Newborn breastfeeding in the hospital. Photo courtesy of Daquella Manera

Sutter Davis Hospital in Davis, California

Stephanie Cassidy emailed me the following:

I just wanted to say that my experience at Sutter Davis Hospital in Davis, CA was great! They are pro breast feeding and fully support it. The nurses are encouraging and lactation consultants are available to support and educate you. The thing I liked was that if you chose not to breastfeed, use a pacifier, or supplement you have to sign a waiver. So no one is going to give your baby something you do not want them to have. They encourage breastfeeding on their website: “Breastfeeding allows you and your baby to emotionally bond in a special way that cannot be matched, because breastfeeding meets both the nutritional and nurturing needs.”

I love the use of a waiver! It emphasizes the importance of the decision not to breastfeed.

A Not-So-Good Experience

Kelly wrote to share her less-than-ideal interaction with a hospital lactation consultant:

I had my third daughter one year ago yesterday and I am still breastfeeding. I have now breastfed for a total of 5 1/2 years. I LOVED the hospital she was born at. The only bad experience I had was with the lactation consultant. When I got pregnant with my newest addition I was still nursing my almost 2 1/2 year old. I was slowly weaning her off but once I found out I was pregnant I went ahead and called it quits. I never really dried up completely. When I gave birth to my newest little one I had an emergency C-section (yuck) and I wasn’t able to nurse her until about 5 hours after she was born. They had to keep her in the nursery and as soon as I could feel my legs they let me go down to feed her, she latched on perfectly. I got her in the room that night and was able to feed her with no problem. The next afternoon I was already engorged. The lactation consultant came in and I was very open to her being there. I explained to her that this was my third daughter and I breastfed my oldest for two years and my second for 29 months and that my milk never dried up while I was pregnant. My husband hadn’t brought my pump up yet and that I was so engorged that I wanted the pump for a little relief from the pain, so that I wouldn’t get mastitis and so Chloe could eat more comfortably. She basically told me there was no way that my milk was already in and that I shouldn’t pump the milk out. So I then squirted the milk out across the room. I felt like she thought that I no idea what I was talking about. She basically shrugged off everything I said. At least that’s what I felt. Then she told me how I was holding the baby wrong. I was thinking in my head, You know she is making this very stressful. If I hadn’t been so comfortable with breastfeeding she would possibly be making me not to want to do it at all. Breastfeeding is overwhelming enough to have someone like that making you feel like an idiot. Someone else finally brought the pump to me and I did what I need to with no help from her and everything is still fine today. On a positive note, I was surprised to see the diaper bag for breastfeeding mothers. With my other two daughters there where only the formula bags. It’s nice to see that hospitals are more involved in helping mothers breastfeed. That they even have lactation consultants is wonderful I just happened to get someone that thought she knew everything. All I can say to that is everything isn’t written in black and white, there are other circumstances to what she thought was correct, mine was one of those. I’m not saying that every mother will need to pump like I did. I am now going to school to become a nurse and I will then do what is needed to become a lactation consultant.

Kelly, I laughed out loud at the image of you squirting your breast milk across the room to make a point for that lactation consultant! Good for you! Best wishes for your career training — I can tell that your experience will make you a compassionate and helpful LC!

Other Carnival Participants (Stay tuned as links are posted as they come in!)

The Milk Mama: Newborns, Nursing, and Hospital(ity)
Momma’s Angel: My Hospital Experience in Norway
Hobo Mama: Breastfeeding Support: A Tale of Two Hospitals
Whozat: The Nipple Intervention
The Motherwear Breastfeeding Blog: Had a Good or Bad Experience in the Hospital? Tell Them!
BreastfeedingMums: Top Tips for Breastfeeding Success
The Beautiful Letdown: Breastfeeding in the Hospital

Post from: Breastfeeding 1-2-3

Photo by TheTruthAbout...

As a reminder, here are the guidelines that will increase the chances a post will be selected for inclusion in the carnival:
– A well-written, grammatically correct post
– Thoughtful commentary directly on point for the carnival subject
– Overall quality of the rest of your blog and whether the general subject matter is something of interest to our readers (breastfeeding, parenting)

If your post is selected for inclusion, you will be asked on the day of the carnival to publish or re-publish your post with links back to each of the other participants in the carnival.

