Tuesday
May182010
Breastfeeding and Early Weaning
Tuesday, May 18, 2010
In Canada and in Germany, almost all mothers (more than 90%) plan to breastfeed. However, in both of those countries the percentage of mothers who do end up exclusively breastfeeding is much lower than the percentage of mothers who planned to. Unfortunately, there are still people out there who blame the mothers and who say that they were not dedicated enough or didn't really care about breastfeeding. I don't think that is right or useful in terms of solving the problem. Instead, I think we need to ask why women are not meeting their own breastfeeding goals.
A Canadian breastfeeding survey by Today's Parent (2006) found that only one out of ten mothers was lucky enough to breastfeed problem-free. That means that the vast majority of new mothers face some kind of breastfeeding difficulties. The Today's Parent survey noted that [emphasis mine]:
Certainly there are some mothers will low milk supply, there are some babies with low weight gain and there are some babies who cannot latch on properly. However, most breastfeeding advocates recognize that the number of mothers who report those problems is much higher than it should be in the normal course of breastfeeding. But why?
One of my readers passed along links to some German reports on breastfeeding duration. Since both Germany and Canada have a lot of similarities (developed countries, similar breastfeeding initiation rates, maternity leave for mothers of infants), I found a lot of the information I was reading seemed equally applicable to a Canadian scenario. In particular, one of the reports noted the key factors influencing early weaning, broken down into factors on the mother's side and factors in the practice of breastfeeding (clunky translation - sorry).
The report went on to explain that supplementing with formula during the first three days, which was the factor most likely to contribute to early weaning, still happens in about 50 percent of infants in Germany without any medical indication and without the mother requesting supplementation. Babies who were supplemented with formula in the first three days were much more likely to not be nursing at 12 weeks, which is similar to the Canadian study that found that mothers who go home from the hospital with formula samples are much less likely to be exclusively breastfeeding after a few weeks.
As I looked at the key reasons for early weaning in the Canadian survey (low milk supply, low weight gain, difficulty with latch) and then looked at the factors influencing early weaning in the German report, it reinforced my belief that inadequate breastfeeding support and advice in our hospitals is one of the key factors that prevent women from meeting their breastfeeding goals. Instead of trying to convince moms to give their baby a bottle, hospitals should be warning them against it and helping them with alternatives (cup feeding, tube feeding, supplemental nursing systems). Instead of handing out pacifiers, hospitals should be banning them as a handout and warning moms against their use during the first few days. Instead of jumping to give a baby a bottle at the first sign of not by-the-books weight gain, doctors should be referring their patients to International Board Certified Lactation Consultants for advice on increasing weight gain. Instead of taking babies to the nursery to "let moms sleep", nurses should be encouraging moms to keep their baby with them and nurse as frequently as possible around the clock.
I believe that doctors and nurses mean well and want to help mothers breastfeed. The problem, in most cases, appears to be that they do not have the knowledge or the resources to do so. A massive overhaul of hospital policies and a massive reeducation of nurses and doctors is required to ensure that women who believe they are getting breastfeeding support are not instead getting latch problems (due to nipple confusion from bottles and pacifiers), supply problems (due to supplementing or insufficient nursing), and low weight gain (from the supply dropping and the bad latch). Bad breastfeeding advice is a nightmarish dominoes game and is one our hospitals have to stop playing.
A Canadian breastfeeding survey by Today's Parent (2006) found that only one out of ten mothers was lucky enough to breastfeed problem-free. That means that the vast majority of new mothers face some kind of breastfeeding difficulties. The Today's Parent survey noted that [emphasis mine]:
Our data can’t establish the exact extent to which problems cause women to stop breastfeeding before they want to. But three difficulties were roughly twice as prevalent in women who stopped early: low milk supply, low baby weight gain and a baby who seemed uninterested in nursing or nursed ineffectively.
Certainly there are some mothers will low milk supply, there are some babies with low weight gain and there are some babies who cannot latch on properly. However, most breastfeeding advocates recognize that the number of mothers who report those problems is much higher than it should be in the normal course of breastfeeding. But why?
