Kathy Rehmert wrote

>>>>>>Hi all! I work in a very busy LDR unit (#3 in the nation) and We need
some
> advice on what we can do in the first hour after birth to encourage,
educate,
> ... Breastfeeding Moms..I want to do an inservice on this for my co
> workers..We only have an hour after they deliver and then they go to Post
> Partum... Any advice would be appreciated! Thanks!<<<<<<<

My best advice from one L&D nurse to another is don't separate mom and baby
at all.  Mom and baby should be skin to skin immediately after birth.  The
apgars and initial assessment can be done on moms chest.  Some things can
wait, like eye drops, Vitamin K injection, measurements etc.  If the
parents are adament about knowing baby's weight, I bring the scale to the
bedside.  We are so accustomed to having to be efficient, getting the
initial neonatal assessment/admission done (meaning assessed, documented,
etc) in a timely fashion.  Yet, our efficiency often neglects the needs of
families at this special time in their lives.

Over the past 8+ years, I have seen few if any difficulties with latch and
suckling in babies born vaginally, non-operative, non-medicated.  Consider
the first nursing the "introduction to breast session".  Some babies may
latch and suckle for only a minute or two, sometimes they'll go 10-20
minutes each side-each baby is different.  They are learning what mother's
breast looks, smells, feels and tastes like.  Do the best you can with
babies following a medicated labor.  The skin to skin contact and early
exposure to the breast is particularly important for these babies.  Parents
and health professionals need to be instructed in this!!!

Expect some barriers to change from your colleagues, perhaps even your
management team.  The nursing care I've described requires no more staff or
technology, only a change in our professional behavior as well as the
mindset that these first moments are precious, one-in-a-lifetime
experiences and should be treated as such.  Be sure your inservice is very
interactive-it's imperative to supporting "buy-in" from the staff.  Dr.
Lennert Righard's video demonstrates the importance of unmedicated vs.
medicated births and the effects labor meds have on breastfeeding.  'A
picture is worth a thousand words."

Can you tell this is a soapbox for me??  I was separated from my first
child for 4 hours after birth because I was on MgSo4 and "needed to rest".
Are you surprised that she was fast asleep at 4 hours of age and that I
couldn't get her to wake up to nurse?  Is anyone surprised that I continued
to have difficulty nursng her and that she developed jaundice, was under
the bililights for 24 hours and was supplemented with formula?  (Needless
to say, my husband and I didn't let this happen with baby number two.)
This is a sad story that continues to happen every day.  I'm glad we have
discussion groups like Lactnet to share ideas.  If I can do anything to
prevent any mother going through what I went through unnecessarily, I'll do
it.

This is one of my favorite topics to present so e-mail me privately if you
would like to borrow my outline or get more ideas on how to educate your
staff so you create a positive birth atomsphere for breastfeeding families.

Maurenne Griese, RNC, BSN, CCE, CBE
Birth and Breastfeeding Resources
Manhattan, KS  USA
[log in to unmask]