PEER Counseling is Unparalleled Breastfeeding Support–> Do You Have a Great Story?

Our new NICU policy–>Breastmilk IS our babies food!

Yes! This HAS been accepted!!!

Here is an excerpt from our NEW NICU policy:

Policy Statement: It is the policy of the NICU to provide all mothers with factual information regarding the superior nutritional, immunological and therapeutic beneficial effects that human milk and breastfeeding will have on the health outcomes of their preterm or sick newborn so that their feeding decision will be evidence based. The healthcare professional has an ethical responsibility to avoid withholding information because of any unfounded concerns that informing mothers of research-based options may make them feel guilty if they choose not to breastfeed. The mother’s informed decisions will be totally supported and her infant will be provided nourishment in accordance with her decisions.  All mothers should be considered breastfeeding candidates until they specify intent to bottle feed.

Purpose: To promote and support human milk as the preferred method of providing nutrition. Provide assistance to the mother in establishing and maintaining breastfeeding.

Policy:

1. Any mother desiring to breastfeed or provide breastmilk for her baby will be given consistent current and correct evidence-based information, emotional support and encouragement she may need to reach her individual goals. Healthcare professionals will avoid conveying information based on any personal breastfeeding experience as it may not be appropriate or applicable in discussions with mothers.
2. Mothers may be asked/encouraged to temporarily pump/express and provide colostrum for their infant’s immediate protection and health needs regardless of their feeding choice.
3. The mother will be involved in all feeding plans as soon as possible.
4. All NICU infants will be fed according to their nutritional requirements as ordered by the physician.
5. Early trophic feedings of colostrum/milk to stimulate intestinal maturity will be utilized as ordered and when there is colostrum available. It is beneficial for infant to wait a day or two until colostrum is available to maximize the transfer of protective components. Colostrum should be given to infant in the order it was pumped.
6. Oral care/ mouth swabbing will be done using colostrum/ breastmilk.
7. A multidisciplinary approach involving the physician, NICU team, the mother and a lactation professional to develop an individualized feeding plan will be utilized as soon as feasible in accordance with each infants requirements and feeding abilities.
8. Cue-based feedings will be encouraged and utilized as soon as possible. All mothers will be provided educational information and encouraged to understand and participate in reading their infant’s feeding cues.
9. Kangaroo care and/or skin-to-skin will be utilized and encouraged as much as possible..
10. Stable premature infants should be allowed to go to mother’s breast during gavage feedings to ready infant for transition to breastfeeding.

Etc etc etc……………………………….. much more……………..

The policy I submitted was written using Marsha Walker’s  “Breastfeeding Management for the Clinician. Using the Evidence” as a major guide. I think I even used her words a lot. (Seriously-who can say it better?)

YAY! Thank you to my team and thank you Marsha!

DUE TO REPEATED REQUESTS FOR THE WHOLE POLICY… HERE IS WHAT I HAVE… I HAVE INCLUDED THE REFERENCES

 

Policy  Statement:      It is the policy of the Special Care Nursery/NICU to provide all mothers with factual information regarding the superior nutritional, immunological and therapeutic beneficial effects that human milk and breastfeeding will have on the health outcomes of their preterm or sick newborn so that their feeding decision will be evidence based. The healthcare professional has an ethical responsibility to avoid withholding information because of any unfounded concerns that informing mothers of research-based options may make them feel guilty if they choose not to breastfeed. The mother’s informed decisions will be supported and her infant will be provided nourishment in accordance with her decisions.  All mothers should be considered breastfeeding candidates until they specify intent to bottle feed.

 

Purpose:         To promote and support human milk as the preferred method of providing nutrition. Provide assistance to the mother in establishing and maintaining breastfeeding for optimal growth and development.