One of my readers passed along links to some German reports on breastfeeding duration. Since both Germany and Canada have a lot of similarities (developed countries, similar breastfeeding initiation rates, maternity leave for mothers of infants), I found a lot of the information I was reading seemed equally applicable to a Canadian scenario. In particular, one of the reports noted the key factors influencing early weaning, broken down into factors on the mother's side and factors in the practice of breastfeeding (clunky translation - sorry).
KEY FACTORS INFLUENCING EARLY WEANING
Mother's Side
- Breastfeeding difficulties in the first 14 days
- Lacking or unclear breastfeeding advice/support
- No prenatal information on infant feeding
Practice of Breastfeeding
- Supplementing with formula during the first three days
- Frequent weighing of the infant
- Giving other liquids during the first three days (e.g. carbohydrate solutions, tea)
- Rooming-in only during the day
- First latch on more than one hour after birth
- Use of pacifier during the first few days
The report went on to explain that supplementing with formula during the first three days, which was the factor most likely to contribute to early weaning, still happens in about 50 percent of infants in Germany without any medical indication and without the mother requesting supplementation. Babies who were supplemented with formula in the first three days were much more likely to not be nursing at 12 weeks, which is similar to the Canadian study that found that mothers who go home from the hospital with formula samples are much less likely to be exclusively breastfeeding after a few weeks.
As I looked at the key reasons for early weaning in the Canadian survey (low milk supply, low weight gain, difficulty with latch) and then looked at the factors influencing early weaning in the German report, it reinforced my belief that inadequate breastfeeding support and advice in our hospitals is one of the key factors that prevent women from meeting their breastfeeding goals. Instead of trying to convince moms to give their baby a bottle, hospitals should be warning them against it and helping them with alternatives (cup feeding, tube feeding, supplemental nursing systems). Instead of handing out pacifiers, hospitals should be banning them as a handout and warning moms against their use during the first few days. Instead of jumping to give a baby a bottle at the first sign of not by-the-books weight gain, doctors should be referring their patients to International Board Certified Lactation Consultants for advice on increasing weight gain. Instead of taking babies to the nursery to "let moms sleep", nurses should be encouraging moms to keep their baby with them and nurse as frequently as possible around the clock.
I believe that doctors and nurses mean well and want to help mothers breastfeed. The problem, in most cases, appears to be that they do not have the knowledge or the resources to do so. A massive overhaul of hospital policies and a massive reeducation of nurses and doctors is required to ensure that women who believe they are getting breastfeeding support are not instead getting latch problems (due to nipple confusion from bottles and pacifiers), supply problems (due to supplementing or insufficient nursing), and low weight gain (from the supply dropping and the bad latch). Bad breastfeeding advice is a nightmarish dominoes game and is one our hospitals have to stop playing.
Reader Comments (38)
We fought all of those problems by having the baby room-in with us at all times, as well as leaving a sign in the bassinet that said "MILK AT MOM'S! (No Pacifier or Bottles)" so no one would make any mistake.
I was lucky enough to have no problems nursing, and have watched and helped as friends struggled to make the same. A brave friend allowed me to nurse her 2 week old after non stop latch problems, and has nursed successfully every since. Another friend didn't ask for help, and gave up to formula at 8 weeks. I feel guilty that I wasn't there for her. :/
So much can be done with help and support! And EDUCATION! No one has to do it alone.
Some of the hospital practices I hear about here in the US make me cringe. I think the nurses are truly trying to be helpful, but end up sabotaging breastfeeding attempts... for example, when I hear of moms raving how they got 6-7hrs of sleep in the first nights after birth. They see it as so great that they got sleep (and I get that) but then they have trouble with supply and breastfeeding, and I can't help but think that not nursing around the clock from hour 1 put them on a bad track from the get-go.
I give my son almost more credit than I do myself for the fact that we nursed for 14 months. Between 5-6 months he started dropping on his weight gain charts (this was even on the breastfed-baby charts). By 7 months my pediatrician recommended trying to supplement with formula. My son, however, would have nothing whatsoever to do with bottles. At 10 months I went through about a week of very low supply for some reason (noticed he wasn't having many wet diapers). Again I tried to give him formula-- he refused it all. In the end, my supply went back up, and his weight settled down at about 20% and we realized we had a perfectly normal, if skinny, baby. But if he hadn't been so adamant about only using the boob, we may have weaned much earlier. I'm pretty grateful to him for that (and the lessons he taught me to trust my body, and his).
