XP: More Critiques of "Baby-Friendly" hospitals.

[sparkythelawyer]

Glad to see other medical providers are starting to question this move. 



JAMA Pediatrics and "Baby Friendly"

[pooh8402]

every. single. thing. they said, I have been saying for years now. yay!

[preppy]

I am already anxious about the fact that the hospital I am delivering #2 at is "baby friendly".

[hamster]

Interesting. The hospital I assume I prefer to go to is baby friendly, but if I switch doctors I'd go to the other hospital in town.

[sparkythelawyer]

What drives me nuts when I think about my delivery experience (Feb 2015) is that I really think my hospital had the best of both worlds:

1)  All of the nurses were trained in lactation.  The nurses were very helpful in helping me get things going.

2)  They had an LC on the floor 24 hours a day

3)  They did not hand out formula willy nilly.  

4) They did skin to skin

5) They had us nursing within the first hour.

Other than them waking me to ask if they could give her a pacifier, I have no qualms about the nursing/lc care I received.  But I know the "Baby-Friendly" purists would scourge my hospital (which was supposedly at a Baby-Friendly place) because:

1)  They had a night nursery.

2)  They had pacifiers.

3)  They sent me home with some "just in case" formula samples because the baby lost 10 ounces by discharge.  

Like, they did everything right, they helped me get started, all that jazz.  But because they weren't strict disciples, they wouldn't be "friendly."  Which is some seriously epic bullshit.

[vtdiamond]

Yes, I completely agree with this. It's nice to see a reasonable response to this from the medical field.

[Deleted]

Interesting. The hospital I'll be delivering at is newly "baby friendly" as of March. I haven't toured the maternity floor yet, but I'll be keeping this in mind when we do.

[Susie]

I delivered at a baby-friendly hospital, and found it kind of funny and hypocritical that they pushed immediate skin to skin so hard that they cut my bra off me after I delivered to get her on my chest NOW (I had only been admitted 23 minutes earlier, pretty sure I was perfectly capable of taking it off if they just gave me a minute), but then as soon as Hobbes was admitted to the NICU, a variety of things went out the window. They put a Soothie paci in with her, wanted me to pump colostrum and leave it for them to give her at night instead of me coming down from my hospital room on demand to nurse, offered formula if I wanted, etc.  They acted like it was a huge ordeal when I asked to have an LC visit me in the NICU during the day instead of coming to see me in mother/baby (where I had no baby).

I gave it a little  ^o)  to all of it.  It really made me question what is "best practice."  It was pretty clear a lot of the baby friendly stuff was strictly checklist stuff.

[bunch]

Amen.   

For like 1000th of the cost my hospital spent 'upgrading' to baby friendly they could have just hired another LC or two, so that you don't have to wait forever to see one and probably had much better results.

If they force me to have the baby's full exam (and PKU stick) in the room again, I'm leaving until its over. 

[preppy]

Aug 23, 2016 15:16:18 GMT -5 @tambcat said:

Also I love that the baby isn't supposed to be moved from skin-to-skin until after the first feeding if your breastfeeding, but if you're FF the nurse can just take your baby and feed her without asking. Because who cares, right?

This pisses me off, is this true?! I plan on FF from the start with #2 and feeding is still a bonding experience and I don't really want rando people feeding my baby without my permission. 

[pooh8402]

Aug 23, 2016 15:15:05 GMT -5 sparkythelawyer said:

What drives me nuts when I think about my delivery experience (Feb 2015) is that I really think my hospital had the best of both worlds:

1)  All of the nurses were trained in lactation.  The nurses were very helpful in helping me get things going.

2)  They had an LC on the floor 24 hours a day

3)  They did not hand out formula willy nilly.  

4) They did skin to skin

5) They had us nursing within the first hour.

Other than them waking me to ask if they could give her a pacifier, I have no qualms about the nursing/lc care I received.  But I know the "Baby-Friendly" purists would scourge my hospital (which was supposedly at a Baby-Friendly place) because:

1)  They had a night nursery.

2)  They had pacifiers.

3)  They sent me home with some "just in case" formula samples because the baby lost 10 ounces by discharge.  