 

Policy:

1. Any mother desiring to breastfeed or provide breastmilk for her baby will be given consistent current correct evidence-based information, emotional support and encouragement she may need to reach her individual goals. Healthcare professionals will avoid conveying information based on any personal breastfeeding experience as it may not be appropriate or applicable in discussions with mothers.
2. Mothers may be asked/encouraged to temporarily pump/express and provide colostrum for their infant’s immediate protection and health needs regardless of their feeding choice.
3. The mother should be involved in all feeding plans whenever possible.
4. All SCN/NICU Infants will be fed according to their nutritional requirements as ordered by the physician.
5. Early trophic feedings of colostrum/milk to stimulate intestinal maturity will be utilized as ordered and when there is colostrum available. It is beneficial for infant to wait a day or two until colostrum is available to maximize the transfer of protective components. Colostrum should be given to infant in the order it was pumped.
6. Oral care/ mouth swabbing will be done using colostrum/ breastmilk.
7. A multidisciplinary approach involving the physician, SCN/NICU team, the mother and a lactation professional to develop an individualized feeding plan will be utilized as soon as feasible in accordance with each infants requirements and feeding abilities.
8. Cue-based feedings will be encouraged and utilized as soon as possible. All mothers will be provided educational information and encouraged to understand and participate in reading their infant’s feeding cues.
9. Kangaroo care and/or skin-to-skin will be utilized and encouraged as much as possible..
10. Stable premature infants should be allowed to go to mother’s breast during gavage feedings to ready infant for transition to breastfeeding.
11. Promoting non-nutritive suckling at mother’s recently pumped/drained breast will be encouraged whenever applicable. Although pacifiers are not routinely used for healthy term breastfeeding infants, preterm infants in the Special Care Nursery/NICU or infants with specific medical conditions may be given pacifiers for non-nutritive sucking.
12. Feeding at the breast will be introduced as soon as possible for those sick or preterm infants as they improve and display appropriate feeding readiness cues.
13. Supplementation, complimentary feedings and use of alternative feeding devices including nipple shields will be individualized in accordance with the multidisciplinary feeding plan above. (#7)
14. Human milk fortifier may be indicated and will be added as ordered by the physician.
15. Breastfeeding Policy  #6250-OB-B-3 and Breastmilk Collection and Storage Policy #6250-OB-B-3A will apply wherever applicable.
16. If a mother is unavailable for feeding and/or has chosen to pump and store her breastmilk for infant feedings, she will be provided with written pumping instructions. These pumping practices to maximize early production and volume include:

1. Begin pumping within 6 hours after delivery whenever possible (as clinically indicated by infants and/or mothers medical condition). Early and frequent pumping in the first week is crucial.
2. Double pumping with high quality hospital grade pump (or pump which cycles 48-50 times/minute and with vacuums not exceeding 240mm Hg.)
3.  Simultaneous pumping with properly fitting flange and added breast massage yields more milk and higher fat content.
4. Pump at least 6 times in 24 hours (100 total minutes/day). Mothers pumping at least 8-12 times in 24 hrs yielded higher milk output.
5. Evaluate any mother’s concerns over low milk volume promptly to promote maximal adequacy of milk expression.
6. A mother may be encouraged to use the breast pump at the infant’s bedside as a means to increase milk production.
7. Collect milk in plastic tightly lidded containers (ie Snappies) which are self labeled by mother with infant’s name, date of birth, MR#, date and time milk was pumped.
8. Freshly expressed milk that can be immediately given to infant provides optimal protection factors.
9. Milk must be promptly stored in the refrigerator if it is to be used within the next 48 hours.  Breast milk may be placed in the freezer for 3 months or in a deep freeze for up to 6 months.  If the infant is preterm or a sick term infant, frozen breast milk should be used within 3 months, however, it is preferable to use outdated breast milk as opposed to artificial milk.
10. Mother should transport her milk to the hospital frozen in a cooler with an ice pack.  Thawed breast milk must be used in 24 hours.
11. If milk brought by the Mother is thawed, it must be placed in the refrigerator.  It cannot be refrozen.

 

 

References:

Bakewell-Sachs, S. and Brandes, A. (2003).  Nutritional Management. In Verklan, M.T. and Walden, M.  Core Curriculum for Neonatal Intensive Care Nursing, 3^rd Ed. St.Louis,MO: Elsevier Saunders.

Crosson, D.D and Pickler, R.H. (2004). An Integrated Review of the Literature on Demand Feedings for Preterm Infants.  Adv Neonatal Care. 4(4): 216–225.

Dougherty, D.  and Luther, M. (2008). Birth to Breast—A Feeding Care Map for the NICU: Helping the Extremely Low Birth Weight Infant Navigate the Course. Neonatal Network. (27) 6.  Pp 371-377

Kirk, A.T., Alder, S.C., King, J.D. (2007).  Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants:  Cue-based oral feeding clinical pathway.  Journal of Perinatology (27) 572-578.

