Sherry Weersing wrote:
"I think the change on our unit to extremly liberal hours (11am-8pm for all
visitors) has
been a major setback to breastfeeding. I come in at 7pm and moms are
cross-eyed exhausted because they've had visitors all day and really haven't
spent time working on feeding the baby and now are too tired and want the
baby sent to the nursery."

Let me second this, emphatically.  We moved into a new facility 13 years
ago.  At the old building, visitors were allowed for 30 minutes in the
evening, and fathers and sibs had 30 minutes of their own just before
regular visiting hours, I think.  We all realized this was not right, and we
wanted to open up.  Visitors were allowed from 3-8 or so, right after a two
hour siesta we had instituted at the same time.  It took us a few weeks to
admit our mistake and change to a more family-friendly system.  The mothers
were desperate, but the visitors LOVED the long hours.  It was like going to
the zoo to see the baby animals.  Absolutely awful for mothers and babies.
Would you want to be an animal in the zoo?

Now, visitors can come for one hour in the early evening.  Fathers (or other
support person as designated by mother) and sibs can come nearly any time at
all, but may not go into the rooms in the daytime unless mother is alone, to
protect the privacy and rest of roommates.  We had the siesta already, an
idea we got from a Swedish unit we visited in 1989, which is now from 2-4 pm
when mothers are promised they will not be disturbed by visitors, phone
calls, or our routines including cleaning the rooms or checking stitches
etc.  If a baby is discharged from the NICU during the siesta, we will go in
to the mother with it, but that's about it.  Visitors who come during that
time are gently but firmly turned away, preferably with an explanation of
why, and most of them seem to understand, but it took years of repeating the
same message to every new visitor before we started seeing a change there.

The siesta is the one thing consistently mentioned by mothers in their
comments to us, which are along the lines of 'whatever changes you make,
don't TOUCH the siesta!!'  They also have 'do not disturb' signs they can
hang on their doors, but they don't need to use them much.

Regarding 'complementary' feeding on the indication 'exhausted mother', when
we were doing BFHI evaluations here we did accept supplementing, with plain
water, for that reason, which we cleverly called a 'nursing indication'.  We
tried to distinguish between supplementing that undermined BF and
supplementing that really did seem to relieve mothers in need.  Water
supplements don't work once milk supply is abundant.  Babies won't settle
for water by then, but sometimes the first couple of days they do seem to
calm down for an hour or two so mother can just sleep.  I have always been
ambivalent to this practice because it goes against my grain, but I have to
admit I have seen many women respond positively to it and it hasn't stopped
them from breastfeeding.

Rachel Myr
Kristiansand, Norway

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