Phyllis says:
"What the RNs say about our Couplet Care is that the moms are exhausted
at
discharge from the hospital because they are expected to be so
completely
responsible for baby care, including breastfeeding."

It seems they are missing the point.  It's COUPLET care, not MOM IS
COMPLETELY RESPONSIBLE FOR BABY care!  Our philosophy is that at first,
the nurse does baby cares (except breastfeeding, of course), encouraging
the parents to observe and learn.  The parents are encouraged to
practice handling, changing, dressing baby with the nurse to "coach"
them as needed, and by the time they take baby home, they have gained at
least a little confidence in handling their baby.  A far cry from not
that many years ago when baby was brought in for feedings; mom attended
a class where she watched someone change and bathe baby; and on the way
out the door the baby was handed to the parents with a "good luck-it's
your responsibility now"!

"Some RNs say when mom
asks to leave baby in the Nsy & the RN to feed formula, they don't
argue,
they just do it so mom can get some rest."

Are you sure the mom is initiating the request all the times?  I
frequently find that morning report states "mom requested baby fed in
(meaning in the nursery)", but when I talk to the mom she says the nurse
suggested she needed more sleep and offered to take baby in the
nursery!  I still feel the biggest interference to rest is not having
baby in the room.  It's the interferences with her being able to rest
during the day when baby is sleeping.  And the biggest interference is
the "revolving door" visitors policies.  Someone (I'm sorry, don't
remember who so I can give credit) once pointed out that noone would
think of dropping in to visit newlyweds the first few days after they
are married.  New families should be given the opportunity to have a
"babymoon" just as a new couple has a honeymoon.
One question on our staff competency quiz is how to handle it when a mom
asks about having baby fed in the nursery.  The choces (they're worded
better, but I don't have exact wording here) are;
1. Oh no, you mustn't do that if you're breastfeeding.
2. Of course I can do that so you can sleep.  No problem.  When would
you like me to wake you?
3. I could do that.  You should know, however, that if baby gets a
bottle before he has mastered the technique of nursing, he may not nurse
as effectively tomorrow.  Your milk volume will "kick in" sooner if you
don't skip feedings.  In addition, your milk, especially the initial
milk (even though the volume is low) is exactly what your baby needs.
It can take several weeks for his gut to get back to normal after even
one bottle at this stage.  If you really feel you can't sleep with him
here I could take him in the nursery and bring him to you when he wants
to eat.

Of course, late at night when mom "hits the wall" is too late.  Nurses
need to facilitate her resting when baby does during the day so night
feeds aren't so overwhelming.

Winnie

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