Meier PP, Engstrom JL, Patel AL, Jegier BJ, Bruns NE. Improving the use of human milk during and after the NICU stay. Clin Perinatol. 2010 Mar;37(1):217-45. Accessed via PubMed July 17 2010

Walker, Marsha (2011). Breastfeeding Management for the Clinician- Using the Evidence 2^nd ed. Jones and Bartlett, Sudbury MA

Little Old Men… & Nursing in Public (Back by “PUBLIC” Demand)

Welcome to The Breastfeeding Cafe Carnival!
This post was written as part of The Breastfeeding Cafe’s Carnival. For more info on the Breastfeeding Cafe, go to www.breastfeedingcafe.wordpress.com. For more info on the Carnival or if you want to participate, contact Claire at clindstrom2 {at} gmail {dot} com. Today’s post is about nursing in public. Please read the other blogs in today’s carnival listed below and check back for more posts July 18th through the 31st!

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My first baby was born in sunny Florida during a particularly hot stretch in May 1979.  Although I was an OB nurse, I knew very little about breastfeeding other than what my older co-workers had taught me—which was not all that correct or very helpful information. Luckily, I had a great friend who was nursing her 3 month old at the time my son was born. She really showed me the ropes. It just so happened that she was the one who took me home from the hospital. We had to stop at the store for a few items so we went in to a “Publix” supermarket with both babies in our arms.  My newborn son began fussing to nurse soon after we hit the air conditioning.

I said.. “I’m going to have to go back out to the car and nurse him.”

My friend says “Oh..You’ll do no such thing.. You’ll die in that heat.. Just hook him up and keep shopping so we can get finished and out of here!”

Me- “Nurse him in here?”

Friend- “Well if he’s hungry.. yeah!.. (after looking at my face) Oh stop worrying about it..go over to a deserted aisle, get him hooked on and put your receiving blanket up near his face… nobody will know!”

Me- timidly…above the louder howls.. “Alright, be right back..”

I found the most private place I could. I started cursing that complicated “wonderful nursing bra” I just had to have. (Remember..this is 30 years ago… this bra is now an antique!) My skills handling newborns allowed me some grace as I attempted to multitask by stooping down, prop my loudly crying baby on my partial lap, use 2 hands to fiddle with the damn nursing bra, then get him back up near my finally free boob and latched on.

Ahhhh~ quiet, happy, drinking baby!

Still stooped down, I peered slowly behind me — expecting that a large crowd must have assembled. Somewhat surprisingly, everybody was just going about their business and I happily realized that noone was looking at me! I stood up, made sure I wasn’t showing anything, and walked off with my happily nursing baby to find my friend.

It’s amazing how many people want to see a quiet baby as opposed to a screaming infant!

A sweet little old man stopped me first and asked me how old my baby was….”3 days”, I replied. He peeked in for a closer look and he actually didn’t get it right away.. “I can’t really see his face.”.. I said “Well- he’s feeding right now.”.. He just said..”OOPS….sorry about that! Well he’s a cute one!” then walked off.

The next person who stopped me was again.. a sweet little old man. He was very smiley and jolly. He asked all about the baby but didn’t lean over to look like the other man. I quickly said he’s nursing now and then answered all the small talk.  He never seemed uncomfortable about it at all! That probably gave me a lot more confidence. We parted ways and I finally found my friend. She gave me an approving thumbs up, asked me to hold a basket with my other hand and said we were almost done.

Another little old man stopped us by the register to ask about both babies. We gave him all the small talk answers and let him know my son was nursing. This guy was a real sweetie, commenting on how lucky kids were that moms were starting to “nurse their young” again and ‘good for you.”  He never tried to look in at my son. He didn’t seem embarrassed by the process at all. He was the coolest guy!

I left the Publix Supermarket on my way home to begin my life as a mommy…. with a little public education bonus.  Encountering those sweet little old men while feeding my baby and receiving their positive type feedback was the gentle support I needed. I went on to feel empowered to nurse in public for all three of my babies…  Those little old men were just so supportive! ~ When my baby was hungry, he needed to feed and it really didn’t matter where I was at the time.  Thank goodness for my friend’s wisdom and support to go for it!

