before they had a mom code on the delivery table along with her baby and they resuscitated both of them and they left the hospital a week later BFing.

[brittone2]

I always HIGHLY recommend to mothers-to-be who want to BF, even those who failed with their first baby, but want to try to BF again with their subsequent babies, the importance of attending LLL mtgs. You find out so much info, are in the know about which docs are pro-BF, the best LCs, and are able to prepare yourself for what to expect at local hospital for your birth, it's invaluable.

This was very helpful to me the first time around. I was really worried about whether I'd be able to BF as some women w/ PCOS have supply issues. I ended up with overactive letdown and the total opposite of what I expected. On the bright side, my concern over being able to BF is what got me interested in attending a LLL meeting while pg. That was a huuuuuge help. I got a lot of tips, attended one meeting that dispelled a lot of the concerns about supply and addressed things you could do to encourage good supply, etc. and it was really helpful. If I didn't have the PCOS concerns I doubt i would have attended. I also had a network in place in advance if I needed anything...support, phone numbers, etc.

Our hospital BFing class was okay and was somewhat helpful.

Another thing that was hugely helpful was reading up on latch, how to determine if I really had a supply problem, how to address the most common issues, etc. before I had the baby. I read the Womanly Art of BFing and started reading Kellymom. Again, had I not had PCOS I probably wouldn't have gone that far, but I really, really wanted to BF and wanted to stack the deck in my favor. It is a lot harder to wade through books and know what to look for and what to do when you are already sleep deprived or in the throes of BFing issues. Having some ideas on how to solve the more common problems before we actually had a problem was helpful. I encourage women to consider doing that in advance. IMO it is easier to push back on a "need to supplement" type of doctor when you've read the info while clear headed, not sleep deprived, and not in the throes of panic.

eta: BFing went rather well for us, so I didn't really have to "test" the support all that much. However, some other things I can think of: our first ped was affiliated with a top notch children's hospital and we were living in the suburbs of a large city with lots of academic medical facilities, etc. At our first appt when DS1 was discharged, I got an eyebrow raised because the ped asked if my "milk was in yet" and I said well...no, not all the way. It was coming in, but DS1 was doing fine. She kinda gave me the wary eyebrow like it was totally out of whack that my milk wasn't fully in. Yeah um...it isn't an off/on switch. It was coming in, and DS1 was doing just fine weight wise. She also was terribly annoyed that we didn't have a paci to give him during her exam. I was letting him suck on my (clean knuckle) but she sighed and kind of rolled her eyes. It was off putting as a new mom...I was trying to follow the advice I had read and not offer artificial nipples but apparently I had the gall to make her job more difficult.

[hellokitty]

Another thing that was hugely helpful was reading up on latch, how to determine if I really had a supply problem, how to address the most common issues, etc. before I had the baby. I read the Womanly Art of BFing and started reading Kellymom. Again, had I not had PCOS I probably wouldn't have gone that far, but I really, really wanted to BF and wanted to stack the deck in my favor. It is a lot harder to wade through books and know what to look for and what to do when you aren't already sleep deprived or in the throes of BFing issues. Having some ideas on how to solve the more common problems before we actually had a problem was helpful. I encourage women to consider doing that in advance. IMO it is easier to push back on a "need to supplement" type of doctor when you've read the info while clear headed, not sleep deprived, and not in the throes of panic.

That is awesome that you did all that reading ahead of time and attended LLL. Our LLL didn't even exist when I had DS1, but I did start attending when he was 9 mo old and I was pg again and was freaked out about BFing while pg. ITA about educating yourself BEFORE having the baby, I have run into many women who say, "oh, I'll attend a mtg AFTER I have the baby." Guess what, many of these women, ever ended up coming to LLL, b/c they ended up formula feeding d/t BF issues, even though they had expressed interest in BFing while pg. It kills me, it's like we are there as a wonderful resource and just completely under-utilized.

I have a family member who basically blew me off about reading up on BFing and attending a LLL mtg while pg (she's a physician, and I can't help but feel as if she basically felt that as a doctor, she knew everything, so didn't need to further educate herself) before having a baby. She had the Womanly Art on her registry, so I got it for her, but I do not think she read it at all, or even referred to it after she had the baby. She basically knew NOTHING about BFing, to the point where she was freaking out that she did not have enough supply (apparently, all of her friends, who are also doctors, all told her that they ALL had supply issues... WTF?) and had already supplemented BEFORE her milk even came in, b/c she was convinced she had low supply! I had to explain to her that colostrum is not abundant in quantity. I honestly do not think she realized this, I think she knew about colostrum, but didn't realize that it's such a small amt, and that the amt of it isn't doesn't really matter in it doing what it is supposed to do. She did end up supplementing and had a LC who worked closely with her, but it took over 2.5 mo for her to wean off her baby off of supplements and she was a complete mess during that time. Like you said, by that point, you aren't going to be sitting down and doing reading on BFing, you'd too overwhelmed and exhausted, you just want to figure out a quick fix. I'm convinced that co-sleeping (she finally got desperate enough) was what really helped her to overcome the fear that she didn't have enough milk and it forced her to BF her son often enough to boost her supply, which probably had become low, b/c she introduced formula before the baby was even 48 hrs old. I had even told her the stats and that it's mostly women with PCOS (which she doesn't have), who have supply problems, but she was convinced that low supply was a common problem. I get super annoyed that so many ppl have blamed low supply as their reason for not BFing (even though it is rarely an actual low supply, but other issues, mostly being lead down the wrong path by HCPs who are eager to supplement and then it leads down the slippery slope), that ppl just assume that low supply is as common as the common cold. Ppl don't seem to realize that the low supply is usually SECONDARY to the introduction of formula.

[bisous]

One thing I did think was awesome during my hospital tour and another reason that I do think many of the "innovations" that I detest at our hospital are TRULY to helpful promote breastfeeding is that they have just a handful of handouts but one of them is all about the size of a newborn's stomach. They have a marble and show that the newborn only needs about a marble's sized amount of liquid to feel full. I think that is a good tactic to counter those who are truly concerned about the moments leading up to when milk comes in. I know many women who are concerned about their colostrum not being quite enough!

[fumofu]

I am one of the lucky ones. My hospital was pro-BF. LC's were available on weekdays and Saturday mornings. DH and I went to the BF class (for a fee) beforehand. And while it wasn't very helpful in terms of the mechanics of breastfeeding, the BF educator made a point to tell us to call the LC for a room visit, no matter how well BFing was going, even if it was just to confirm that it was done properly. I was having a lot of problems, so I called for an LC every day.

We were not given a pacifier until the nurse who took DS's hearing test had to give him one to subdue his crying during his test. We were also not offered formula.

I also really like how my hospital has a breastfeeding/new mom's support group that meets weekly. It's headed by a veteran LC and the BF educator from the class. DS is one now, and we still go to the group every once in a while. I like to go in there and check on DS's weight, especially when his weight plateau'ed.

I am very surprised by the statistics that only 30% hospitals encourage rooming in. That saddens me. I really enjoyed rooming in with DS. Gave me peace of mind that my little baby was sleeping next to me. Especially the first night when he passed out. Ahh, those were the days!