Like, they did everything right, they helped me get started, all that jazz.  But because they weren't strict disciples, they wouldn't be "friendly."  Which is some seriously epic bullshit.

other than the LC on the floor 24 hours (ours is a few hours 5-6 days per week), this is exactly my hospital. I love that it is best of both worlds.

[preppy]

Aug 23, 2016 15:21:18 GMT -5 @tambcat said:

Aug 23, 2016 15:19:23 GMT -5 preppy said:

This pisses me off, is this true?! I plan on FF from the start with #2 and feeding is still a bonding experience and I don't really want rando people feeding my baby without my permission. 

After she examined E, the pediatric nurse just suddenly whipped out a bottle and started doing the first feeding. With me right there across the room! I wish I'd said something, but once I realized what was going on, she was already feeding after having to wait so long, and it didn't seem worth stopping it. I really wouldn't have minded for a later feeding, but I wanted to do the first one.

I am so sorry, that would bother me so much, but like you I am not sure if I would have said something in the moment. 

[Deleted]

I hated my "baby friendly" experience. Like, how was I supposed to sleep? I had DD3 at 4:30PM and by 3AM I finally begged the nurse to take her. I literally couldn't sleep until they took her out of the room. My sis in law delivered at the same hospital and ended up sleeping with her baby on her chest out of exhaustion. How is THAT safe?

[dottyblue]

I am so thankful that both of my "baby friendly" hospitals maintained an OUNCE of common sense. I had nurses who were happy to take the babies to let me sleep (with DS2, the nurse talked me into letting her take him... my anxiety was so high because I was beyond exhausted). They provided pacis. They gave me formula (which I ended up needing with DS1) even though I planned to EBF.

I'm so glad that JAMA has issued this statement since clearly common sense is in short supply.

[statlerwaldorf]

I had a postpartum hemorrhage after my c-section with the twins and was in pretty bad shape. Dh had to go back to work and take care of my older kids at night. I didn't have anyone else to help me.

I was trying to bf one twin and pump for the other in between nursing sessions. I was so incredibly exhausted. I really needed a nursery, but my baby friendly hospital got rid of it.

[awkwardpenguin]

I'm generally a relative defender of the baby friendly initiative, but I absolutely think the program was established in 1991 and hasn't kept pace with research and best practices. Safe sleep is actually the more important issue of the two (breastfeeding is important, but SIDS is the leading non-congenital cause of death in newborns).

I know rooming in is the most hated of the baby-friendly practices, but I actually think the way it is done in most hospitals (baby in bassinet in mom's room) does actually model the safest sleep situation for when babies are brought home, which is room sharing without bed sharing. I think it also supports breastfeeding in ways well baby nurseries are unlikely to achieve.

[cgpm]

Aug 23, 2016 15:10:18 GMT -5 @tambcat said:

eta: My H and I have discussed how he might go chill in the hallway with the baby for a few hours so I can get some sleep. It's insane that my choices are that or send my baby out to be put behind the nurse's desk and watched by who the hell knows- and that's assuming I can get a nurse to take pity on me.

You can't even do this in my hospital.  All the babies had alarms on them. 

[miniroller]

Aug 23, 2016 15:16:18 GMT -5 @tambcat said:

Also I love that the baby isn't supposed to be moved from skin-to-skin until after the first feeding if you're breastfeeding, but if you're FF the nurse can just take your baby and feed her without asking. Because who cares, right?

Obviously not "the mom" PSH!

This is such an indicator of the gross preferential treatment. We Get It!! But some of us can't (or, GASP, don't wanna!) nurse!! Come the F on with this nonsense

[nabum]

I'm glad to see that some of these practices are being questioned. I think the militant breastfeeding movement really turns some people off who may be on the fence with their decision. Have hospitals done away with nurseries as a cost saving initiative? I just can't imagine this only being an initiative related to improving breastfeeding percentiles.

My son was born at 4am. I didn't sleep that night and begged the nurses to take him the next night so I could get some rest. They took him for a couple of hours but brought him back to nurse. I was so annoyed because we ended up having to supplement in the hospital anyway and I really needed the rest.

When I had my daughter it was at a baby friendly hospital. I had to practically beg for a pacifier, and finally on my third nurse she realized that the girl just wanted to suck and gave me one for her. It was really annoying. I definitely drifted off while holding her which probably wasn't particularly safe.