I became a lactation professional while nursing my last baby. It was then, only after I really became more aware of issues surrounding nursing in public that I actually took any kind of public action to empower other moms.  I’ve done lots of different little things as the years have gone by. I want to mention one fun way that I thought I could help gently re-educate some of the “new” sweet little old men of this day and age.  Our local paper has a lot of little retired guys commenting back and forth on various local articles. I’m guessing their age and status by all the things they say. I took this opportunity to possibly educate some of these forum readers about breastfeeding rights in public.  Every once in a while, on the forum, I put out a little snippet on nursing in public… and sit back and watch what they have to say in reply! It’s quite fun!

Here’s an example I wrote on a long forum discussion a couple years ago on a breastfeeding article:

On another note, regarding a reader reaction in the forum, a skimpy bikini or the bathing-suit issue of a favorite sports magazine show more skin in a provocative, sexy way than any mom breast-feeding. Even the movie stars in their gowns with plunging necklines are showing almost the entire breast! Somehow, that is OK. It is sad that the public opinion of a baby breast-feeding (the most natural way for him to eat) is something that should be done in private … yet young girls are encouraged by media to bare more and more skin. Of course being discreet while feeding is important, but I can assure you, most girls in a tiny bikini are thinking more about “tacky exhibitionist behavior” than a mother breast-feeding her baby. August 1-7 is always World Breast Feeding Week. The theme this year is “Welcome Baby Softly,” focusing on the importance of the first hour or two after birth. Learn more about it. I would love to see the paper do an article on that.

This one provoked a few responses in both directions and sometimes there were a few people who actually thought out loud that …gosh maybe I was right… never thought about it that way…etc..

Here’s an example I wrote on a recent article about the appropriate % amount for tipping :

I have never left an establishment without tipping– however, I also tip according to service up to 20%. If there are unkind reactions to small children in a FAMILY establishment, they will be getting a bare minimal tip for sure!! I do my best to keep my children behaved with table manners AND respect other patrons… but fact remains, they are children! I cannot possibly be prepared for every behavior or an accidental spill. In addition, my breastfeeding baby may be hungry.. By PA law, I have the right to nurse my baby in a public place wherever he and I are allowed to be. I am discreet.. I am protected by law… I don’t need an unkind comment from servers. They do not get a 15-20% tip if nasty, unkind or disrespectful comments have been made about my children or my breastfeeding baby!

This provoked a foray of comments ranging from ‘good for you’ to ‘you should be in the back booth…controlling kids etc..’  Sometimes the opportunities to educate others come at unexpected times but produce amazing results!

On a few occasions, other readers were supporting my comments and

helping to educate those sweet little old guys with me!

😉

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Here are more posts by the Breastfeeding Cafe Carnival participants! Check back because more will be added throughout the day.

• Emily @ Baby Dickey—baby eats when baby wants: nursing in public
• BoobiesNBabies @ Num In Mind—NIP a Lil Giant, How We Do It
• Sylko @ Chaotic Mama—Breastfeeding Carnival: Nursing in Public
• Claire @ The Adventures of Lactating Girl—My Biggest Advocate
• Timbra @ Bosoms and Babes—Making it easy for everyone to nurse
• Kaitlin @ Bringing Birth Home—Breastfeeding Uncovered – A Peaceful Protest
• Claire @ Geeky Gaming Mama—Nursing in Public: What Makes it Easier
• Brooke @ Milk Maid Mama—Nursing in Public
• Kathy @ Musings From an Arid Neverland—Do I need fancy clothes to nurse in public?
• Shary @ Mama Fish—NIP: Nursing in Public
• Kimberly @ Monkey Tales Mama Thoughts—Nips: Not those, well kind of those
• Shelly @ Lousy Mom—Breastfeeding Public
• Sarah @ Most Revealing—Nip
• Renee @ Just the 5 of us!—No Reservations
• Natasha @ Natural Urban Mamas—Nursing in Public-Not a Big Deal
• StorkStories @ Stork Stories… Birth & Breastfeeding—Little Old Men… & Nursing in Public (Back by “PUBLIC” Demand)
• And of course the guest poster on the Breastfeeding Cafe’s Blog today is Heather Hendriksen—Tips for Nursing in Public

INSUFFICIENT MILK? Did You use REGLAN or DOMPERIDONE?? They Need YOU!

A message from the USLCA asking for mothers help!

