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Scary 1975 Breastfeeding Policy

 This story is about

VINTAGE Breastfeeding information

NOT Current Information

 

1979 Father wearing gown and mask to attend feeding

1979 Father wearing gown and mask to attend feeding

 

I have attempted to give an overview of our Maternity Ward as it was when I started to work there. I mentioned how “Once delivered, the baby went to the nursery and became the immediate property of the nurses, only to be seen from a window and allowed to be with the mother at token intervals. The poor little baby was often keep without food/ only water for the first 12 hrs. (Breastfeeding was something only the hippies did.)”

The thought process, as I was instucted even in nursing school, was that most newborns needed to rest after birth, and didn’t require food for 4 to 24 hours. They felt that postponing food would allow time for the mucous to be cleared from the throat and the baby would be allowed ample rest after the exertion of birth and all that handling by doctors and nurses as they provided the necessary care.  My nursing school textbook (Marlow, Pediatric Nursing, 4th ed. 1973) even goes so far as to say that this lag time would allow the mother sufficient rest before giving her infant the breast because….. this first offering is…… difficult. ( Oh… You’d better rest up, dear…)

Another thought process that unfortunately is still around today was that the nurse should not encourage the mother to breastfeed over bottle feed…. least she arouse or cause any maternal guilt feelings. My old textbooks all did list some basic benefits of breastfeeding and proclaimed this as the ideal food. Ie: easier to digest, natural diet for the newborn, convenience, availability AND the provision of identified and unidentified substances which may be protective.  The nurse should provide the information to the mother but not encourage her. They felt prepared formulas (Evaporated or whole milk formulas with added carbohydrates) OR the newer commercially prepared formulas were an “equal” substitute. We did have a full formula preparation room in the nursery with a refridgerator, range, sterilizing equipment etc. When I started, the Similac and Enfamil reps had already just hooked up the hospital with the marvelous free individual bottles of their products which were piled high on top of the former work area for formula prep. I don’t know when they actually stopped making it themselves.

Our 1975 Hospital Policy & Procedure  *

  • We start with NPO (nothing by mouth) for 12 hours.  Then feed one feeding of sterile water to confirm the infants ability to swallow.
  • If the baby has excessive mucus secretions, he should be fed 5% glucose water (G/W)  every 4 hours for the next 12 hrs before his first breast feeding.
  • The father may be present for feedings provided he is properly gowned, wearing hat and mask and has scrubbed hands.
  • For the first breast feeding,  teach the mother to cleanse her nipples with the cotton ball (soaked in a Benzalkonium chloride solotion) and teach proper latch-on techniques where-by the mother should cradle the baby near her breast, stroke his cheek so he turns and assist him to “grip” the nipple when he opens his mouth. Place the baby at both breasts for no longer than 2-3 min each side to avoid sore nipples. Feed the baby 5% G/W if he is still hungry when removed from the nipple.
  • Feedings should be every 4  hours, the mother should cleanse her nipples as above before each feeding.
  • If the baby should cry within 3 hrs of his last feed, he may be offered more 5% G/W.
  • The time spent at breasts should gradually increase to 3-5 min each feed for the first 2 days then continue to increase up to 10 min each side by the 4th day. When her milk begins to flow and the baby will actually be receiving milk.
  • Instruct the mother to pay close attention to which side she began and ended each feeding so she can alternate which side to begin the next feed.
  • Babies will usually require 6 feedings a day for the first several weeks.
  • Once lactation is established, she should be instructed to limit a feeding to 20 – 30 minutes total per feeding. The baby gets 90% of his milk in the first 5 minutes, any additional time is for his enjoyment. Some babies may “cling” to the breast after feeding and may need to be removed. Teach the mother to use her finger gently in the babies mouth to break the suction and remove him.
  • Babies may be taken to the mother for a breast feeding “on-demand” if so written on the chart by the physician

 

(*This is a combination of information I have from a scanty old policy,
what I remember
and interviewing some older former colleages about what we all actually did.)

If we were unable to get a baby to latch on, we had one tool available to us at the time. We had a hard rubber nipple on a glass base shield that we placed over the breast/nipple and we used the same timing of feeds.  We would only help a mother pump her breasts if she was engorged. The only tool we had to assist her with this was a bicycle horn hand pump. 