[pooh8402]

Aug 23, 2016 15:31:16 GMT -5 cgpm said:

Aug 23, 2016 15:10:18 GMT -5 @tambcat said:

eta: My H and I have discussed how he might go chill in the hallway with the baby for a few hours so I can get some sleep. It's insane that my choices are that or send my baby out to be put behind the nurse's desk and watched by who the hell knows- and that's assuming I can get a nurse to take pity on me.

You can't even do this in my hospital.  All the babies had alarms on them. 

the alarms in my hospital allow the babies to be transported out of the room, but not off the floor. we encourage mothers, especially after c-sections, to walk the halls while pushing their baby in their cribs.

[sparkythelawyer]

Aug 23, 2016 15:30:05 GMT -5 awkwardpenguin said:

I'm generally a relative defender of the baby friendly initiative, but I absolutely think the program was established in 1991 and hasn't kept pace with research and best practices. Safe sleep is actually the more important issue of the two (breastfeeding is important, but SIDS is the leading non-congenital cause of death in newborns).

I know rooming in is the most hated of the baby-friendly practices, but I actually think the way it is done in most hospitals (baby in bassinet in mom's room) does actually model the safest sleep situation for when babies are brought home, which is room sharing without bed sharing. I think it also supports breastfeeding in ways well baby nurseries are unlikely to achieve.

Ok, but.

Offering/Supporting rooming in?  ABSOLUTELY.  Requiring it?  Please to be explaining how the hunger cues given between midnight and 6 am AND ONLY THOSE CUES are so damned important that it is worth sacrificing Mom's ability to meaningfully recover?  Baby is still in Mom's room like, 75% of the day.  Hunger cues are most definitely being learned.

I would love to see a correlation study between BFI hospitals and PPD rates among their patients.     

[Deleted]

Aug 23, 2016 15:30:05 GMT -5 awkwardpenguin said:

I'm generally a relative defender of the baby friendly initiative, but I absolutely think the program was established in 1991 and hasn't kept pace with research and best practices. Safe sleep is actually the more important issue of the two (breastfeeding is important, but SIDS is the leading non-congenital cause of death in newborns).

I know rooming in is the most hated of the baby-friendly practices, but I actually think the way it is done in most hospitals (baby in bassinet in mom's room) does actually model the safest sleep situation for when babies are brought home, which is room sharing without bed sharing. I think it also supports breastfeeding in ways well baby nurseries are unlikely to achieve.

My biggest problem with "baby friendly" is it takes away the moms right to choose her postpartum experience.  If there is a nursery, you can still have the baby in your room in a bassinet if that is what you want.  If there is no nursery, you have no option.

[osulori]

sparkythelawyer and pooh8402, the hospital I delivered at was the same except for not having an LC on the floor 24h/day. It was great!

[thebreakfastclub]

I'm the person who didn't know or care where my baby slept the first night. Someone gave him a bottle.

I had a c-section, there's only so many things you can care about in the hours after major surgery. The baby didn't make the cut, lol.

[Susie]

Aug 23, 2016 15:34:44 GMT -5 nabum said:

Have hospitals done away with nurseries as a cost saving initiative? 

Ding ding dingSaveSave

[lostarz]

I delivered at a baby-friendly hospital but it was my first birthing experience so I had nothing to compare it to. DH's daughter was born at the same hospital 9 years ago when they still had a nursery.

We did skin-to-skin right away but only for like 10 minutes, then they took her to do whatever it is they do, then gave her back to me for like 45-60 minutes and to try the first feeding. There seemed to be a LC available whenever we wanted and I saw quite a few different ones. I supplemented with formula since DD didn't have a good latch and it was the LCs that suggested it. I brought my own paci since they told us they didn't provide them but they didn't say we couldn't use them. At some point I was worried about there being no nursery but I was pretty much running on adrenaline and couldn't sleep. By the time we got home I had pretty much been up for like 4 days. DH slept way more in the room than I did.

All in all I didn't have a bad experience and I plan on delivering there again should I get pregnant in the future. The only thing is that I kind of hated BFing and only battled with it for about 6 weeks then went to pumping. They did bring me a pump right away since she wasn't latching, to help stimulate things.