Mandy:
When I had latch problems with my first child, I often wished I could hand him to an experienced nurser to see if it was me or him that was the problem. Or that I could borrow someone else's baby to nurse so that I would know what a good latch felt like. It is wonderful that you were able to be there for one of your friends to help out in that way.
While I also wish hospitals, doctors and post-partum nurses would become more educated about breastfeeding, I also think having better pre-natal classes would really benefit moms.
I went to the breastfeeding class that is offered as part of the pre-natal class and it was good but not great. There was a lot of information missing that should be mandatory (newborn stomach size, jaundice, different holds) which would really help before the problems start. It seemed like the pre-natal class was just there to talk about labour, pain management and c-section potential. Both my husband and I thought more focus should have been on the "Baby is here, now what?".
Wouldn't it be great if everyone had access to midwifery care like we have in Ontario? If you're having trouble with a latch, they'll look at it, give pointers, make corrections (even in the middle of the night).
We were required to bring our son to the pediatrician 4 out of his first 5 days home, due to weight loss (he was born at 9lbs8oz and got down to 8lbs10oz). They had us supplement with formula and made me feel inadequate, stressed and frustrated. Now at 10 wks old, I'm happy to report we have a great breastfeeding relationship, thanks to my wonderful support system of family. HOWEVER, I can totally see how someone would quit after dealing with all the crap they put me through... more details in my post here: http://farmersdaughterct.wordpress.com/2010/04/17/following-my-instincts/
I'm writing a letter to the pediatrician group so they know exactly what they did wrong, and in the future, I'll refuse to go for re-weighs and refuse to supplement, as I now believe it did more harm than good. I'm going to include some of the info you have here.
I usually don't comment on blogs, but I had to comment on this post. I agree wholeheartedly with your conclusions. I have a few friends who had babies around the same time that my Abigail was born, and they gave up exclusively breastfeeding fairly early on. I was very, very fortunate to have had an easy time with Abby. She latched on as soon as they got me out of the OR, and I was in a breastfeeding-friendly hospital that does not have a "nursery". We roomed in, and I had support from the nursing staff. I think that it might have been the frequent nursing in those first 24 hours that helped my milk to come in by the end of day two. However, despite my surrounding being very nursing-friendly, I have to say that I did play a huge role in my own success. I had a midwife - something I still consider to be instrumental. She was my cheering squad - I felt so proud when my milk came in so early, and even more so when Abby was back up to birth weight in just six days. She never, ever mentioned formula, and admonished me for keeping the Nestle Good Start samples that I received in the mail. I also prepared for breastfeeding - I had breast pads at home, and a manual pump for relieving engorgement. The midwife suggested things like cold/warm facecloths during her home visits (I love midwives) and she encouraged me to check for blocked ducts and massage the heck out of any lumps to prevent mastitis. When I had to go on antibiotics when my tear got infected, she made sure that I took acidopholous to prevent thrush. It may have been luck, but I think it was the preparation and attentive care from my midwife that prevented me having major problems in the first six weeks.
I am going to say something controversial here, but she was also supportive of pumping and the use of pacifiers AFTER four weeks. We were getting along so well, and the pumping helped me to feel more like I could leave the house (public nursing is tough in the beginning). Happily, Abby rejected the pacifier, but she has always switched easily from bottle to breast.
Soooooo, to sum up, I think that a supportive care provider should be added to the list of factors contributing to success. That, and some preparation before baby! In my experience, breastfeeding is similar to childbirth in that you can't just decide what you'll do without any education or preparation to back it up.