United States Lactation Consultant Association Please encourage mothers who have used Reglan or Domperidone to participate in this quick survey. It is very important that research such as this be done to enrich our knowledge of how to better assist mothers with insufficient milk production.Thanks so much Marsha Walker, RN, IBCLC, RLC Survey of Domperidone and Metoclopramide Use in Breastfeeding Mothers Thomas Hale & Kathleen Kendall-Tackett, co-investigators We are pleased to announce our new online research study, a survey of women’s experience with the drugs metoclopramide and domperidone, which can be used to stimulate milk production.  We would like to collect side effect information on both drugs from as many mothers as possible worldwide. The survey link is: http://surveys.ttuhsc.edu/wsb.dll/s/60g759. For more information about the study, contact Dr. Kendall-Tackett at: kkendallt@aol.com Please let mothers know about our study. The more women we can get to participate, the more valid our findings. Thanks for your help. The survey takes 20-30 minutes to complete and is confidential.  It has been approved by the Institutional Review Board at Texas Tech University Health Sciences Center, Amarillo, TX.

“Breastfeeding is a Health Preventative Behavior” ILCA Press Release

Please send this press release too any local media companies!

United States Lactation Consultant Association Announces

Date: May 14, 2010
Contact: Scott Sherwood                                                      For immediate release
Tel. 919-861-4543
Email: ScottSherwood@uslcaonline.org

National Woman’s Health Week

Morrisville, NC- The United States Lactation Consultant Association (USLCA) joins the US Department of Health and Human Services in celebrating National Woman’s Health Week. The week of May 9th to 15th is dedicated to empowering women to make their health a top priority. In honor of this week the USLCA reminds women that breastfeeding is a health preventive behavior that reaps benefits for a lifetime. Avoiding or abandoning breastfeeding increases a woman’s risk of developing premenopausal breast cancer, ovarian cancer, type II diabetes, hypertension (high blood pressure), hyperlipidemia, and cardiovascular disease.

The decision to breastfeed is a health promoting public health behavior that benefits not only infants but also their mothers. During National Women’s Health Week, communities, businesses, government, health organizations, and other groups work together to educate women about steps they can take to improve their physical and mental health and lower their risks of certain diseases. Women are often the caregivers for their spouses, children, and parents and forget to focus on their own health. But research shows that when women take care of themselves, the health of their family improves. Health care providers are urged to remind the childbearing population of women that they work with of the importance of breastfeeding as a method of reducing diseases and conditions that can rob them and their family of a healthy mother. Heart disease is the number one killer of women in the US. Epidemiological data suggest that women who do not breastfeed or wean too early face a higher risk of diease and early death.

USLCA president, Laurie Beck, RN, MSN, IBCLC would like to celebrate National Woman’s Health week by wishing all moms a Happy and Healthy Mother’s Day. “USLCA urges all mothers and health care providers to view breastfeeding as a health promoting and disease preventing behavior just like nutritious eating and physical activity.”

Knowledgeable professional breastfeeding support can be obtained from lactation consultants with the IBCLC credential (International Board Certified Lactation Consultant). To locate a IBCLC for assistance with breastfeeding go to http://www.uslca.org

Mission: To build and sustain a national association that advocates for lactation professionals

Vision: IBCLCs are valued recognized members of the health care team.

The United States Lactation Consultant Association (ULSCA), is organized exclusively for the advocacy of Lactation Professionals.

“The American Propensity to Shun Human Milk is a Public Health Problem”

A Historical Perspective

Bulletin: Chicago School of Sanitary Instruction (June 3, 1911)

This is a part of my comment reply placed to an individual who had commented on The Feminist Breeder’s  post “When It Comes to Breastfeeding, We Can’t Handle the Truth”

“There were countless situations over the last 200 years which forced caregivers (whether the natural mother or another individual)to resort to artificial feeding of one kind or another. It is amazing what some of them came up with to try to feed those infants! Necessity was the mother of invention. And many were able to survive. It’s wonderful that they could. Many more, however, sadly died. Many many babies were sickly or died in those times.
You say: “The matter is that formula/breastmilk substitutes became so helpful that people continued for centuries to make it work.” I agree.
But my take on it is that the necessity of an available safe artificial alternative to breastfeeding for those mothers who could not breastfeed their babies took centuries to formulate…to make it nutritious enough and safe enough and to come up with a safe enough feeding container. It was just that.. an artificial substitute.
Gosh– I am NOT an expert on this aspect at all.
I just feel that the heart of this conversation is that artificial infant feeding has risks. Risks that mothers aren’t informed about because society has normalized artificial feeding. Breastfeeding is normal feeding.
No one should ever take away an individual’s choice..EVER…!!!!!
Mother’s simply need better information to make INFORMED choices.
I’m very sensitive and careful in my approach to moms… helping them with information they need to make the best choice for them. Then I will ALWAYS support that mother 100%.
Here’s an interesting historical perspective link for your review from the American Journal of Public Health | December 2003, Vol 93, No. 12
It covers history from about 1890 to early 1900’s.”

