First, Hello my name is Stephanie Mabin RNC , I recently received my IBCLC
certification, and a relatively new lactneter.  Although I have only
recently achieved my IBCLC, I have spent the past 12 years helping mothers
and there newborns with  breastfeeding.  I have done this at St. Peter's
University Hospital in New Jersey. The reason for my entry today is to
hopefully clear up a misinterpretation about our c/s mothers at St. Peter's.
Recent entries to lactnet from a new lactation consultant to our hospital
portrays all our c/s mothers as being unable to nurse due to the fact that
they are "too out of it".  This is not the case at all.  The majority of our
mothers receive the epidural anesthesia Doromorph.  They are fully alert,and
feeling very little or no pain. The only complaint that I see often, is the
itching that many experience as a side effect. Although our mothers are not
given the opportunity to recover with their infants, (they are taken to our
newborn nursery- with the fathers) they are not given bottles unless
medically there is a need . They are ready to return to their mothers, by
the time that the mothers are in their room.  I, as the nurse to take these
infants out for the first time, do not see our mothers being out of it.
They do not receive any further medication for the first 24 hours after the
Doromorph is stopped.  The difference between my view and our lactation
consultants view, is the fact that I am seeing all the mothers, and our
lactation consultant is only seeing our moms that are having trouble.  Our
hospital could make many improvements to help our breastfeeding mothers, but
for a hospital that has the number of deliveries and the number of staff,  I
feel are doing well.  It is always hard to have all the nurses and support
people be as supportive of breastfeeding as we would like, but we are
trying.   I initially was going to keep this as a private matter, but I want
to assure everyone that St. Peter's is a very good hospital to deliver at.
We are a leading hospital in our state, we provide good care, and are
constantly trying to improve.  ( this includes in lactation)  -- Original
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>
> Alicia Dermer wrote:
> >As for this problem, it would be nice first of all if mothers could be
> >taught about this in prenatal breastfeeding classes, so that they come
> >in with the expectation of expressing colostrum if their babies can't
> >nurse, and their support persons (husbands, grandmothers, etc, could be
>
> >educated about the importance of this and help to support mothers to do
>
> >this).
>
> I can't agree with you more, Alicia. We do teach this to our Newborn
> Care Groups (32-36 weeks of pregnancy) when we talk about breastfeeding
> after C/Section. I can't say we're there yet as an outcome as we don't
> always have the staffing to recover both mother and baby after the
> surgery but we're working on it. At least if babes and moms aren't
> together after the surgery, dad or other support person can stay in the
> nursery with the baby. No formula is given (we don't give formula to
> breastfed babies without a doctor's order for medical reasons) so
> there's more motivation on everyone's part to get mom to express.
>
> What concerns me more is why these moms are so out of it. It's easier to
> use my own experience at the moment. I delivered by C/Section for
> failure to progress (CPD?) 15 years ago. As a nurse who knew what was
> happening, I really didn't want to be awake. However, I'd already had an
> epidural when the decision for surgery was made and there was no way
> they were going to give me general. I kept saying to the
> anesthesiologist - a wonderful woman who was very kind to me - "put me
> out, please just put me out." So she did her best with as much IV
> morphine as she could. It didn't help because it didn't put me out - at
> least not during the section - but you should have seen me after. I
> literally could not fully wake up the entire evening through the next
> day and to the morning of day 2! Yes, I did get out of bed but I
> honestly don't even remember if my daughter was brought to me. She was
> certainly getting formula.
>
> Luckily for both of us, when I put her to breast in an awkward position
> for the first time ~ 42 hours after delivery, she latched on like a
> champ and barely let got for 2 years!
>
> I didn't know it at the time but my daughter's father told me that there
> was another woman who was in the recovery room after her C/Section at
> the same time as I was. She'd had an epidural and nothing else. Her
> husband was with her helping her nurse her baby. He was amazed at the
> difference between us (I almost shot him for telling me) but it really
> is possible.
>
> So I wonder, why are so many women so out of it?
>
> Joan Edelstein, DrPH, RN
>
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