As a hospital based L.C. and the mother of two adopted breast-fed
daughters (now both in their teens), I would like to comment on the issue
of early attachment.
        Unfortunately there are many times in today's hospital setting
when it is not possible for the newborn to be put to the breast
immediately. Even when it is done, often little or no assistance is given
to the mother.  I frequently see moms who report that the delivery room
attempt at breastfeeding was "only a couple of sucks", which she
perceives as not a "real" feeding.  Since I know from personal experience
that a baby can be breastfed after days or even weeks of artificial
feeding, I am never ready to give up, even if early difficulties arise.
I am especially sad when the mom really wanted to breastfeed, but gives
up because of problems that could have been avoided had the early hours
in the hospital been handled differently.
          The biggest obstacle I see to establishing the baby at the
breast is the idea (often pushed by hospital personnel including doctors)
that if the baby doesn't nurse "well" every three to four hours right
from the start, we must intervene by giving formula, usually by bottle;
mothers and dads pick up on these concerns and often begin supplementing
"to be sure the baby gets something".  A few peciatricians are still
insisting that formula supplements be offered after early feedings "to
prevent jaundice".  Mom's don't know whom to listen to, and I can't blame
them for being frustrated.
        We have managed to get policies changed, but how can we get staff
to follow them? I find myself frequently trying to force a sleepy baby to
the breast, just so I can chart a feeding and prevent formula from being
given.  Any ideas from those in a similar situation? (LC's are
scheduled only 32 hrs a week, so much happens when we're not there).
        Anne Stiller, RNC, IBCLE in VA