Dear Listmates,
It's been a lively and informative discussion of the various scenarios we
are seeing in the hospital regarding the difficulties some women are having
initiating breastfeeding within the context of a "routine medicalized birth."
I know it has been mentioned in the past, but perhaps some of the newer
listmates might not be familiar with Mary Kroeger and Linda Smith's book "Impact
of Birthing Practices on Breastfeeding." It is well worth reading.
One of the things we can do is be extremely proactive in our prenatal
teaching of immediate and undisturbed Skin to Skin contact after birth, mother and
baby condition permitting. No going to the warming table, no passing of the
baby around to family or friends, not even the partner, no routine procedures
until the baby has had several attempts, hopefully successes, at latching.
I recommend delaying the baby bath for 24 hours and then have it done right
in the room, so there is no mother baby separation.. The Vit K and the eye
prophylaxis can be done right in the room after a few hours. I have seen the
mothers who have done this get breastfeeding off to a great start, even with
many birth interventions. One was my own dear daughter who had just about
every known obstetric intervention, except a c-section. I am encouraging women
to write a "newborn post-birth plan" to cover this departure from the regular
newborn care. Respiratory therapy attends all births here and when it is
explained to them by the staff nurse that this is what the mom plans on doing,
the RT has had no issues.
Of course the mom and partner have to be willing to embrace this concept of
care and it will probably be difficult for them when the family and friends
all want their share of the newborn, so we talk about the various ways they can
overcome that hurdle. It is so helpful to get the staff nurses behind you
and I think that most of them are willing to try to improve the post birth
maternity care practices which can lead to more breastfeeding successes.
Mary-Jane Sackett, RN, IBCLC, RLC, CCE
Registered Lactation Consultant, Certified Childbirth Educator, MCH Visiting
Nurse
Pittsfield, in the Beautiful Berkshire Hills of Western Massachusetts
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