There were some pediatricians who were starting to be flexible and improve the approach to breastfeeding in a more natural sense, encouraging initiation earlier and more frequent feeds “on-demand”. There were more professionals opposed to that train of thought and continued their same practices.  When the women started coming in and requesting a better approach to feeding…. they were sabotaged by the nurses who then fed their infants “white water” while in the nursery so these babies would sleep until the next designated feeding time. 

This was 34-35 years ago and I still work with nurses today who have some of these thought processes behind what they do. Many of the older physicians, if taught anything in Med school, were taught similar management protocols. It is such a difficult retraining, re-educating process that some of us face. 

Just last week.. a brand new RN/BSN asked me how the newborn was supposed to survive on colostrum alone?

She was blank faced dead serious. 
I started my answer with…”You are not the first nurse to ask me that very same question and it’s a good question. Here’s why etc……..”
I hope I answered her well enough so she can someday teach the next one and the next…..
We really need much better Lactation Education 
for our Doctors and Nurses.
They should not be so uneducated or ill-equiped 
to properly care for and advise the mother’s in their care!
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29 Comments Post a comment
  1. You always have great stories. This is sad and funny at the same time. The worst part is I have worked at hospitals and with nurses in the 2000’s that believe you should give an infant some form of water to see if he can swallow. Crazy …. I know.

    GREAT way to start your answer to the new nurse. So supportive. We need more experienced nurses like you!

    May 5, 2009
    • Birth_Lactation #

      Thanks Nicole, I agree it is sad and funny at the same time…. I have
      developed this knack for talking to people without confrontation. I ask the
      doctor “help me understand…or teach me… I thought we used 100mg per kg
      per dose when we suspected this…etc…” or “Help me understand the latest
      protocol…..etc…” Many times they stop, think, and actually change what
      they were going to do. Sometimes not. I hope I am always patient as I was
      with this young nurse but I get sometimes get tired of developing
      presentation after presentation only to have people fall back into their old
      habitual approach. I get defeated but then pick it up again later. It’s who
      I am. Thanks for reading and commenting! Happy International Midwife Day!
      Melissa

      May 5, 2009
  2. Joy #

    That’s just so strange to think that was once the norm. Did it seem to you, in retrospect, that babies were underestimated in that time?

    May 5, 2009
    • Birth_Lactation #

      Oh Yes …ABSOLUTELY underestimated. Back then, babies were thought of as
      …well …just babies.. without any real Health-Care needs, requiring just
      basic care unless there was an obvious anomaly. We didn’t do vital signs or
      hardly make much of a medical record for them. I feel like I was
      instrumental in making some changes back then and more as time went on. and
      I got more involved. I FINALLY got a decent Evidence-Based Breastfeeding
      Policy in 1989. It took a lot of work and re-education. Thanks for reading.
      🙂

      May 5, 2009
  3. What I find difficult is that almost every new mom thinks that because she has “no milk” for the first few days, that the baby is going to be hungry and/or starve if we don’t give the baby a bottle of formula. I try, over and over again, to explain colostrum to them. It doesn’t always sink in. Some moms (and family members) insist that because they don’t see any milk, that the baby is getting nothing at all.

    **sigh** Education, education, education.

    May 6, 2009
  4. I’m very glad that things have improved. But I’m also sad that there’s still so much room for improvement. I’m a LLL Leader, and we occasionally have young nurses (with no children of their own) attend our meetings. They explain how difficult and overwhelming it is to find themselves teaching women to breastfeed, when they’ve never done it themselves and have only minimal information. I agree that much better lactation education is long overdue.

    May 7, 2009
  5. I breastfed my first two children–the eldest, especially–in spite of my post-partum nurses. Bobbie had to be in the observation nursery for 24 hours after she was born because of the mag sulfate I was on. Even though they were instructed to bring her to me any time she showed signs of hunger, I had to call them to demand her every three hours, and they gave her a bottle of formula. Just one. It almost ruined things. This baby–who had latched on so perfectly during her first feeding the nurses were amazed–suddenly couldn’t latch. My nurse told me it was because my breasts were too big; I was hurting her chin. Thank GOD I had read The Baby Book & was a regular reader of Mothering as well. Every feeding in the hospital ended with both of us in tears, but it got much better once I got home.