As a postpartum doula, I've seen so many women and babies struggle to overcome difficulties in the first few days. The biggest issue I've noticed is a societal-wide lack of trust in a woman's body and a baby's instinct to make the nursing relationship successful. Doubt is placed in mothers' minds from the very start; everyone has a story to tell an expectant mother about how they "weren't able to" breastfeed. Every hospital I've visited has at least one nurse who will try to put baby on a schedule or insist mom "needs a break" (especially after a c-section - I went through this fight personally). Every family has well-meaning relatives who are uninformed and hinder the breastfeeding relationship more than help it.
We need more fact-based information in our communities. We can do this in very simple ways. For example, I've had some low key educational conversations at the park with moms and grandmothers I just met who have questions once they find out I work in the lactation field. I post links to articles like this on Facebook and Twitter to passively inform those who may not look for good information otherwise. If a few of us educate ourselves on the facts and pass it on, knowledge and truth will spread throughout our communities -- hopefully faster than links to free formula samples. Ugh.
I was fortunate enough to have my sister give birth only 10 weeks before me. Even with the added advantage of getting to nurse her baby things took a while to work out... but at least I knew the issue was with me, and not my baby.
You make so many great points. Until more institutions follow the 10 steps outlined by the Baby Friendly Hospital Initiative we will continue to see mothers being set up for failure. The support mothers get (or don't get as the case may be) in the intra and postpartum period is extremely important. However, it's not the whole story.
It isn't necessary to blame or vilify mothers to notice that yes some are more committed than others and **very generally speaking** the results often follow. Rather than trying to ignore that whole component and throw the blame entirely on the medical profession it might behoove us to take a hard look at why breastfeeding matters more to some and less to others. Is it their level of confidence? The attitudes in society? Influence from formula marketing? The perception that breast is "best" and has "benefits" but formula is fine? Myths like bottle-feeding is easier?
I see a trend lately, probably borne from diplomacy, to focus on one target (the medical community) and downplay or outright ignore the roles played by the people who are actually DOING the infant feeding. While well-intentioned, this worries me a little. Not because I think it's necessary or good to point fingers at mothers and make them feel bad but because all the potential avenues for improvement need to be explored. I absolutely agree with The Maven that more fact-based information has to be available to communities. And I am really hoping that social networking and the internet in general will be able to play a big role in this.
Very well said The Maven:
"Every family has well-meaning relatives who are uninformed and hinder the breastfeeding relationship more than help it. "
I would also put more pressure on moms (and dads!) to get some advice and some help to have a great nursing relationship - and if you "really wanted to" but couldn't (because of some lame excuse) and then you"really want to" for the next baby and don't do any research or ask questions, then don't "give your excuse on why it didn't work again" (ie low milk - argh!)
Back to what The Maven said about uninformed families.... if you have moms who had kids in the 70's shopping the formula sales and coupon hunting, your chance of success is probably zero. (not unless if you live very far like we do!!! and we are just now weaning at 18 months...)
Thanks so much for this post Annie. As you know baby boy is now 4 days old and I want to exclusively breastfeed for as long as possible. I always watched other mothers nurse & thought how natural it looked, therefore it must be instinctive between mom and baby and that there are hardly any problems. Boy was I wrong!
Baby latched immediately after birth and ate well for the first 24 hours. We then started to have latch problems with one breast, leading to a small blood blister and some minor nipple damage. There was no support in the hospital the first 12 hours. Luckily on nurse shift change an experienced nurse came in and gave me a few techniques, but was really nothing in comparison to the education that really should be provided to new mothers.
When my milk started to come in a few days later my nipples flattened and latching became very hard. We went to see a LC on Monday who did confirm that baby has no problem with his ability, but more b/c of my engorgement. We tried several different holds and did not latch successfully on the one side. We then tried a nipple shield and he fed immediately. The problem now being, or I feel it is my problem, is that he doesn't like to take the other breast without the shield now that he has had a "taste" of it on the other side.
We will go back to the LC tomorrow and see what she has to say. I get worried that we will be dependant on the shields, it may decrease my milk supply, etc. However on the upside the pediatrician was concerned about his weight loss when we had our first Dr. appt and was suggesting that we needed to supplement. I know the importance of early bf & not supplementing, confusing with soothers, etc. We went back 24 hours later, today, and he had gained weight over the last 24 hours. So I am trying to relax knowing at least he is eating and gaining weight. Hopefully we will get a successful "natural" latch in the future and be able to feed in other various positions (right now only side-lying & football).
