This article is going to talk about breastfeeding support at the hospital — and ask the question if baby-friendly hospitals are really all that friendly long-term?
I read another thought-provoking postpartum article this morning about how tough life can be after a baby. There seem to be a lot of those out there, and I gave a silent amen as I finished it. I’ve certainly had my own.
And it got me thinking of the thousands of babies that I’ve seen born. I’ve had a cold lately, so I’ve also watched more Call the Midwife than my tear ducts can tolerate and I often make parallels between the two.
I thought about the whole baby-friendly movement (hospitals can be certified as baby-friendly, and it is published as to who is and is not on the list). How we have somehow made the baby King (or Queen) of the castle.
Don’t get me wrong. I love babies. I think they’re soft and cuddly. Of course, they grow up to be great leaders and do amazing things in the world. That is probably the best part. A baby is a fresh start on this earth. They could grow up to be Mother Teresa or Stalin.
But, the baby-friendly movement isn’t always family-friendly or, most importantly, mom-friendly.
Check out my podcast episode about breastfeeding myths:
The baby-friendly movement is sort of a Nazi organization that has certain criteria a hospital needs to meet in order to be considered “baby friendly”
- No nursery for well babies — those babies have to room in with mom
- No formula. No free diaper bags, no samples sent home. No coupons, nada. You also can’t give out formula information in any prenatal classes.
- Patients must sign a consent in order for their baby to be given formula
- Good breastfeeding training for all staff (not just lactation)
- Skin to skin after birth, and initiate breastfeeding within that half hour
- Encourage moms who are separated from their babies to maintain lactation (pumping)
- No pacifiers, and tell mothers of the risk of using pacifiers
- Good breastfeeding support groups
They do have a mother-friendly section but it mainly talks about HIV and breastmilk, and a little bit about what we do before the baby is out. Things we mostly do anyway (a few things that are initiated by MD’s and we have no choice). There is no talk about mom-friendly initiatives after delivery.
Ok, there are a lot of good things on that list up there. I love getting breastfeeding training. It’s really tough. We only have one lactation consultant, and she can’t be everywhere so it’s smart. Plus, having us all on the same page leaves mom empowered with the right information!
I love skin to skin. It stabilizes both patients. But not in every case. Sometimes the mom feels so unstable that having the baby there makes her anxious and she just needs to be able to relax. Because I am a trained nurse I know when to ask her if she’d rather the baby hung out with dad for a bit. Dads are also welcome to do skin to skin.
I love breastfeeding support groups. So much good can come out of the shared postpartum experience that they are all in. Great friendships and supports can be made in these groups. #heartwarming
But, for the rest of them — they have good bones, but the way they are carried out ends up NOT being mom friendly.
First off, these women are in labor and have likely not slept well for days. Then, we stick them in a room with their baby where they hear every peep and sound, and then we come in every few hours to check on the baby and they end up with no sleep at the hospital stay.
They’re told to keep constant vigilance for breastfeeding cues when in reality they’re considering slipping into a coma because they’re SO tired. Then, after 48 hours we boot them home where the sleeplessness continues.
I sometimes wonder how much of postpartum depression is due to a lack of sleep vs the hormones. You just haven’t slept in DAYS. People just can’t function like that. Wouldn’t it be amazing if those women could get a good 4 hours in a couple of times while at the hospital?
I don’t know if nurseries have been eliminated due to hospital financial constraints or due to the baby-friendly movement, but the option of having a nursery should be available to all moms.
There, I said it.
It also needs to be staffed by personnel trained in how to watch for baby cues. No baby should be screaming in the nursery due to hunger. But no mom should have to be sleeping with one eye open to see if that baby is rooting or moving their tongue.
Sometimes those babies just suck, and suck, and suck, and suck…. those moms nipples bleed because the baby won’t STOP sucking. They’re not hungry, they don’t care that they’re not getting any more milk…. but a pacifier is just out of the question if you want to be baby friendly!
Nevermind that sleeping with a pacifier is a SIDS precaution, I actually am not taught to mention that at the hospital (but have seen the research on it).
Is a pacifier the right choice for every baby? No, probably not. It can cause nipple confusion (likely not if your baby just sucks and sucks and sucks), and it can be used in lieu of times where stimulation would help breastmilk come in. But it can give those sore nipples an out. Mine just hurt just thinking about it.
Back in the good ol’ days you always knew you had a couple of cans of formula in the cabinet in case things went south. It was like the little secret, just in case you needed it.
It was your out. You knew it was there, and it somehow made breastfeeding easier because you knew you had a backup.
Now, no formula comes to your home, because it’s not baby friendly to have it there.
There’s no out.
In my case, I needed those cans. I was actually starving him. I was just constantly told that my milk would come in, and he’d be fine. Those free cans kept him alive.
And either way, moms need to know that they have an out. There’s another option. They’re not the only thing that can feed their baby.
I like to call this the guilt consent. I was on baby #3. Milk had never come in with any of them. During a feeding at 3 am that wasn’t going anywhere I was asked to sign a consent saying they could give her formula. To a tired mom, it basically reads like this:
“You are a horrible mom, you aren’t making good choices for your baby, but we can allow that if you sign this. We wish your poor baby luck. Too bad it wasn’t chosen to be born to live with that lady down the hall who has plenty of milk. You are aware your child will get cancer and die early in life and that if you’d just try harder you could prevent that. Just making sure you know this all lies on you. Okey dokey?
^Signture of the mother of shame^“
YES. Tell the moms the pros and cons of giving their baby formula. And yes, moms need support and encouragement to try breastfeeding, especially in the hospital. But dangit — it’s their baby.
This isn’t the worst parenting choice they will make. Not by a long shot.
Don’t forget you can qualify for a FREE Breastpump! Aeroflow makes it easy!
So, this is what I have to say:
We need family-friendly care. We need dads who are involved and able to come and go. They need to know that half of this baby lies on them. They are there to change the diapers and support the mom however she needs it. It does NOT all lie on her.
We need individual care. All moms are different, and they need the care that they need. Not that some policy requires. Our hospital is REALLY good at individualized care. It’s one of the things I like most about working there.
We need moms who get some rest after the baby, so they can go home and face what could possibly be some of the hardest moments of their life.
We need to be able to educate them about how their emotions will be up and down and they truly need to take care of themselves. They’re going to need help. Help of all kinds and support.
We need moms who are trusted to make their own decisions — be it about formula, or pacifiers. And it isn’t our job to second guess them.
Educate, always. Support, always. Belittle or guilt, never.
I am a big fan of breastfeeding, I do think it’s the best choice in how to feed your baby. However, I am a bigger fan of moms who feel supported, empowered to make their own choices and know that parenting has no best answers for everyone. Be it breastfeeding, working/staying at home or giving your kid a smartphone, we’re all just winging it and trying to make the best call for that child and our family.
And God gave you this baby for a reason. You’ll know what to do because you’re amazing, and you have plenty of hearts and hands around you to help out.
You might be interested in my FREE birth plan template — and check out all of my pregnancy posts below that!
Karen Kostohris says
Wow! You bring up some really great points in this post, Hillary! Thanks for your frank discussion on baby-friendly hospitals. I have never really thought about some of these points. Although I am definitely a fan of breastfeeding and supporting breastfeeding mothers, I do agree that many new mothers feel shamed or pressured when they are struggling to make it work for them. I am a postpartum doula and I see it all the time! Moms need TONS of support during the postpartum weeks and they especially need to hear that they are a GREAT mom, no matter how they feed their baby! I love your blog. Keep up the good work!
Hilary Erickson says
Awh, thank you so much! This is one of my favorite articles!