    My second daughter was a near term preemie. She was quite literally smaller than one of my breasts. I learned quite by accident a couple of years ago that all the advice for getting normal newborns to nurse is the exact opposite of what you are supposed to do with a near-term preemie. My (then) husband and I stumbled upon it by accident. All my nurse could ever tell me was that I had to “make” her nurse longer.

    This post gives me insight into the breastfeeding advice my aunt gave me after I had my first. She just told me what she’d been told. It’s amazing that she nursed at all in the ’70s, but she said her doctor made all his patients breastfeed. Of course, she also said she started all her kids on solids at two months old “Because they were just hungry.” Well, with nursing 2 minutes every 4 hours, I’m sure they were!

    May 8, 2009
    • Birth_Lactation #

      Thanks for your comment and sharing your story Sabra! It’s nice to meet you in the blog world. I am happy for you that you were able to improve your situation at home with your first baby. Sounds like you were unfortunately dealing with a lot of uneducated nurses for your births. how long ago was your near-term preemie? There is a lot of education going on now about this special group of newborns. Thanks again, Melissa

      May 8, 2009
      • Melissa, my preemie was born in 2004. So, five years ago. She was three when I learned about how I should have fed her on the blog of an NICU nurse. Like I said, thankfully we stumbled across how to do it, but had I the knowledge back then, it would have saved us all much stress. I think she will wind up as my longest nurser (we practice child-led weaning), in fact.

        I only recently gave a presentation on prematurity and was sure to mention the issues with nursing near-term infants. Lots of nursing students in that class, so hopefully they will remember it in their work.

        It was largely the interaction with nurses post-childbirth that led to my desire to become a nurse myself; I’ll get there in the next couple of years & hope to work in OB.

        May 8, 2009
      • Birth_Lactation #

        Hi Sabra- I am meeting more and more nursing students who have gone into nursing after exposure to the field with their births. Welcome aboard! I am very much into Neonatalology now. I am a Neonatal Resuscitation Instructor, and seeking to be a S.T.A.B.L.E. Instructor. My co-workers refer to me as “Linus”… their security blanket when attending births. I do love to teach. I applaud you for doing a presentation on prematurity…esp the near-term preemie while in Nursing School. That’s a big important project! Am I right… you are still a student? The time- line seems about right, cuz I started to see more in the literature about these special babies about 2 – 3 years ago.Such a misunderstood little baby in the Nursery world. Everyone wants and expects them to behave like their either older or younger. We recently built a NICU and I’m excited to see how things are going to get going. I will miss all the births if I really get into it but…. so be it.

        May 8, 2009
  6. Having been born in 1978 in a hospital, I imagine that this is the “system” I was put through as a baby. It makes me sick to my stomach to read about it.

    I remember my grandmother always telling the story about how they started feeding me rice cereal at 2 days old because I cried in hunger and the doc said “that baby is starving! feed it!”

    Cereal. To a newborn. Just, wow. But after reading these (I’ll refer to them as “horror”) stories about breastfeeding in the 70’s – it paints an interesting picture of the misinformation that existed. And I don’t think we’re even that much better off today.

    May 8, 2009
  7. Reading this made my little baby heart sink for itself. I was born in 1974 and my mom didn’t breastfeed. I imagine myself lying there in the nursery, starving to be held, starving for food, and getting fed glucose-water and formula. Good grief! I sure am glad those days are over.

    May 11, 2009
  8. Kinda makes you wonder what is in the textbook nowadays that will be found to be bogus later on.

    Only the Hippies breastfeed? That’s crazy. Why did they think breasts made milk if not to feed the baby?!?