Thanks Annie for all your wonderful posts :)
Pretty much sounds a lot like like our medical system and health care professionals here. As in what they need to be doing better to support breastfeeding for any extended length of time. Great post as usual though! :)
This is why I am becoming a Lactation Consultant. In the hospital I had little help from the LCs... instead the sweet nurses tried to help me but they didn't know much about bfing and w/o asking one nurse dripped formula on my breast to help my daughter latch. My daughter had an extremely hard time latching. I called and called for an LC but no one ever came. The nurses offered me a nipple shield and finally we were able to nurse. Weeks later I tried to wean the nip shield but my daughter still couldn't latch properly. A YEAR later I still couldn't wean the shield. Well, it took until I was taking my breastfeeding management course ( LO was 18 mos) to realize my daughter had a tight labial frenulum. If my daughter would have been checked by an LC when I was complaining about our bad latch, she could have been snipped and we would have never needed the nippy ( as she called it). None the less, we enjoyed a beautiful 25 months of nursing with "the nippy"!
To Amanda, with the new baby: First of all, congrats on your new baby and on breastfeeding. You're doing great....baby is gaining weight! I got mastitis with my first baby because she couldn't latch onto one side correctly, mostly because of engorgement. The ONLY way I could get her to eat on that side was with the nipple shield. I also had to use the football hold exclusively for that side. I'm happy to report that after using it for about 2 weeks, I gradually "weaned" her off of the shield successfully and we went on to breastfeed quite happily until she was 28 months old! So take heart.....it can be done! Keep talking with your LC, and keep nursing your baby. It will come. All the best to you!
As a postpartum nurse this is something I see each and every day. It is not that we do not have the knowledge, it is that our policies do not back us up. There are so many policies that say we have to supplement for this that and the other thing. It is hard not to send mixed messages to patients when we are required to supplement so often. Also, as a nurse working with a mother who's intention it is to EBF, if the baby's pediatrician is not on board with it, often his/her wishes dictate what I have to do.
Even with my last child, had I stayed in the hospital I would have been encouraged time and time again to supplement with formula as she did not pee enough, her weight loss was too much yet I could pump a ton of milk and see lots of swallows. Thankfully I had a midwife who encouraged me to stand by my reasoning that the baby didn't need supplementing, and agreed that there were other reasons for the lack of output despite the copius input.
Many many of the postpartum nurses that I work with truly support breastfeeding, but it is the policies that get in our way. Even when our gut is saying it is going to work, if the policy says something else, legally, we have to cover ourselves.
Locally, a lot of our hospitals are working towards Baby Friendly accreditation, which is a great thing. It means no formula and no pacifiers and no separation. However, I think that a lot of the support falls off after a mom leaves the hospital. And many of us leave within 24-48 hours, well before our milk has come in. The result is that support and information ends up being very spotty in the time period when breastfeeding is still being established.
Those of us who have midwifery care have the advantage of having someone to call, who will visit our homes and help us out. But most moms don't have that, especially if it's an evening or weekend and the public health nurse isn't in the office. Follow-up after leaving hospital is one area where I think we could really improve our postpartum care.
Exactly. For instance, I was told I could not breastfeed my son in his first 2 days because I was given medications (mag) to lower my blood pressure. Researched it. Not true.
We had SO many difficulties mainly due to this, but I weaned him off formula fully at 4 months and have breastfed him since! He's 14, almost 15, months old and no signs of stopping!
I was extremely stubborn and research savvy and fully intended to exclusively breastfeed him and had a relatively good basis of knowledge about breastfeeding when I had him, but being that I was feverish, had very low blood sugar, was devastated my birth did not go very well, and had been awake for 2 days.. I just could not fight them. They told me it wasn't safe, and I took their word, giving them an ounce of trust, only to question it when my mind was clearer and find out that that it resoundingly was.
This sort of thing just should not happen and I am sure it happens in Germany and Canada as well, along with all sorts of other stupid things like with jaundice, the tiniest amount of normal weight loss, etc.
