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Overheard NICU Nurse “I Don’t DO Breastfeeding”

Sad but true…

I just overheard a comment from a potential new experienced NICU nurse (we open in July!) where she actually said .. out loud .. during her interview to the many interviewers and our manager (who happens to be an IBCLC) …….

“I don’t DO Breastfeeding”

What. The. Hell. Does. That. Mean?

So I thought… perhaps this young girl is just grossly uneducated. Perhaps she is so inundated with the detailed scientific absolutes of NICU management that she was only making comments related to direct breastfeeding. Surely she can’t be talking about actually thinking breastfeeding isn’t the best care for her small vulnerable patients!!

I’m afraid I may be wrong…

I’m afraid she may get hired……

Well– that’s OK… I’ll work to gently re-educate her about breastfeeding while she helps me learn NICU care!

I was wondering how to approach a post about this when I was notified by Melodie (@bfmom) encouraging feedback from her latest post on “Breastfeeding Moms Unite” blog entitled  Do Nurses Learn about Breastfeeding in Nursing School? a guest article by Jennifer Johnson who writes about Nurse Practitioner Schools.

Here was my comment on that post:

Sad but true…
I- of course- had my training a thousand years ago and there was only about a 30 min section of one class covering mostly anatomy & physiology of lactation…. not much on management of breastfeeding. That may have been it. I have no recollection of really helping any mom during my OB rotation in school. The nurses owned the babies back then and they stayed in the nursery most of the time!
My experience at 3 different hospitals from 1974 thru 1981 before I intensely studied lactation has been that a prevailing approach or “policy” was followed by all duty nurses “just because” or “because the doctor wants his moms to follow these rules”.
There was no current research or evidence to back anything up. One nurse then taught the next new nurse this incorrect, outdated information and so on. This practice still exists in many areas and unfortunately, they don’t know or realize they are wrong. The mothers were then given very little if any instruction.. mostly incorrect.  Dated textbooks were the only resources.
Now things are much better in many areas. Lactation education is just starting to be recognized as an important piece for nursing and medical schools. The true recognized lactation experts are IBCLC’s. Those other professionals who have been  formally educated in lactation, and remain current, can provide sound effective management advice. LLLL’s are awesome and also have some good educational background to become leaders.
Nurses today who work with mother’s and babies should and must have sound lactation management education.
Everybody should do their part and write letters to the editor of their paper/ or their hospital’s board to ask for this. JCAHO is now measuring exclusive breastfeeding as a perinatal core measure. This has become a catalyst for change for many facilities. It is for ours. We were given a presentation on this yesterday.
I do what I can. I have annual educational competencies usually coinciding with WBW. I also now have 3 nursing schools which come thru our department who utilize my  PowerPoint Presentations as an education requirement in their curriculum! Good for them !! 

We have so much to do to help spread the word about the importance of current evidence-based lactation education for the professionals of our nation.  Our mother’s and babies depend on us.  Don’t they??? Shouldn’t they be able to??

We need to get it right!

13 Comments Post a comment
  1. The snarky reply to that nurse in my head right now: “I don’t DO nurses that don’t DO breastfeeding!” I totally heart you in a big way Melissa!

    May 13, 2010
    • StorkStories #

      I heart you back!

      May 13, 2010
  2. Based on my experience in the NICU with my own premature daughter, there is not a lot of support for breastfeeding there. The goal is just to get the babies to eat. WHAT they eat seemed to be much less important than overall weight gain. It’s very sad for me, because a lot of the initiatives like Baby Friendly target healthy full-term infants only, and they leave the vulnerable preemies who really need mother’s milk behind.

    May 13, 2010
    • StorkStories #

      Your right, it does seem that way… although not familiar with the exact plans, WBW is going to revisit the BFHI this year. I will make sure a NICU version is brought into the theme. There are many BabyFriendly places that have policies for NICU’s/ I think there is gap between actual practice and the policy in many places.

      May 13, 2010
  3. Karen #

    You want some irony? In about 8 cumulative years of breastfeeding my babies, only twice have I been asked to cover up/move somewhere else. Both times were in hospital nurseries. Once it was framed in the ‘woulnd’t you be more comfortable behind a screen….” way and the other time I was told “you can’t do that here (the nursery), you might scare some of our younger fathers.” the former was the NICU step down unit, the latter the well-baby nursery. both babies were receiving light therapy for jaundice at the time.
    That said, while my son was fed via IV/TPN and tube fed when he was in the regular NICU the neonatalogist was extremely gung-ho about getting him on the breast and exclusively so as soon as he was stable. She was extremely supportive, making sure I had a room to stay in the hospital 24/7 so we could nurse on demand and co-sleep and was just giddy as a school girl when he latched on like he had been doing it forever.