[Deleted]

I delivered in a baby-friendly hospital as well. I liked some aspects of it - delayed cord clamping, immediate skin-to-skin - but other parts were just exhausting. Rooming in with DS was fine except for the nurses bursting into the room constantly, every hour, so I got no sleep. I said I wanted to breast-feed, so I had nurses and LCs all trying to help me even though DS wouldn't latch and it was obviously not working. So they had me pump, which yielded nothing. Every time they came in, I had to get back in bed for another nursing attempt, which was excruciatingly painful because my tailbone was broken.   Because sitting and laying down hurt, I spent most of the time standing and walking around, which tired me out and caused my blood pressure to spike.  

I barely ate, and when I did the food was already cold, because people kept coming in the room and asking questions. By the time I got home, I was so unbelievably exhausted, which I don't think is a good way to start off as a mom. I understand they were trying to cover all their bases, but it felt ridiculous. One nurse was incredibly put out that it took me so long to go to the bathroom (it was my first post-partum poop!). Another told me that DS would have FTT if I didn't learn how to BF. It's like they were trying to make me feel as discouraged as possible. Fortunately, it was the end of her shift and a new one came, who gave us RTF formula, and so we fed DS and it was such a relief.

[quesyrah]

Aug 23, 2016 15:36:14 GMT -5 @tambcat said:

Aug 23, 2016 15:30:05 GMT -5 awkwardpenguin said:

I know rooming in is the most hated of the baby-friendly practices, but I actually think the way it is done in most hospitals (baby in bassinet in mom's room) does actually model the safest sleep situation for when babies are brought home, which is room sharing without bed sharing. I think it also supports breastfeeding in ways well baby nurseries are unlikely to achieve.

I agree with this, but the 48 hours after birth is not the same as the next 6 months. The mom is still recovering from a huge physical ordeal, has likely been up 24 hours or more, and really needs to rest before being sent home with a newborn. IMO. I think it's well and good to allow moms to room in if they want to (and I didn't mind with Joanna), but I wish they would keep a (safe) alternative for moms who want to rest. H and I actually did have one of us room sharing with the babies for awhile after we got home, just not BOTH of us at the same time. That was unsustainable for us.

Yes to all of this. I don't know why hospitals forget that the mother is recovering from a major event. Including surgery for C-sections moms! I really think the way hospitals treat new moms is awful.

[Deleted]

Aug 23, 2016 15:31:16 GMT -5 cgpm said:

Aug 23, 2016 15:10:18 GMT -5 @tambcat said:

eta: My H and I have discussed how he might go chill in the hallway with the baby for a few hours so I can get some sleep. It's insane that my choices are that or send my baby out to be put behind the nurse's desk and watched by who the hell knows- and that's assuming I can get a nurse to take pity on me.

You can't even do this in my hospital.  All the babies had alarms on them. 

Wow really? I've never seen the alarms only work in the patients room. That sounds unrealistic as sometimes the baby does leave the room for exams, even at baby friendly hospitals. I've only seen them to be alarms for the entire floor. That seems like a horrible idea!

[namasteak]

Aug 23, 2016 15:15:05 GMT -5 sparkythelawyer said:

What drives me nuts when I think about my delivery experience (Feb 2015) is that I really think my hospital had the best of both worlds:

1)  All of the nurses were trained in lactation.  The nurses were very helpful in helping me get things going.

2)  They had an LC on the floor 24 hours a day

3)  They did not hand out formula willy nilly.  

4) They did skin to skin

5) They had us nursing within the first hour.

Other than them waking me to ask if they could give her a pacifier, I have no qualms about the nursing/lc care I received.  But I know the "Baby-Friendly" purists would scourge my hospital (which was supposedly at a Baby-Friendly place) because:

1)  They had a night nursery.

2)  They had pacifiers.

3)  They sent me home with some "just in case" formula samples because the baby lost 10 ounces by discharge.  

Like, they did everything right, they helped me get started, all that jazz.  But because they weren't strict disciples, they wouldn't be "friendly."  Which is some seriously epic bullshit.

This sounds like a hospital that is doing what's right for baby AND mom.