Post from: Breastfeeding 1-2-3

Today she talks about how breastfeeding success begins in the hospital:

Five Hospital Practices that Extend Your Duration of Breastfeeding

Photo by Vedrana Bosnjak

Your hospital experience — brief as it may be — can have a powerful impact on your long-term breastfeeding success. Making hospital changes in maternity care practices has been shown to significantly increase breastfeeding initiation and duration rates. The Baby-Friendly Hospital Initiative (BFHI) — launched in 1991– is a worldwide campaign to encourage hospitals and birthing centers to adopt maternity practices supportive of breastfeeding. (See www.babyfriendlyusa.org.) Hospitals that commit to improving their support for breastfeeding mothers by successfully implementing the BFHI’s Ten Steps to Successful Breastfeeding can apply for and receive the designation as a “Baby-Friendly Hospital.” While only 83 maternity facilities in the U.S. (among more than 3200 hospitals and birthing centers) have chosen to comply with all Ten Steps and be awarded “Baby-Friendly” status, a recent large study in Colorado1 has identified five of the BFHI supportive practices (dubbed the “Can Do 5!”) that have a significant impact on breastfeeding duration among mothers of healthy newborns. The following “Can Do 5!” successful maternity practices can help extend your duration of breastfeeding after you are discharged from the hospital:

1. Baby is breastfed in the first hour after birth. The AAP recommends that healthy infants be placed skin-to-skin with their mothers immediately after birth and remain with their mothers until the first feeding occurs. Immediate skin-to-skin contact not only eases your baby’s adaptation to the world, it allows the two of you to get to know one another, and promotes early breastfeeding. A baby who nurses well shortly after birth is more likely to continue breastfeeding effectively, and a successful early first breastfeeding experience promotes a mother’s confidence. Ask to have your baby placed tummy down on your bare chest immediately after delivery, and watch how her inborn reflexes help her achieve a successful early feeding. You may want to limit your visitors during this intimate bonding time.

2. Baby is fed only breast milk in the hospital. Many studies show that giving supplements to breastfed infants is linked with a shorter duration of breastfeeding. Supplemental milk should be offered only for a valid medical reason. When babies are supplemented with formula, they breastfeed less often, since formula takes longer to digest than breast milk. Infrequent breastfeeding may interfere with establishing an abundant milk supply. Furthermore, giving unnecessary supplements undermines a mother’s confidence in her ability to produce sufficient milk. Ordinarily, frequent, round-the-clock breastfeeding will provide all the milk your baby needs.

3. Baby stays in the same room with mother. By keeping your baby in your room throughout your hospital stay, you will learn to recognize her earliest feeding cues and be able to offer your breast whenever your baby is ready to nurse. Furthermore, studies show that babies are less stressed and do not cry as much when they are cared for in their mother’s room. Rooming-in is a great confidence builder. When you provide most of your baby’s care yourself in the hospital, you leave knowing that you will be able to meet your baby’s needs at home. To make the most of your rooming-in experience, ask your partner to help limit your visitors at the hospital and monitor their length of stay.

4. Baby does not use a pacifier in the hospital. Several studies have found an increased risk of early weaning when a pacifier is introduced to breastfed infants in the first weeks of life. During this sensitive time, all your baby’s sucking efforts should provide her with the milk she needs and stimulate your breasts to produce a generous milk supply. Sucking on an artificial nipple can interfere with learning to nurse, and frequent use of a pacifier may limit how often your baby breastfeeds. Once breastfeeding is going well and your baby is thriving, you can introduce a pacifier if you desire. To reduce the risk of SIDS, the AAP recommends that babies use a pacifier when falling asleep. Mothers of breastfed infants can wait about a month to offer a pacifier.

5. The hospital gives mother a phone number to call for breastfeeding help after hospital discharge. These days, most new mothers are discharged before your milk has come in and before your baby has become proficient at breastfeeding. Even when breastfeeding seems to be going well in the hospital, problems commonly arise in the early days at home. Knowing where to turn for help can allow you to overcome early breastfeeding glitches before you get discouraged. There’s no need to struggle on your own. All breastfeeding questions are important, and expert help is available. Ask your hospital nurse or lactation consultant who you can call for breastfeeding help after you go home.

Each of these five hospital practices was found to have a significant positive impact on breastfeeding duration. More importantly, breastfeeding continued longest among mothers who received all five supportive hospital practices. Nearly two-thirds of mothers who reported all five breastfeeding-friendly practices (versus half of mothers who did not) were still nursing their babies at four months after hospital discharge.