    May 13, 2009
    • Birth_Lactation #

      Thanks for reading and thanks for your comment! I have researched some historical data for you to help you understand the times better. “By 1971, breastfeeding
      had reached an all-time
      low in the United States. Only
      24% of mothers initiated breastfeeding—
      that is, only 24%
      breastfed at least once before
      hospital discharge…. Not until
      later in the 1970s did the feminist-
      inspired women’s health reform
      movement rekindle interest
      in breastfeeding. {those are the hippies I was talking about} One young
      mother, caught up in the social
      activism of the 1970s, recalled
      how the politics and communalism
      of the time heralded new infant
      care practices. Her daughter
      “never drank out of a bottle. . . .
      When we needed a baby sitter,
      there were always other nursing
      moms in the neighborhood willing
      to take her. We all nursed
      each other’s babies. In fact, it
      seemed that every woman I
      knew was nursing.”
      Yet the breastfeeding initiation
      rate has not seen the steady increase
      that this woman and her cohorts
      might have predicted in the
      1970s.” Taken directly from this article… http://tinyurl.com/qve7oa in the American Journal of Public health, December 2003..
      This is sadly what I lived through.

      May 14, 2009
    • StorkStories #

      Thanks Michelle! I checked your website because I was drawn to the URL even though I am CLUELESS as to what it means! Your family is beautiful! Your photography brillant! I have 3 sisters and 1 brother. We are tremendously close (even still all in our 50’s) thanks to my mother. Your family is beautiful! I love the names… LOVE THEM! I too am from Irish (also English & Russian) background. We chose names with some Irish or English background..David, Corey and Caitlin. All adults now. Great that your family were beating the “odds” and standing by you too breastfeed. The loss of extended generations of family experience and support is the main reason society had stopped viewing breastfeeding as the norm.
      Also– My grandson was born on July 20, 2008! Cool! Stop by again. I try to rotate some old stories with current stories. Whatever I feel like. –Thanks for stopping by.
      Melissa

      September 12, 2009
  9. Wow, just wow. After reading that I feel so very privileged that my mother (who had me in 1981) and my mother-in-law (who had my husband in 1972) both breastfed. That breastfeeding was never even a question for me — I was encouraged by both of them to breastfeed exclusively and for as long as my baby wanted. I know it was a fight for them, my grandmother tried to sabotage my mom’s breastfeeding and my mother-in-law’s doctor was always pushing her to start solids early, and I am so grateful that they fought that fight for me. I should go thank them.

    September 12, 2009
  10. brianne #

    *sniff*
    this really makes me want to hug my mom! first off, you resemble her so much in that photo! same hair, same glasses, same excited look i’ve seen in old photos of my mom. she breastfed both her babies ( i was born in ’79 and my brother in ’82 ) and i never thought to ask her if she had any support, or if it was hard for her. i think i will now.

    funny enough, when i had my son almost ten(!) years ago now, i never even thought about bottle feeding, and my kiddo and i had a two year long happy and nearly problem free nursing relationship. i’m sure i have my mom to thank for her relaxed attitude rubbing off on me, even though not all of the family had the same attitude. (a stepmother, for one, who thought it was, get this… “unnatural”!)

    aside from the trip down memory lane, the content of this post has reminded me of something. brb

    September 20, 2009
    • brianne #

      ok, lets see. here it is. i couldn’t resist a yard sale find of a 1940s baby care book, from the writers of better homes and gardens no less. here are a few infant feeding “what to expect”s from the 40’s:

      ~infant weight loss of 1/2 pound in first 3-4 days, “As much as a pound may not be cause for alarm.”
      ~nipple washing with boric acid solution before and after each feeding
      ~baby first to breast 6-8 hours after delivery.
      ~baby to breast 4 times in the next 24 hours, for “five to six, maybe ten” minutes
      ~babies weighing >7lbs fed every 4 hours
      ~babies weighing <7lbs fed every 3 hours
      ~no supplementary feedings in the first few days "for they spoil Baby for working at the breast"
      ~"Continue whichever schedule your baby was on at the hospital."
      ~feeding between 10pm and 6am eliminated by 7 weeks
      ~introduction of food in 3rd or 4th month

      interesting, no?
      there are also numerous home made formula recipes, all of which contain "Karo sirup", "Dextri-maltose", boiled water and your choice of either fresh boiled milk or "irradiated evaporated milk". how did babies live on this? one formula calls for adding lactic acid so you don't need to refrigerate it.