“Low Breastfeeding Rates and Public Health in the United States”

Here are some quotes and excerpts from this article published in the American Journal of Public Health (December 2003, Vol 93, No. 12 ) discussing Public Health THEN and NOW.

Quotes:

“Late-19th-century physicians . . . constantly
decried the ‘children with weak and diseased
constitutions belonging to that generally
wretched class called bottle-fed.’ “

“Today’s medical community recognizes what their
predecessors knew a century ago—that the
American propensity to shun human milk is
a public health problem and should
be exposed as such.”

Abstract: “The medical community has orchestrated breastfeeding campaigns in response to low breastfeeding rates twice in US history.
The first campaigns occurred in the early 20th century after reformers
linked diarrhea, which caused the majority of infant deaths, to the use of cows’ milk as an infant food.
Today, given studies showing that numerous diseases and conditions can be prevented or limited in severity by prolonged breastfeeding, a practice shunned by most American mothers, the medical community is again inaugurating efforts to endorse breastfeeding as a preventive health measure.
This article describes infant feeding practices and resulting public health campaigns in the early 20th and 21st centuries and finds lessons in the original campaigns for the promoters of breastfeeding today.”

I found this article to be very informative and very interesting.

WHAT HAVE WE LEARNED???

Overheard Hospital Roommate Discussion on Formula vs Breastfeeding

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We don’t often “double-up” the new mothers on the postpartum unit but occasionally in times of high census, we simply have no choice. We were incredibly busy this week, so short term doubling occurred.

In one room there was an experienced 3rd time breastfeeding mom (BF mom A) born and raised in an Eastern European country and her roommate was a new first time formula feeding mom born and raised in the USA (FF mom B).

Both were within about 12 hrs of birth.

I had been in the room doing basic exams/vital signs for each baby, asking each mother how she thought things were going etc. etc…. I stepped to the doorway to converse with a co-worker about unrelated tasks and that’s when I started to overhear a very interesting conversation.

I admit it…    I eavesdropped–> I learned.

😮

I stayed in doorway reading a chart……..

FF mom B: “So — are you breastfeeding your baby?”

BF mom A: “Oh yes– Is best for us” (heavy accent)

FF mom B: “Does it hurt?”

BF mom A: “No no- not hurting, good feeling. You do too?”

FF mom B: “Me? No, I’m bottle feeding. My mom said that was easiest.”

BF mom A: “I see…”  pause ……. “Why you not breastfeed? In my country– we are told is healthy way- natural way, most everybody does this. You are told this- yes?”

FF mom B: “Well– yeah, I remember hearing that it was best, but I didn’t try to learn about it because I have to go back to work in 6 weeks and my mom said formula was the same or just as good. And everyone can help me feed the baby too.”

(I’m still looking at a chart in doorway waiting……)

BF mom A: “Is nonsense…sorry don’t know words..false?”

FF mom B: “What’s false?”

BF mom A: “Is false- the baby bottle is same as mother’s breast. False. You are baby’s mother, you do what you must, but all more important reason to know truths– as his mother– so I tell you…  You need truths….   just ask nurse.”

I’m thinking, this will either be a great opportunity to educate a new mom further OR I’ll be moving beds because the bottle feeding mom is now all upset with her roomie…..

FF mom B: “Is it true? (She asked me)…. Is there really that much of a difference?”

I said actually there is a big difference and I’d be happy to talk to her about if she’s interested. I felt this mom was possibly considering to breastfeed and I wanted to preserve that gently… away from any real or perceived pressure. I invited her and her baby into a little conference room so I could have a private conversation with her and give her information without the possibility of her well-meaning roommate piping in.

We actually had a very good discussion. She had a lot of questions which I was so happy she felt very free to ask ….such as all the health benefits, combining work and breastfeeding and how to get started now after 13 hrs.  I answered them and asked her if she wanted to think about it or if she was interested in getting started.