I do think they meant well, but, the road to hell was paved with good intentions.
I feel fortunate that I was experienced enough in breastfeeding my second child to get around some of the problems the hospital could have caused. They kept him in the nursery for 4 hours after my C-section to check him over and to let me recover. Told me it was necessary. One of the loneliest times of my life. They gave him formula in there. I was furious.
So glad he was my second because I still managed to breastfeed him after all that for about 18 months. I knew what I was doing and got past the hard parts.
I hope that my daughters get better support when they are old enough to give birth and breastfeed their own children. Hopefully hospitals, OBs, nurses, midwives and so forth will have learned from the mistakes we're still making now.
Nicely put. I fully agree. I've seen this personally, and I will say something even MORE controversial - sometimes, occasionally, there are mothers who get great advice and still don't follow it because they really don't want to breastfeed. That is not a judgement; it is just the way it is.
Typically, though, it's bad advice that creates the situation, I agree.
I totally agree with Gina on the midwifery care here in Ontario. I am so fortunate to have had all three of my babies at home, with amazing and experienced midwives who gave me hours and hours of breastfeeding help and assistance. I most certainly did call them in the middle of the night! And they came and helped. It was so supportive, they really and truly helped me see how natural and amazing nursing can be. I totally support any initiative that would be helping new mothers receive better support in the first few days - it is so crucial.
I laughed when I read about moms from the '70s, because that was exactly my experience. My insistence upon nursing my firstborn made my mother (already a total neurotic) feel guilty for not nursing me in 1971, so she was VERY quick to tell me to give it up any time I encountered a challenge. Fortunately, I am the type of daughter who stubbornly digs in and will do the OPPOSITE of what her mom tells her to do! I struggled to establish the nursing relationship with my son but made it through, with much credit to my husband, the only person who told me that I could do it. A little confidence and support can go a long way. I try to pass along that same confidence and trust to every other parent I meet.
I also thank my baby for making his preferences known -- I planned to wean him to formula at 6 months but he wouldn't touch it (and he'd had bottles of EBM, so it wasn't the bottles). Knowing what I know now, I'm very glad. I learned a lot from that little guy :)
I absolutely agree (and have experienced) that lack of knowledge and support from medical professionals is a major contributor to low breastfeeding success rates. But even if those are in place, I think it's still going to be hard to fight the misinformation that pervades our culture in general (and perhaps it's the same in Germany). I know this has been discussed before (the booby traps), but it's so easy for a new mom to convince herself she has "low supply" when people all around her are telling her the baby shouldn't be hungry every hour or three, that she shouldn't feed the baby every time it cries, that sleeping through the night should happen sooner rather than later etc. Then of course it's likely she WILL end up with a low supply, especially if she starts supplementing. There's that domino effect. I also think we as women in this day and age are (justifiably) used to our independence and freedom that it really throws some of us for a loop when the reality of motherhood, and exclusive breastfeeding, sets in. That baby really does need us 24/7. That's not a sign of a problem, it's nature.
I recall a mom-to-be friend being surprised that my then 9 month old had never had a bottle. She gasped "so you can never be away from him!" That wasn't completely true, but to a large extent, I guess it was, I only went out without him between feedings. Despite my assurance that this really wasn't a burden on me, that I knew as he got older I would have more flexibility, this friend was supplementing her baby by 2 months, so she could get out. It's hard to remain dedicated when what you've been led to believe isn't the way it really is, or doesn't fit in with the lifestyle you expected to have.
"A massive overhaul of hospital policies and a massive reeducation of nurses and doctors is required to ensure that women who believe they are getting breastfeeding support are not instead getting latch problems (due to nipple confusion from bottles and pacifiers), supply problems (due to supplementing or insufficient nursing), and low weight gain (from the supply dropping and the bad latch). Bad breastfeeding advice is a nightmarish dominoes game and is one our hospitals have to stop playing."