Clearly, what happens in the hospital in the first day or two after birth powerfully impacts a woman’s breastfeeding experience after discharge. Expectant moms can take heart in knowing that requesting five simple steps while you are in the hospital can boost your chances of long-term breastfeeding success.

Additional Hospital Practices That Promote Successful Breastfeeding

Other supportive breastfeeding practices that help lay the foundation for success include:

* Nurse as Often as Your Baby Gives Feeding Cues. Many new parents expect their baby to cry when she is hungry. But crying is the last sign of readiness to feed. Instead of waiting for your baby to cry, look for earlier, more subtle clues that she wants to nurse. Babies signal their readiness to feed by rapid eye movements, arousal from sleep, increased alertness, flexing their arms and legs, squirming, wrinkling the forehead, bringing a hand to their mouth, turning their head, or moving their mouth or tongue. One of more of these signs will be evident before your baby cries out loud.

* Nurse as Long as Your Baby Desires. In the past, new mothers often were advised to keep breastfeeding sessions brief until their milk came in. This dictum was based on the mistaken belief that sore nipples could be prevented by slowly building up an infant’s sucking time. Actually, the most important cause of sore nipples is improper infant latch-on, not lengthy breastfeeding sessions. If your newborn is latched on well, she should be allowed to nurse at least 15 minutes at each breast. Strictly limiting how long your baby nurses can prevent her from getting all the milk she needs and keep you from establishing an abundant milk supply.

* Forego Gift Packs Containing F*ormula. As a marketing strategy, infant-f*ormula companies routinely supply hospital nurseries with free f*ormula and giveaways for new mothers. However, some studies show a link between receiving a f*ormula gift-pack and a shorter duration of breastfeeding. To avoid an implied endorsement of f*ormula-feeding, some hospitals have stopped giving f*ormula-company gift packs to nursing mothers. If you receive a gift pack with f*ormula, make sure you understand when, and when not, to use it. Giving your baby f*ormula without a valid medical reason can undermine successful breastfeeding.

1 Erin Murray, Sue Ricketts, and Jennifer Dellaport. Hospital Practices that Increase Breastfeeding Duration: Results from a Population-Based Study. BIRTH 2007; 34 (3):202-211 (September)

©2009 Marianne Neifert, M.D., author of Great Expectations: The Essential Guide to Breastfeeding

For more information please visit http://www.dr-mom.com/

Post from: Breastfeeding 1-2-3

Photo by Anselm

One way would be to point to the scientific studies that back up the safety of home birth. I was so happy to see news of a study showing that home births are safer than hospital births for low risk pregnancies. Yes! Shout it from the rooftops! Do more studies! Spread the word!

Have you seen the movie? What are your thoughts? Have you heard word about when the book the sequel will be released?

P.S. My husband read this post and wants to say the following: “People who are planning a hospital birth can benefit from watching the movie too because it points out common mistakes that hospitals make such as pushing epidurals and other pain medications and unnecessary interventions such as pitocin. The movie can help women and their partners manage the care in the hospital and avoid common pitfalls in hospital births that taint the experience.” (I love that man — he reads my blog AND agrees with me!)

Post from: Breastfeeding 1-2-3

The average uncomplicated vaginal birth costs 68% less in a home than in a hospital, and births initiated in the home offer a lower combined rate of intrapartum and neonatal mortality and a lower incidence of cesarean delivery.

“The Cost-Effectiveness of Home Birth.” J Nurse Midwifery. 1999 Jan-Feb;44(1):30-5. Gee, what a novel concept — care that costs less but has a better outcome!

I did an informal survey of sources online to determine that the average hospital birth costs around $8,000 in the United States, depending on exactly where the mother lives. That does not include the additional costs of an epidural or cesarean section, nor does it include the prenatal care from a physician, which costs anywhere from $1,500 to $3,000. For the sake of discussion, let’s say the total cost of prenatal care and physician-assisted hospital birth is approximately $10,000. Compare that to my prenatal care and home birth with a midwife, which cost a total of $4,300. That’s $5,700 — nearly 60% — less! And I was far happier with my home birth experience than my two hospital birth experiences.