She said she’d like to do it now before her mother got here. She felt fine going back to her room. Since her baby had been fed a bottle only an hour before this started, I suggested she spend some time skin to skin and maybe…. her baby would root and self attach when he was ready.

I assisted her into a comfortable position and we snuggled a naked sleeping baby skin to skin. She was smiling but not feeling very sure of things. I told her to rest and I’d check up on both of them.

Her roommate chimed in “You are good mother learning this for baby. You feel better yes? I help- if you need- I help”

In the end, the baby nuzzled, licked & rooted about a half hour after being placed STS, but didn’t self attach. I assisted her to latch him in a football hold. She was very surprised to see colostrum and became quite engaged in the process. She was breastfeeding when her own mother arrived. This grandmother was kinda taken back at her daughter’s change of heart but was more supportive than the young mother thought she’d be.

Perhaps the roommate had another discussion I didn’t overhear…….. Sometimes you never know…..

The door to more education opens from many different angles. Sometimes pushed open from an individual with a different background.

I hope we have more happy beginnings like this in the future.

🙂

We Deliver? How about we make it a better delivery?

permission from CartoonStock

Our Maternity Services

Need Help!

The Maternal Child care delivery system in this country as a whole needs vast improvement. All of these 10 steps as well as the 10 steps to ensure optimal successful  breastfeeding are very important.

These items are sadly grossly misconstrued or ignored by many facilities offering maternity services in this country. I have been having the same discussions and occasional arguments with co-workers  lately on this battle of the newborn baby staying in the moms room overnight!!! I know~ it is a no brainer to those of you who read, research and understand. Many of my co-workers still defend their philosophy that the baby needs to come into the nursery at night so the mom can sleep!!  Many argue with me about labor positions and inductions!! AARRGGHH! I won’t get into our details right now…….

What I have here for you today is NOT new info but I recently reviewed it again as I was searching for evidence to back my discussions with staff. If you haven’t placed this information in your workplace to nudge some resistant peers, I urge you to do so!

This document : THE COALITION FOR IMPROVING MATERNITY SERVICES:
EVIDENCE BASIS FOR THE TEN STEPS OF MOTHER-FRIENDLY CARE can show you research studies or data which support the ten steps below.

The 10 steps for Mother-Friendly Care from CIMS {Coalition for Improving Maternity Services} taken from their website…..are:

Ten Steps of the Mother-Friendly Childbirth Initiative
For Mother-Friendly Hospitals, Birth Centers,* and Home Birth Services

To receive CIMS designation as “mother-friendly,” a hospital, birth center, or home birth service must carry out the above philosophical principles by fulfilling the Ten Steps of Mother-Friendly Care.

A mother-friendly hospital, birth center, or home birth service:

1. Offers all birthing mothers:
   • Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends;
   • Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional;
   • Access to professional midwifery care.
2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
5. Has clearly defined policies and procedures for:
   • collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
   • linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
   • shaving;
   • enemas;
   • IVs (intravenous drip);
   • withholding nourishment or water;
   • early rupture of membranes*;
   • electronic fetal monitoring;
   • Has an induction* rate of 10% or less;†
   • Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
   • Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
   • Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.

other interventions are limited as follows:

7. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
8. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
9. Discourages non-religious circumcision of the newborn.
10. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:
    1. Have a written breastfeeding policy that is routinely communicated to all health care staff;
    2. Train all health care staff in skills necessary to implement this policy;
    3. Inform all pregnant women about the benefits and management of breastfeeding;
    4. Help mothers initiate breastfeeding within a half-hour of birth;
    5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;
    6. Give newborn infants no food or drink other than breast milk unless medically indicated;
    7. Practice rooming in: allow mothers and infants to remain together 24 hours a day;
    8. Encourage breastfeeding on demand;
    9. Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
    10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

† This criterion is presently under review.

I endorse these steps. You can visit their website to also endorse.

Kathy from Woman to Woman Childbirth Education wrote about the CIMS press release on the Need for Transparency regarding the rising C/S rates. Excellent information is discussed here by the CIMS and I enjoyed the discussion between Kathy and RealityRounds.

I also would urge you all to visit and give information to The Birth Survey.

How is your birth place measuring up to these initiatives?