    May 13, 2010
    • StorkStories #

      Wow– That’s quite a story! Luckily with a great ending for you and your baby!

      Good for that neonatologist. I am so happy she was there to support and encourage. Hope she’s still doing that!
      Thanks for stopping in/ SS

      May 13, 2010
  4. Onnie #

    Just came across this post and your blog. What the heck? I took a breastfeeding elective in nursing school just this spring (in addition to the combined 2 hrs covering breastfeeding in pediatrics and OB rotations) and I’m firmly committed to promoting breastfeeding for all families. I also really REALLY want to work in a NICU or PICU and I’m hoping that my coursework will be an added bonus in getting hired. But I guess it’s true what I read, in all my coursework promoting “Evidence-Based Nursing”, that many hospitals, nursing units and NURSES are not on the same page regarding EBN – which is especially disheartening seeing how simple and beneficial pro-breastfeeding interventions are to all infants and families.

    Hire me instead? I’m graduating in July!

    May 21, 2010
    • StorkStories #

      HI Onnie, I am so glad to hear that you got some good breastfeeding education and it’s great you took an additional elective! There is a lot to learn right? Please don’t be discouraged. There are so many of us out there working and striving for excellence in nursing as a whole. Many of those who may be negative are either resistant to change, afraid of the unknown OR simply unaware…not staying current. I’d love to hire you! if only I had any say! I do usually tell new nurses to take extra courses, additional education in their field of interest because there is SO much to learn when you are out of school! I’d encourage you to take PALS for PICU or NRP for NICU if you are interested and of course additional lactation education is fabulous to stay true to your commitment for promoting breastfeeding!! Thanks for stopping by.

      May 23, 2010
  5. how rude, you may think it but never say it it may be the rule of thumb on the ward to encourage it first, sad but i wonder did she get the job?

    May 26, 2010
    • StorkStories #

      Just found out yesterday…. Yes.. she DID get a job :-/
      But then again… so did I!
      Hopefully we can teach each other as we become a team!

      June 11, 2010
  6. Debbie #

    Just found your post and wanted to add something from my experience with my 30 week preemie. I really wanted to breastfeed. As everyone was working on me to try to stop my labor and I was getting the 5 minute intro to what to expect with an early baby and the NICU and everything, one of the thoughts going through my head was that I wouldn’t be able to feed my baby. I thought that my body wouldn’t be ready since I was supposed to still have 10 weeks for my body to prepare. I didn’t know how to ask about that and I was so overwhelmed that I wasn’t able to frame my question correctly, I just asked if I would be able to feed him and didn’t explain beyond that. Luckily, the Neonatologist was very happy at the question and told me that would be the best thing for him and made sure I had a pump and an early visit from the lactation consultant. He was wonderful and the entire staff was very supportive! So, the point of this rambling is that it is possible that other overwhelmed Mommy’s might not even know that they will be able to breastfeed with an early birth.

    June 30, 2010
  7. When Alex was born weighing 1.7 kgs and spent 12 days in SCBU, I was told by the nurse-midwives that he was feeding well from me. When he didn’t gain as much as they expected, the doctors recommended a bunch of blood tests to find out if there was anything medically wrong with him. “An LC might be available in a few days.”

    I freaked out and with support, we discharged him against medical advice. For one thing, he’d only just stopped having awful heel pricks day in and out for hypoglycaemia, which had been getting measured on a faulty machine….and so probably unnecessarily.

    A couple of days later, Alex figured out how to actually get milk out of me and began gaining at a healthy rate.

    The hospital MWs didn’t know what anybody with 6months attendance at La Leche League meetings knows – what nutritive sucking actually looks like. Of course, it had been remarked upon for days how much milk I was pumping after feeds…why didn’t anyone have their brain turned on?

    The hospital sent me an unsolicited physiotherapist with a pamphlet on C-Sections (3 days after I’d had mine), but you have to request an LC – and nobody seemed to think I needed one! I wish that an LC visit would be prescribed for any special care baby who is learning to BF.

    I bear a lot of resentment about my hospital care (that story is only one facet), and it makes it very difficult for me to feel grateful that at least my baby and I are alive, which is the usual canard when birth experiences don’t go as desired.

    July 19, 2010

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