This, 100%. This is the problem. If someone doesn't want to breastfeed, fine. I have no quarrel with people's personal decisions. But people who want to, intend to, and get sabotaged (like me) - that needs to stop. All nurses need to be re-trained in teaching breastfeeding, or else just not try to teach it because they do more harm than good. Lactation consultants should be freely available, not "she can get here the day after tomorrow". A bottle shouldn't be the first and only fallback if your milk doesn't come in right away. It's not hard to fix. There just has to be the will.
We went to the breastfeeding class that the hospital sponsored, but I can't say that it was very helpful- classes are great, but what moms really need is good advice and help after. I kept hearing in the class that "it only hurts if you're doing it wrong". I had no problems breastfeeding Claire after she was born, but I did have very sore nipples for about a week, which made me think I was doing something wrong- really, though, it was just something that cleared up and is pretty common even with a good latch. I wish they had mentioned that in the class so that I wouldn't have to stress over it.
The lactation consultants at the hosptal weren't very helpful in my opinion. They kept trying to get me to hold her in a way that just wasn't comfortable for me, and weren't very good at instilling confidence in my ability to breastfeed.
There were hospital breastfeeding classes for new moms during our hospital stay. I skipped it. Why? They said to drop off your baby in the nursery! What help is a breastfeeding class to a brand new mom if her baby's not there? I was really pleased with my hospital experience otherwise (I gave birth at Yale New Haven Hospital in CT), and I think they're really progressive. But who came up with that idea??? Instead, I stayed in my room and nursed my baby by myself, and fortunately he did fine.
Wow Abbie...that is unbelievable. ?!?!?
OMG! I didn't try in the classes with my baby because it was prenatal. But a class AFTER the birth is a great idea. Major fail not allowing the babies to take part! Almost laughable, if it wasn't so sad!
I am still angry at the nurses I dealt with when my son was born. They weren’t so bad in the hospital because things were mostly going ok. He nursed a lot even though my milk wasn’t in yet and I did have some nipple soreness. He did lose weight but his pediatrician assured me that all babies do that. Then came the in-home follow-up visit a couple of days after we got home. On the nurse’s portable scale, it appeared that he had not gained any weight since his check-up in the doctor’s office the day after we were released. So in two days, he hadn’t gained or lost any weight (according to her scale, which she admitted sometimes showed different numbers than the scale in the doctor’s office). So she called the nurse at the hospital and they requested we bring him in. She tried to push formula on me, which I accepted since at this point I was petrified that I was starving my baby. He refused to take a bottle. They hooked me up to a pump to see if I “was producing milk.” All I got was a few drops, but of course, he had been nursing all day, I was still less than a week post-partum, and I was extremely stressed. They sent us home with a bunch of bottles and instructions to supplement because she wanted him “full as a tick.” She proceeded to call me at home several times, hounding me about bringing him in for another weight check. I stopped taking her calls, so she had the pediatrician’s office call me! I took him in and he was back up to his birth weight and the doctor said “He is perfectly fine. He’s gaining weight, he’s got good color, he’s not dehydrated. Go home and keep nursing your baby.” I really have to give credit to my sister and my fiancé and his parents, who all assured me that people had been feeding their babies this way for years without books and nurses and doctors and the human race had done just fine. Thankfully, I didn’t give up and we are still nursing now at 23 months. And sometimes I would like to take him back to the nursery, all 36 inches and 34 pounds of him and tell him this was the baby they thought wasn’t gaining enough weight. But then I’m vindictive like that. :)
Abbie,
I'm so glad to hear that you stuck with it and that your nursing is going well now! We had the same issues with slow weight gain when my daughter was a newborn. She was even teenier--born at 6 lbs. 8 oz and got down to 5 lbs. 8 oz. We had to go in to the doctor all the time to weigh her and fret. I
I feel that some doctors are way too concerned with weight loss over 10%, when it is very common and normal. If the baby is nursing on demand and well-latched, they will start to gain. The constant weigh-ins just stressed me out and made those first weeks harder! The doctors truly made me feel like I was putting my baby at risk by not giving her formula! I believe that some doctors do not like breastfeeding because they can't measure exactly what the baby is eating.
Thank goodness I had great support from family, friends, my doula, and La Leche League. I wish that all struggling new mothers had the support to make it through those first difficult weeks.
