I listened in on a very interesting conference call today. The call was about Best Fed Beginnings, which is an effort to help hospitals nationwide make quality improvements to maternity care to better support mothers and babies to be able to breastfeed. This project will address the need to improve hospital practices to support breastfeeding by helping hospitals move toward Baby-Friendly status.
Baby Friendly Tallahassee
Oh, how I would LOVE our hospitals to be baby friendly because, believe it or not, they are not designated baby friendly hospitals. Tallahassee Memorial Hospital and Capital Regional Medical Center, I’m talking to you.
The policies and protocols that are not baby friendly consist of a bath within the first hour of birth, little concern of skin-to-skin with mama and baby, overuse of the breast pump and bottles, incorrect and overuse of pacifiers, but underneath all of that is simply a lack of education from the top down. And those that are educated on true breastfeeding support are not supported by the higher-ups.
Evidence based breastfeeding care is not happening in my local hospital. I’ve had client after client sent home from the hospital pumping and supplementing with formula instead of having fixed the root of the problem (an incorrect latch). My clients either give up in despair or call a private lactation consultant who corrects the latch and dispels the erroneous breastfeeding advice that had been received (They then go on to successfully breastfeed their child for a LONG time!).
I would love either hospital in town to apply to be a part of the Best Fed Beginnings initiative. Jacksonville just had their Naval Hospital become “baby friendly” and I think we should be next. This program would impact our hospital by promoting, protecting and supporting breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO.
10 Steps to Successful Breastfeeding for Hospitals
The steps for the United States are:
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 one hour of birth.
5 – Show mothers how to breastfeed and how to maintain lactation, even if they are 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 pacifiers or artificial nipples to breastfeeding infants.
10 – Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Be The Change
Since the change we’d like to see isn’t happening, the users of the hospital (The Women of Tallahassee) need to elicit this change. If the consumers of the product are not happy with the product, the law of supply and demand will be on our side. And since I am more of a do-er rather than a complain-er, I have some ideas.
1) Write a letter to your OB/Midwife and/or the director of labor and delivery at your hospital and explain to them the changes you’d like to see. Include personal experiences. Above all, encourage them to become “baby friendly”. Our care providers will not know that there is a problem unless they hear some “noise” about it. Of course, I encourage all writers to be friendly and courteous in their writings and simply stick to the point.
2) Distribute breastfeeding posters and booklets to the OB offices in town and ask for them to be placed in waiting rooms, bathrooms and exam rooms. I bet this would be simple to do. Us Tallahassians are very resourceful! A simple google search led me to this:
Remove Formula Marketing
“To enable mothers to make the best possible feeding choice, based on impartial information and free of commercial influences, and to be fully supported in doing so.” “The Code explicitly states that “there should be no advertising or other form of promotion to the general public” and that “manufacturers and distributors should not provide … to pregnant women, mothers or members of their families, samples of products…” Promotion through any type of sales device, including special displays, discount coupons and special sales, is prohibited. Furthermore, no company personnel should seek direct or indirect contact with, or provide advice to, pregnant women or mothers.
Get on Board: Baby Friendly Tallahassee
This is something that I am passionate about and I hope you are too. Please, please comment on this post and let me know what you’re going to do to help. Tallahassee has made incredible changes in the past on a plethora of causes, let this be one more to add to the list. It’s just that important.
TM
Sunday 28th of December 2014
Hi Lindsey, I realize that a bit of time has passed since this article was written, but this can serve as a bit of an update. I am a postpartum nurse, breastfed my baby, had a completely natural labor and delivery at TMH, so I am definitely very encouraging, supportive and almost pushy toward being a baby friendly/breastfeeding friendly hospital. TMH (I hear) is beginning changes soon (within the next few months) to delay baths for many hours after delivery and to bring the entire admission process (weights/measurements, medications) to the mother's bedside once she is upstairs on the family care unit which is usually at least 2 hours after delivery. This should allow more bonding time for mom and baby downstairs after delivery. There has also been a huge push for some time now to ensure babies are placed skin to skin immediately after birth and latched (correctly!) as soon as possible. There is still work to be done and sadly it cannot all happen fast enough for my liking, but I am hearing good things are coming, so please keep up the awareness, and women keep pushing (no pun intended) for the things we know are good and right for us and our babies. Thanks again for helping to make the changes we so desperately need!
