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From:
Michelle Meeks <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 16 Apr 2004 18:39:07 -0500
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Connie - I understand your frustrations. I am a NICU nurse working towards
IBCLC. I hear other nurses tell mothers that we should bottle feed in the
NICU, the baby can breastfeed when they go home, or formula is better
because it is sterile.... On and on. It is a slow re-education process, and
culture changes take time. I have over the past year started correcting
these fallacies on the spot (With evidence and explanations of course) when
I hear them, and I keep a resource notebook of journal articles on the unit
so I can refute such things and support it with evidence. Your best bet will
be to form strong alliances with a few of the nurses who are knowledgeable
and helpful with breastfeeding, and have THEM push things through. Work on
educating e individuals and creating go-to's that are in the same discipline
as the "nots". We shouldn’t HAVE to do that, but I can tll you I am seeing
small changes over time with this process. 

Our unit will be remodeled soon and will incorporate rooms where mothers can
pump right at the bedside, there will be room for large confortable chairs
at the bedside to encourage mothers to stay, and there will be more rooming
in rooms. Hopefully, not having to trip over pumping moms, roll screen
around and such will help improve some of the staffs attitudes regarding
breastfeeding too. 

If anyone has any suggestions about other ways in which we can make the NICU
more family and breastfeeding friendly, I would love to hear them before we
set everything in stone!

Michelle

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Connie
Sent: Friday, April 16, 2004 11:13 AM
To: [log in to unmask]
Subject: Breastfeeding Climate in NICU


I wanted to post a question to see if anyone else has encountered these
issues.

At our hospital, the Lactation Consultants will work with breastfeeding
mothers in the NICU.  We all are careful with pre-term or sick  babies to
observe for signs of fatigue, stress, etc. when we assist the mother in
putting the baby to the breast.

The protocol has always been that when a baby is allowed to P.O., the baby
can go to the breast.  The problem is that we have nurses that will only
allow a baby to attempt to breastfeed if they have seen the baby "nipple
well" on a bottle first.  They also inform the mothers that they will be
able to take their babies home sooner if they strictly focus on getting food
in the baby via the bottle.  This conveys to the mother that breastfeeding
is a waste of time and energy.  So, often times we will have spent a lot of
time with a mother and baby only to come back in the next day to find out
that the mother has changed her mind and wants to only pump and bottle-feed.
The mother also may comment that she "wants to take her baby home as soon as
possible".

What we know has been happening is that there has been lots of *gossip*
about the LC's.  The NICU staff seem to think we are extreme and have also
made comments that we aren't RNs. (Actually, there are three on staff who
are RNs, and IBCLCs the other four of us are not.)  We are all IBCLCs.  They
have also made similiar comments about our Speech Pathology
staff..........of which we often work closely with.  They seem to think that
because they are RNs, they are the only "experts"!

I can't say that all of our nursing staff in the NICU are like that, we have
some very fine nurses dedicated to assisting our mothers with breastfeeding.
It just seems that lately that the few who aren't supportive have sabotaged
a lot of our mothers big time!

I am just curious to ask how others have handled these issues.  Our hospital
has had consistently, 80-85% breastfeeding initiation rate every month, we
even have patients choose our hospital because of our Lactation Program, we
consistently offer breastfeeding education opportunities to our staff and
have great support from all our nurse managers.

Just venting today.


Connie Chiavario, IBCLC, RLC

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