      what fascinates me the most, is found in the back of the book, where there are spaces to write information about your own baby. it's like a time capsule. this particular baby was born on April 5, 1947 at 3:32pm. he was first put to his mother's breast at 10 pm, and as he weighed 7lb 3oz the dr. prescribed a 4 hour feeding schedule. his mother marked no difficulties in nursing at the time. mom and baby left the hospital on the 10th with baby weighing 7lb 1/2 oz. by the 15th she writes "Found breastfeeding unsatisfactory". his first formula was evaporated milk, dextro-maltose, and water. cereal was stared at 4 weeks.

      i realize that this sort of went off on a tangent, but i just found this fascinating and relevant to your post.

      thank you so much for being a voice of reason and a vehicle for change. can we clone you and hand you out? 😉

      ~brianne

      September 20, 2009
      • StorkStories #

        Thank YOU so much for my trip down memory lane!. The unit where I started in 1974 had been re-built in 1951 with a collection of some of the nurses – still there from that time! I think I have written in here or the other “1970’s Maternity Ward” post about a kitchen where the formula was made … by the nurses. They had some recipe concoction! I came there after the prepackaged formula was available so I didn’t see the kitchen in use other than storage. The philosophies of many nurses and doctors remained the same, however…. at least not much had changed. We had a basin of some pink solution and cotton balls in the nursery that we gave to the mom’s to wash off their nipples!!! Horrors!!
        Thanks for all the king things you’ve said! I keep pluggin away. I wish I had the energy of a lot these great bloggers to post something regularly. After I work on work and home projects, It’s usually rest time for me. LOL. Right now I am working on a post about my experiences with breast pumping from the 70’s to 90’s to coincide with a guest post over at another website. Thanks for stopping in. I’d LOVE to know if this book has any old pumping/expressing info. I want to head to eBay now and find a book!

        September 20, 2009
  11. Cindy #

    I nursed all three of my children right after birth-oldest one born in 1975. I nursed my oldest for 6 weeks, second and third for 6 monthys. There were no supplements fed-including sugar water, and formula was not pushed. I was encouraged to nurse. There were no gowns, face masks needed by anyone during nursing. I did not clean my nipples other than to wipe the stray milk. I stayed in the hospital for 3 days with each of the two oldest, and 4 days with youngest due to sterilization. There were no problems that I know of by anyone because I nursed. I nursed on demand.

    March 24, 2010
  12. Cecelia #

    I had a friend with a 7-week-preterm baby who hadn’t nursed her first. The neonatologists convinced her that the baby would “never tolerate” breastmilk because it aggravated his reflux. This, after giving him first pumped milk thickened with rice cereal, then formua with cereal because the bm/rc combo was ‘too lumpy’. She didn’t seem 100% onboard with the idea, but “the doctors know best”. I cried for her.

    July 19, 2010
    • StorkStories #

      Sad– In our new unit, the neonatologists have proclaimed we ARE a breastfeeding/breastmilk unit. All mothers will be encouraged to provide their colostrum/milk for their sick or preterm infant regardless of their ultimate feeding choices because it is considered medicine for their newborn. We will OF COURSE support a mother’s decision not to provide her milk and there may be health circumstances which don’t lend themselves to this philosophy…. However, we feel that ALL mother’s deserve to know the importance of their milk in the health of their child before making a decision.

      July 19, 2010
  13. Rania #

    I have been reading a very interesting book entitled FREE YOUR TRUE SELF 1 by Annie Marquier. In it there are many chapters that explain some of the fears and obsessive behaviours we have in stuffing ourselves and never feeling satisfied originating from the way we were starved as babies on these wards.

    October 11, 2011

Trackbacks & Pingbacks

  1. nursing-world.com » Scary 1975 Breastfeeding Policy « Stork Stories… Birth & Breastfeeding
  2. Breastfeeding, Bottle Feeding and Somewhere In-between « Stork Stories… Birth & Breastfeeding
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  5. Repost~ The Guilt trip~ Breastfeeding, Bottle-Feeding and…. Somewhere In-between…. Why the Guilt? « Stork Stories… Birth & Breastfeeding
  6. Little Old Men… & Nursing in Public (Back by “PUBLIC” Demand) « Stork Stories… Birth & Breastfeeding

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