Mandi,
I run into this same problem where I work but here are my thoughts on why it
happens.
1. The assumption is that at night is when one sleeps, so naps during the day
are not encouraged enough.
2. The visiting hours are too generous and not enforced, so even if a mother
were to nap she feels compelled to stay up to visit here guests.
3. Mothers are told that they cannot sleep with their babies in the hospital,
so there is fear of falling asleep while the baby is with them.  Mothers try
to sit up to breastfeed so that they do not fall asleep or do not get help.
4. The staff encourage the babies to be in the nursery at night, encourage
supplements so the mother can sleep through the night, and top off babies
after they come back from their mothers to "help them settle".
If these 4 issues were addressed first then I think you can look into what to
do if a mother is too exhausted to feed her baby.  Most of the times one can
just put a mother on her side and place the baby next to her.  Then place a
roll behind the baby. Having a support person with mom is ideal.
Ann Perry RN, IBCLC
Boston, MA

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