Let’s all continue to make this a better world

in which to give birth!!

Webinar~ WHO CODE ~ “The Code, Companies, and LC’s”

This is a reprint of an email invite I received today and wished to share with all those interested. Brought to you by the USLCA ON Wednesday October 14th 2009 “The Code, Companies, and LC’s” by Marsha Walker Participants will be able to describe the LC’s manufacturing or distributing products within the scope of the Code. Participants will be able to discuss the elements of the WHO Code as they relate to companies that manufacture or distribute products covered within the scope of the Code.The Code within lactation consultants practice.  LC and ethical Practice within the Code. Use of company products Use of educational materials Exhibiting at conference Attending company sponsored education programs Accepting meals or free items How does a company meet its obligations under the code Company websites What violates the Code and what does not Pictures-where and how are they acceptable Idealizing language Marketing vs Selling Course Details 60 Min program 1 E Cerp Awarded for participating (Certificates are emailed to attendees) Price: USLCA Members $20,   Non-members $30, Groups 2-10 $45, 10 or more $65 Click here to sign up “The Code, Companies, And LC’s”

Here’s how to sign up for a USLCA Webinar1. Down load the sign up sheet for the appropriate webinar.Click here for list of scheduled webinars. 2. Submit your sign up sheet and payment information to the National office through mail (address located on sign up form), email ScottSherwood@uslcaonline.org or by fax 919-459-2075 Attn: USLCA Webinar 3. You will then receive an email invitation to register for the webinar. Please complete this as soon as possible. You will not be able to sign on to the webinar until this registration is submitted, and approved. If you have any questions please contact us at any time for assistance Cerps are available only after payment is received.  If you are a member of the USLCA email Scott Sherwood to find out how to pay online.  Please feel free to forward this email to co-workers and friends. Thank you for your support!

Are YOU an Activist? Healthy People 2020 Public Meeting Announcements

 

ARE you an activist?

Do you want to have input or learn more??

What do you know about the Healthy People 2010 National Objectives ……. and how the breastfeeding goals haven’t been met?

 

The PLAN ~ The GOAL:

(From the Healthy People website:)

Healthy People 2010 challenges individuals, communities, and professionals, indeed all of us to take specific steps to ensure that good health, as well as long life, are enjoyed by all.

 Healthy People 2010 objectives for breastfeeding in early postpartum period, at 6 months, and 12 months are 75%, 50%, and 25%, respectively. Healthy People 2010 objectives for exclusive breastfeeding through 3 and 6 months of age are 40% and 17%, respectively

 

  So how are we doing???

From the CDC website regarding Breastfeeding Data:

Breastfeeding rates have improved since 1999, but fall short of Healthy People 2010 objectives regarding duration and exclusivity. Among children born in 2006, 74% initiated breastfeeding, whereas 43% were breastfeeding at 6 months and 23% at 12 months of age. Approximately 33% of infants born in 2006 were exclusively breastfed through 3 months of age, and 14% were exclusively breastfed for 6 months.

 

Check the CDC website above for a complete evaluation of how we measure up. I am so happy for thoses states who actually accomplished these objectives! There are some that exceed these goals and others who are really behind. I think because of this, the national picture as a whole is misleading, reflecting an average of a lot of highs and lows. It doesn’t show a true picture for those areas struggling.  I want to learn more to help my area move up towards the goals.

What can we do to improve and work towards accomplishing these goals ????

 I got this important email letter today and promptly registered to go the meeting in Philadelphia on November 7th.  I want to learn all that I can about what goes into the planning and possibly what more I can do at my local level to help meet the breastfeeding objectives. From the US Lactation Consultant Association:

 

During October and November the Department of Health and Human Services (DHHS) will conduct public meetings in Kansas City (Kansas), Philadelphia (Pennsylvania), and Seattle (Washington) on draft objectives for Healthy People 2020. The public will have an opportunity to comment on the draft objectives at the public meetings, and on the public comment Web site. The comments received will then be used to revise the objectives appropriately. We hope that you will consider attending if you live near one of these sites. We will coordinate work on this with the US Breastfeeding Committee. This presents a wonderful opportunity to have our voices heard on national policy-making relative to breastfeeding.

I’m not public speaker, I am interested in policy making for the HP2020.

I want to go and learn from my well respected colleagues.

Check it out! Click on the HP 2020 icon at the top of the post!