Good morning!
First, many thanks to those of you that wrote to the list and to me
privately in response to my question. I am presenting several classes this
summer on supporting breastfeeding in the hospital setting. My question
was "What are the top three interventions that undermine breastfeeding in
the hospital setting and what would you recommend for changing these
practices?"
What follows is a synopsis of the responses I received. It's not
scientifically perfect since some let me know what their problems were but
offered no solutions or gave me less or more than three responses. I
believe this information will be helpful to me and you Lactnetters. What
is interesting and certainly expected is that if hospitals simply followed
the "10 Steps to Being Baby Friendly", these problems, for the most part,
would be avoided. I've listed both the problem and strategies for solving
the problems. If any of you have additional strategies for solving these
problems, let us know!
Mother and baby separation- 11 votes
SOLUTION: Change our practices to avoid this, such as doing assessments
and interventions at the mother's bedside. Close all nurseries except the
intensive care nursery. Establish a written non-separation policy.
Labor Interventions (medications, operative birth)- 9 votes
SOLUTION: Stay out of the hospital all together and give birth at home.
Educate labor attendants (MD, CNM) about non-interference and patience in
caring for laboring women. Each woman should a doula at her bedside.
Educate women about normal birth and instill confidence in her that her
body is designed to give birth.
Lack of education, positive attitude, consistency, communication or BF
education among Health Care Providers- 8 votes
SOLUTION: Basic BF education for all (length unspecified) and consequences
of poor information and practices (poor outcomes, increased health care
costs, litigation). Have a written breastfeeding policy that is
communicated to all staff.
Supplementation- 5 votes
SOLUTION: Educate staff on how to avoid supplementation and assist BF moms
who are having problems with confidence. Have a written policy and MD
orders that discourages this. Complete incident reports when
supplementation occurs without appropriate rationale and documentation.
Vigorous Suctioning- 3 votes
SOLUTION: Avoid vigorous suction. Observe baby at bedside instead of in
the nursery. Let these babies nurse.
Circumcisions- 1 vote
SOLUTION: Avoid circumcision all together or don't limit feeding a male
baby who is going to have a circumcision.
Lack of Follow-Up After Discharge-1 vote
SOLUTION: Establish a drop-in BF clinic for weight checks, reassurance,
and assistance with breastfeeding problems.
Thanks again everyone!
Maurenne Griese, RNC, BSN, CCE, CBE
Pregnancy & Childbirth Contributing Editor
http://www.suite101.com/welcome.cfm/pregnancy_childbirth
Manhattan, KS USA
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