I am an IBCLC at a tertiary level county hospital in the US with over
4,000 births per year.  Basically, the births are a conveyer belt system
which is designed to keep mother and baby safe and alive until
discharge.   Breastfeeding is a very low priority in the eyes of many.
However, I am very confident that this can be changed.  I am addressing
the wise ones on the list for a problem for which I need research backed
evidence.

 

When a baby is born vaginally in the birthing room, a nurse is assigned
specifically to that baby. She is responsible for a large amount of
tasks to be preformed within the first hour of life or less.  There is
always a rush to get the mother baby couplet moved to the postpartum
floor as quickly as possible because we have patients backed up in
triage waiting for a labor bed.  The nurse taking care of the baby has
been taught the importance of skin to skin and no separation. Many
babies do latch at this time.  However, there are sacred routines which
some nurses are unable to part with which disturb this.  The main
obstacle I am running into is that the nurses want to bathe the baby as
soon as the temperature of the baby is 36.6.  The nurses believe that
giving the baby a bath (not immersion) helps them oxygenate and helps
lung expansion.  Another argument that they give me is that the mothers
don't like a "goopy" baby on them. I point out that usually a good
drying off of the baby is adequate. 

 

Most of the nurses are open to change of practice if there is good
evidence supporting the change (scientific name journals).  Please, do
we have evidence that shows that a bath during the first hour of life
does more harm than good? One of the nurses bathes baby all but his
hands because she says that the smell of the amniotic fluid on the hands
is enough to not disturb the breastfeeding.

Please help! Any ideas to assist with this culture change? 

 

Signed,

"Desperate"

 

(Mary Westra RN, IBCLC) 


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