Guess how much of that $4,300 my insurance company covered? $2,947.08. Compare that to what the insurance company theoretically would have paid for physician-assisted hospital birth: $8,000! By that token, the insurance company should have been paying ME to have a home birth. My choice of home birth saved the company over $5,000. And the irony is, I had to fight to get the company to cover a home birth at all. Because there were in-network midwives who could attend births at a hospital, the insurance company initially denied my request for a homebirth. I had to have my midwife write a letter to the company stating that I had a “medical need” for a homebirth (basically we argued that I had had such bad hospital experiences — with a fourth-degree tear and a failed epidural — that for my mental health I needed a home birth!) Luckily, the company agreed to pay, although I had to pay 25% co-insurance, rather than 20% co-insurance for an in-network provider. In the end, I wound up paying about $450 less out of pocket for a homebirth, and had a safe and satisfying birth.

Post from: Breastfeeding 1-2-3

“So we do all the pre-natal classes like the good parents we are supposed to be, and it started from the very first one: breast is best, don’t use formula, everyone can breastfeed and if you don’t it’s pretty close to child abuse.

So my son was born. Guess what, despite any jokes I made to my wife about her now officially being a milking cow, she wasn’t very good at breast feeding. She delivered via cesarean section so she was in hospital a full week, during this time she struggled with the breast feeding….turns out she didn’t make a good milking cow after all, but I make that note because we had 7 days in a private hospital with lots of one on one time with midwifes about how to get breast feeding right.

Anyhow so we get home thinking, ok, it’s hard but they’ve spent all this time with us, surely this will work out. Mind you, at this stage, although we’d both raised switching to formula up, we were told basically it was tantamount to child abuse, and were told it’s not an option. So things start getting bad, our son clearly isn’t putting on weight, and he starts to get quite gaunt. At about 10 days, as much as he was still with us, his skin had started to turn blue, and his limbs were limp. I eventually convince my wife to take him to emergency at 10pm at night. After waiting 3 hours to see a doctor were told he’s fine (and the post-natal specialist wasn’t available till the next day). We take him home, at this stage I’m in tears, you could see life was dripping away from him. The next day the specialist calls us and we rush off to hospital, where he is admitted immediately into emergency and he’s put on a drip. So then we go through the bs again: my wife mustn’t be breast feeding properly, it must be her fault, she should have stayed longer than the 7 days in hospital so she could get the breastfeeding right, etc, etc…this goes on for 2 days with them treating her like she was a child. Still no change. If it were not for the drip and the little breast milk he was managing to get, he’d be dead.

Then if there is a god, he decided to be kind, because a new nurse came along. My wife explained what had been going on (by this stage I actually couldn’t be at the hospital because I was about 2 steps away from wanting to kill someone, and my anger wasn’t helping given by this stage my wife is now nearly constantly in tears). God bless this nurse so much, she actually turned around and said that as much as breast is best, it’s also not for everyone and despite everything we’d been told, some mothers just can’t produce adequate amounts of breast milk! My son started on formula straight away, and both of them checked out of hospital within 24 hours. You could literally see life come back into him within his first couple of bottles of formula.

Four years later and he’s in the top 0.1% statistically for his age in terms of height, and he’s a strong, smart and healthy boy…and he grew up drinking formula (I might add though, we always bought the best and most expensive available…which had lots of added stuff I can’t remember but certainly sounded good). Sure, like any parents we’ve had a few health hiccups along the way, we had some hearing issues and he had plugs (which have since fallen out) and more recently we had his tonsils and adenoids removed (but that’s hereditary, I suffered from tonsillitis as a kid as well), but certainly zero health issues relating to him taking formula as a baby.

Moral of the story. Breast Milk is great, but not everyone can do it, and your child can and will still grow up strong and healthy on formula…oh yeh, and it’s not child abuse!”

How does this story make you feel? Aside from lamenting what this family had to go through, it makes me wonder whether there was ever any evaluation of what went wrong – was there a medical reason for a supply issue? Did they try any galactagogues (medicinal herbs or prescription medications)? Did the baby have tongue-tie? Didn’t the hospital monitor the baby’s weight loss and the baby’s output of wet and dirty diapers? There has to be more to the story. This family worked so hard to breastfeed and it would be nice to know what went wrong.

And now back to our regular programming: if you’d like to contribute your positive, touching, humorous or otherwise inspiring breastfeeding story, click here.

Post from: Breastfeeding 1-2-3