Lindsey Morrow
Monday 29th of December 2014
Hey there! I have seen AMAZING changes at TMH recently. Normal protocol is now s2s, delaying meds/bath for baby, etc. Some of my doula clients have even had a family friendly cesarean (that is not their normal protocol, however, progress!)! Change is so hard... but I hope we keep moving forward. Thanks for the comment!
tonyah
Tuesday 15th of January 2013
I am a nursing student and just did my rotation in Labor and Delivery and Mother Baby. I can tell you that TMH teaches their nursing students to promote breast feeding with the caveat of respecting the mother's choice of course. There is no nursery available so rooming in is a must. Nurses are to encourage skin to skin and breastfeeding within an hour of birth. Our Nursery nurse usually does not come to the room for about an hour for bath and weight check etc. You are always going to have nurses who are not as capable or as supportive, it is just the way of things, we don't always communicate on the same levels. In regards to weight loss, I am afraid that this goes back to our litigious society, if a baby loses too much weight- yes it is normal to lose up to 10% of their body weight and to incur some breastfeeding jaundice, but unfortunately there are circumstances in which a baby can get very sick in a short amount of time due to issues unrelated to breastfeeding that cause similar symptoms and the hospital policy is to CYA. The best thing we can do is to make sure women are informed before going to the hospital and lobby for more LC's (longer hours, we don't all give birth M-F 8am-5pm). Doulas are also an awesome advocate for laboring women/new moms.
Denise
Friday 13th of January 2012
I had my first baby at TMH in 2008, it was an overall beautiful birth, a natural one supported by my doula Lindsey and my husband. It feels kindof weird writing this on your blog Lindsey b/c I know you know all this. :-) I had a VERY rough start with breastfeeding, it hurt bad. Like, REALLY bad. I would call the nurse and she would stick my boob in my baby's mouth and then be on her way, not knowing how to explain to me what I was doing wrong. The LC came in once, I guess she was pretty busy. We were never encouraged to give her formula, but I did leave the hospital with open wounds on my nipples (and a big diaper bag full of formula samples). A few weeks later I was back in the hospital with a severe case of mastitis and had to have minor surgery and two days of iv antibiotics to get better. I feel like if TMH had more staff dedicated to helping women establish breastfeeding all of this would not have happened to me.
TMH has beautiful, BEAUTIFUL labor and delivery rooms. I mean, if you want to have a natural birth there they have all the components. With a few exceptions though they lack staff education and support (shout-out to labor nurse Alicia, lactation consultant Heidi, and Dr. McAlpin, who were very supportive of my choices).
becca kingston
Thursday 12th of January 2012
i gave birth to my daughter at TMH in 2010, and knew going into it that i definitely wanted to exclusively breastfeed her from the start. i received my first LC visit only hours after the delivery, and when i expressed dismay at being too exhausted to follow most of what she was teaching me, she assured me that she would be back the following day to go over it all again. true to her word, she did come back the next day, and the day after that one as well. and thank goodness for her, because in the meantime, my milk was slow to come in, my colostrum bolus ran low, and my baby lost several ounces. i've since learned that the weight loss was probably more a matter of fluid loss, since i'd been induced and given epidurals, eventually leading to a c-section, but had no way of knowing that at the time, and found myself being harassed by nurses wielding formula bottles and threatening that my daughter would be kept behind after my discharge if she didn't gain some of those ounces back. luckily, i was able to get away without the formula ever making it into the baby, but it was terrible being so unnecessarily stressed out about the situation. i was also frowned upon by nurses for letting my baby sleep on my chest instead of in her little plastic baby box, and shown how to use the dreaded breast pump very incorrectly by a nurse before being set straight during the next LC visit. so, overall, i wasn't much impressed with the mother-baby nursing staff. the LC was fantastic, however, and just based on three visits from her during my stay, i was able to continue nursing at home without any major difficulties and am still nursing her to this day, 17 months later, with no plans to stop in our near future.
i now live in asheville, north carolina, a city which prides itself on being very progressive and green and so forth. however, based on the experiences of some of my friends who have given birth at our local hospital in the past year, i have to say TMH did a better job preparing me for breastfeeding than what the norm is here. LC's are in such short supply that most new moms don't get a single visit until just before they're due to check out and go home, and in many cases have already been pressured into supplementing by the nursing staff.
even though i won't be having any more babies at TMH, i'd love to see it qualify as "baby-friendly" - i'd love to see ALL hospitals qualify as such, and the sooner the better! :)
Tanashia
Thursday 12th of January 2012
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