Hey Amanda,
I just wanted to say great job and hang in there--it will get so much easier, probably by 6 weeks or so! I had a hard time at the beginning, too, but by 6 weeks my daughter was nursing like a pro. My daughter is 14 months and still nursing (I plan to nurse until she self-weans) and going to La Leche League meetings has really helped me find support. If you have a LLL group nearby, I would highly recommend going to meet other like-minded moms and get help along the way.
I've known other moms who needed nipple shields at first, but they were able to wean the baby off the shields once they were a little older and stronger. I would say don't worry about needing the shields for now, focus on getting him eating well and gaining, and slowly take away the shields when everything is going well. Keep up the great work, you can do it!
I delivered my sons in Edmonton, Alberta and in hospital after my first son was born, was pressured by the nurses to take formula home with me "just in case", and was even warned that if I got in an accident and had to go to the hospital, I wouldn't be able to feed my baby! I was left on my own for virtually the whole first night with my son, trying to latch him with no assistance and having no idea what I was doing AND I was to mark on a sheet each time and for how long I fed him. When the nurses finally came in to check my latch, I was essentially scolded for marking times as feedings when they were "attempts." Later when my son failed to gain weight between 4 and 5 months, nurses again expressed their "concern" and pushed supplementation with formula. Luckily, our pediatrician is a sensible man and quickly put my worries to rest and told me not to weigh my son for at least 2 months. THAT was another battle with the nurses who tried to insist on weighing him at his 6-month immunizations, but again, I held fast citing doctor's orders. All this, and I had a relatively easy experience with nursing, so I can only imagine how much pressure mothers having significant difficulty would face. At 4 1/2 years old, my son is now a strong, energetic lithe young man and the pediatrician tells me that he has the body that everyone in North America wants. I was much more relaxed about nursing my second son and am set to deliver my third child in the next few weeks. There are good resources available in Canada, but as someone who strives to nurse till 24 months, I definitely am in the minority.
Yes, they made an announcement that you could bring a support person, and please drop your baby off at the nursery. It was bizarre, since they have a rooming-in policy. I made sure to write about this when they emailed me a satisfaction survey.
I was really frustrated with my breastfeeding experience. My son had trouble latching. The MRU (major research university hospital in the US) advertised they had a lactation consultant who would help w/BFing after birth - one of the reasons I went there! Much to my dismay, not only could I not get an appointment with her, she eventually came in for a whole 2 seconds and gave me a plastic thing to put around my nipple. I didn't even know what it was! To make a long story short, the night nurse eventually just gave my son formula without asking when she deemed him to be dehydrated (this is a rooming-in hospital BTW). Eventually, we both sort of got the hang of BFing. After leaving the hospital, I went to an LLL meeting where someone took the time to help me and correct our "technique." I have a feeling that my story is not in the minority sadly enough...I am very glad to be in Germany for my 2nd child where, at least now, it feels like BFing mothers are much more supported with the midwife system. At the very least, I know a little better what I am doing.
I'm grateful my son had a good latch from the beginning and I had the ability to hire a doula who was able to help me with the first breastfeeding session, but it was definitely a battle against the hospital to keep my baby in my room and to not have formula samples forced onto me, and I was too exhausted from three days of labor to advocate for myself or my baby. It makes me so angry that moms have to fight so hard to make breastfeeding work. We really need major changes like you propose here in the US as well, to help moms breastfeed so it isn't such a struggle against all odds to make it work. The entire medical birth system from beginning to end hurts breastfeeding success.
Yelli:
I look forward to hearing how your experience in Germany for the birth and breastfeeding support is different from what you experienced in the US. I hope you'll blog about it.
The word "no" is my strongest BF tool. Seriously. I am th eparent, and no one has a right to do anything to my baby without my permission. I actually warn the nurses before birth, and put a sign on the bassinet and the hospital room door. No bottles. No formula. No nipples. No soothers -- without written and SIGNED permission from me. Violators will have consequences.
Luckily, since this is my 4th child, the nurses tend to leave me alone, since I generally know more about BFing my children than they ever could. I don't even let them look at my nipples or check my latch as part of their routine.