The Latch
Over the years, I’ve tried to have one interesting article in our newsletter for those working with breastfeeding mothers and babies. Then, I thought, why not write an entire newsletter just for YOU! Please let me know if you’d like a specific topic to be covered.
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Did you know that the BFHI IS 25?
The “Baby Friendly” term is spreading through our local hospitals like a virus! There are three hospitals in Philadelphia that have received the Baby Friendly status! Congratulations to Pennsylvania, HUP, and Jefferson. This is no easy task.
What most people don’t know is that the Baby Friendly Hospital Initiative (BFHI) was developed in 1991. Many healthcare professionals just started hearing about the BFHI recently, but it’s 25 years old!
Currently there are only 396 hospitals in the US that are designated Baby Friendly. There has been some negative publicity about it. Some feel that mothers are being bullied into breastfeeding, but that is not the intention of this initiative.
The true goals are to be sure that a mother is making an informed choice about feeding and to give her and her baby the best start when it comes to bonding with her child. Basically, if a mother states she plans to formula feed, it is the healthcare providers duty to be sure that was an informed choice. They are to educate mom on the benefits of breastfeeding. Once she receives the information, it is her choice on how she wants to feed her baby. It’s as simple as that – an informed choice.
If a mother plans to breastfeed, the BFHI’s 10 steps are put in place to help a mother be successful! Skin to skin contact, keeping your baby with you, and offering feedings when the baby asks are really not very outlandish ideas. Let’s take a look at some of the fears we’ve heard about.
1. “I can’t believe they won’t take my baby to a nursery so I can sleep!” Parenting starts at birth, not when parents get home from the hospital. Nurses are healthcare professionals trained to monitor mom’s health and the health of the baby. They are not babysitters. They are there to help you if questions arise while MOM takes care of HER baby. Is the mother going to be tired? The answer is YES! Obviously there are special circumstances such as having a C-section patient who is vomiting or is is heavily medicated, we understand that your patient isn’t in the best shape to care for your baby, so guess what? We’ll help!
2. “I heard they don’t give out pacifiers! That’s just crazy.” I say, bring your own pacifier if you’re so worried about it. If a mother is breastfeeding, the research shows that use of a pacifier in the first few weeks can increase problems. So… sorry, we are just trying to be sure babies latches well and mom’s nipples don’t hurt! If moms want to take that risk after they’ve been given the information, by all means, they can use a pacifier, they just have to add that to the list of things to bring to the hospital when you’re having a baby.
3. “I heard the nurses will refuse to give you formula if you ask for it.” Ummm, no. If a patient wants to breastfeed, we want them to be successful. Giving supplements in the early days can screw up latch and milk supply. Wow, we’re really heartless! If mom asks for formula, the nurse should try to trouble shoot to see why she’s having difficulty and try to determine why she needs it. If the nurse educates mom and mom still wants formula, she can have it!
So, bottom line, it’s all about informed choices and helping mothers reach their feeding goals no matter what they are.
Direct Breastfeeding in the NICU
Over the years, the NICU has always been an area where breastmilk is encouraged.Even mothers who weren’t planning to breastfeed are encouraged to pump. Why? Because of the many health benefits from the milk to preemies. But, are mothers getting the support they need when it comes to breastFEEDING?
Being able to latch the baby and feed directly from the breast will increase the likelihood that this mother will be able to provide her milk much longer. Let’s work hard to get these babies to the breast successfully before they head home!
Here’s some research to support this!
Engorgement… What do we really know?
Not a whole heck of a lot! You would think there would be some quality evidence on what to do with this common problem. I think I’ve heard all of them… heat, cold, massage, cabbage leaves, and more! How frustrating for a woman whose breasts are hot and hard as a rock and may be having trouble getting her baby latched! This Systematic Review shows us that a lot of studies were poorly done, had a high risk of bias, was funded by commercial entity, and other issues. Their results: “More robust research is urgently needed on the treatment of breast engorgement”. Is anyone up for it? The BRC can gather you PLENTY of participants!
I’ve giveth and taketh away!
What am I talking about? Nipple shields. I’ve given nipple shields to help babies latch and get milk and I’ve worked with mom’s to be able to stop using it. Bottom line, I’ve found it’s a great temporary tool if used appropriately. If a nipple shield takes a baby from not being able to latch and get milk to being able to latch and get milk directly from the breast, then what’s the problem? Well, there are a lot of misconceptions about the use of them. Mom’s hear it from the internet, HCPs, and more. The BRC is conducting a comparative study. We’re looking at women who are using a nipple shield vs. those who don’t when they’re dealing with nipple related problems. We plan to look at infant weight gain and maternal satisfaction. We’ve just started and we have 8 participants. We can’t wait to share the results!!!
What healthcare practitioners need breastfeeding education?
All of them!
Too often we concentrate on OB offices, Pediatric offices, and maternity floors when educating healthcare professionals about breastfeeding. But here at the BRC, we see the need to educate ANY and ALL healthcare professionals because unless your specialty is geriatrics, you will probably meet up with a breastfeeding mother at some point in your career.
The BRC keeps a “What the heck?” file. This allows our IBCLCs to vent a little after a frustrating consult where mom received very poor information.
From the WTH files…
Mom goes to the dermatologist for an allergic reaction. He says to take Zyrtec. She asks, “Is that OK to take while breastfeeding?” He says, “You’ll need to pump and dump for one month after taking it.”
Zyrtec is rated an L2 – No data, but probably compatible. There was no reason for this mother to pump and dump for an entire month. This was an exclusively breastfeeding mother. What was she supposed to do? She would have to switch to formula, pump 8 times a day, throw her milk out, then hope to get her baby back to the breast. Sound fair? It actually sounds like malpractice to me!
Thank you for choosing the BRC for all your breastfeeding needs. If there is anything else our organization can offer, please let me know!
Sincerely,
Colette M. Acker, IBCLC
Executive Director
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