The only way to deal with this is by eliminating the nursery.  We turned ours into a dining room for the mothers.  Some babies will still end up spending a bit of time in the staff room at night, but since we cut the woman's own support system right out of the picture when we keep her in a hospital room after she has a baby, it's the only way she can have a couple of hours of near-comatose sleep after getting pain meds for her CS incision on day one, for example.  It's not great for the babies but if the mother is really unable to care for the baby, what other option is there?  In our hotel ward, all the beds are double size and there's room for mother and baby together with no danger of falling out, and the mothers on that ward are healthy and have had normal births, AND they can have another adult with them the whole time.  But the regular ward has almost no single rooms, and those awful hospital beds.  The women who are there have medical contraindications to hotel care.  

I didn't read the entire post about having scripts for the staff to use when telling the mothers why they 'should' follow baby-friendly policy, because the very idea put me right off my bedtime snack (too late for it to put me off my lunch).  Staff should speak to the women as one human being to another in an atmosphere of mutual respect. If they are repeating a message they have learned by rote, or, even worse, reading them off of cards in their pockets, the women won't be any more convinced than said staff are, AND they will both very rightfully feel cheated of a genuine interaction.  The staff need to understand and believe what is good about good practice so they can spread the word to the mothers and fathers. 

I think here in Norway there was an idea that we could reduce staff on postpartum if we achieved full rooming-in.  We might have been able to do it, except that the intervention rate in birth has been steadily rising for the last 25 years, the number of bureaucratic tasks we have to tick off for each mother and baby has increased, and length of stay on the ward has declined, so mothers and babies are less able to make good use of their time together than before.  Sometimes staff are resistant to BFHI policies because they fear they will be out of a job.  I'm here to say that is not going to happen anytime soon, and the job of helping mothers get started breastfeeding is a whole lot more fun than trying to calm distressed babies in a nursery all night, *if and only if* you have time to be there to do it.

Rachel Myr
Kristiansand, Norway

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