Hospital Policy on Bottles.... « Back to Group Discussions

[fairyswizzle]

Hiya lovely ladies,

We just moved across the country, and are slowly getting re-accustomed to living in a big city again - Dr. appointments, doula appointments, rental appointments, oh my! 

One thing that has come up a few times, is that because of the higher rate of women having babies here (busy labour wards, less nursing staff available for 1 on 1 time with new moms in post-partum wards, etc), and because the nursing staff only have cursory knowledge of breastfeeding (although on paper the health region is very pro-breastfeeding), it is pretty standard to "give all babies a bottle until your milk comes in". I've spoken to my doula about this, as well as to the Dr. I'm seeing in the interim until I get in to see a high-risk OB/GYN. I've heard suggestions from both of them that to mitigate some of the "confusion" bottle feeding a nb can cause, it's possible to request some kind of syringe-apparatus or to alternately bring our own nipples from home that supposedly reduce "nipple confusion".  The Dr. also said they would happily write on all my charts that I intend to BF and that I want to use alternates to standard bottles, etc.

I'm not really pleased with any of these options, as I'm a first time mom, and really committed to breastfeeding... but in all likelihood, that won't matter much when it comes down to it, as I also understand it is pretty common to use scare tactics ("If you don't feed your baby by bottle, her blood glucose will drop and it will be your fault she winds up in the NICU" and I'm pretty sure, regardless of what I say now, post-partum, I will really struggle with doing something that may potentially wind my child up needing medical intervention).

I understand that they are all about skin-to-skin and trying to nurse right away, etc. so I guess here's hoping that it goes smoothly. My doula is also a lactation consultant, which may help, to some degree, as I won't require as much help from the nursing staff if I have trouble with latching, positioning etc.

I'm just trying to wrap my head around what the net result of a few bottles will be early on, and realising how exhausted I may be, and not wanting to fight with the staff, etc. etc. but tempering that with a deep desire to breastfeed and not have anything stand in the way of being successful at that....

Rant-y rant-y rant-y.

Any suggestions??  TIA for your help!!

[Anilia]

I can only tell you my experience and I hope it will give you heart to say no if that is what you want.

My son was born after I had been at the hospital about 20 hours.  Right after he was born they told me his blood sugar was too low.  My response was something along the lines of- well, of course, I haven't eaten in an entire day!  They insisted on giving him formula by syringe.  I didn't argue- I was tired.  When they came back a few hours later to tell me they were bringing him more formula I asked why and they said, "Because you don't have milk yet."  So I said, "Bring me a pump."

I wasn't trying to be a pain and really had no idea how much of a bitch I may have sounded like.  I was tired and confused about their behavior.  It was also a hospital that was very pro-midwife and nursing.  And really, it was like 80cc's I think.  Hardly anything.  I couldn't believe I wouldn't have enough colostrum to fill that tiny syringe.

They brought me a pump.  I got enough out.  It wasn't hard.  They didn't mention it again.  Later, when a nurse came in to check on my son he spit up and she was all like, "Wow! your mama makes good milk." I still didn't (don't?) understand what the big deal is.  I mean, these boobs are made to feed babies, right?

My son was early, he had jaundice, he was tiny and wanted to sleep more than eat.  His doctor NEVER suggested a bottle.  I went to the midwife desperate the week after he was born because bf'ing was not going well.  She NEVER suggested a bottle.  I can honestly say that the support of the people around me made it a non-issue.  I was going to breastfeed.  That was that. All of my friends who are first time mom's since I had my son have been talked into a bottle by someone.  Doctor, spouse, friend or mom.  You have to decide what you want and ask for the support you want.  And DON'T feel like you are asking for too much.  I wish someone had told me how hard bf'ing could be.  It took us about 6 weeks to get it right.  His mouth was so small and I had a hard time getting the latch.  It hurt.  But then, one magical day, it was easy and wonderful.  And then we had over a year of easy and wonderful.

That is probably more than you wanted to know.  But I hope it helps.  Tell everyone you are working with what you want.  Labor can be hard, but it only lasts a few hours really.  Bf'ing is so much more, but we don't focus there because we are so afraid of birth!

[fairyswizzle]

Thanks so much for your reply - I never thought about asking for a pump - I guess it adds a double benefit of not frigging up my supply and making sure baby doesn't get formula!

I'm trying to put together an arsenal of ideas & discuss them with my partner, doula and Dr.  so I have more support when the time comes... The more info I have in advance, the better I know I will be able to deal with the situation when it arises...

Thank you again!

[hotsauce]

Your baby, your wishes, period.  I ended up in the hospital after a 20 hour homebirth went awry.  I had a c-section I didn't plan for, in fact, I hadn't seriously considered that my home birth could possibly end up at the hospital, so the whole situation was dramatic and felt very out of my control.  I did manage, however, to INSIST that as soon as I was out of the OR my son was brought to me and that he was to sleep in my room.  My partner insisted they not give bottles or pacifiers in the meantime as was written in our birth plan.  You shouldn't have to ask anyone's permission.  You are the mom, you make the rules.  Good luck.  Breastfeeding is hard for some of us.. I strongly recommend going into it determined, passionate, and strong-willed.  It took me four months of cracked nipples, bad latch, two bouts of mastitis, engorgement, etc. but we eventually got it right and had a wonderful breastfeeding relationship for two years.  I wouldn't have succeeded without properly educating myself and being bound and determined to fight for what was important to me.  I didn't have milk for at least the first two days but baby got tons of colostrum and was just fine.  There was no need for my baby to have a bottle, ever.  We were made to do this!  

[Detcb]

...this is so odd to me and I don't live in a particularly bf-ing friendly area. Keep your baby close (in room, no nursery), put them to the breast often.

Babies need the colustrum...not formula. Besides their tummies are like the size of marbles when they are born! Be vocal, be an advocate and make sure your partner and doula are on board.

[Clarasmama]

I am seriously confused by this...the hospital assumes ALL babies need a bottle or some other form of formula feeding at birth?  Where on earth is this coming from?  Full-term babies are born with reserves to last them through a couple of days until your milk comes in, that's how it works.  Your body starts making colostrum during pregnancy, so that is ready as soon as the baby is born.  Then, the baby NEEDS to breastfeed as soon as possible (within the first hour ideally) and then very frequently after that in order to tell your body "MAKE MILK MAMA!" If baby gets something other than your colostrum he/she won't necessarily be hungry enough to ask to feed again soon enough and the spiral of not enough nipple stimulation leading to "I'm not making enough milk so I have to supplement" starts right away.

It took 4 days for my milk to come in with DD.  So that was 4 full days of her getting only colostrum, nothing else at all (no bottle, no pacifier), and once my milk came in we were fine.  I think a lot of first time moms are afraid that their baby really isn't getting enough those first days, but as long as you are nursing VERY often (sometimes multiple times per hour every hour if the baby is asking for it) your body will be stimulated to make milk and it will be okay.  You don't have your "regular" milk the first day, and it's completely normal!  That is how it's supposed to work. 

If it were me, I would tell the doctor/midwife/doula/partner that nothing is to be put in baby's mouth other than your nipple, no supplementation of any kind, no pacifiers at any time.  You need the baby to breastfeed at every opportunity those first days, and if that is interrupted it can be harder to keep your milk supply strong.  If you feel like you need more education and information about breastfeeding and establishing your nursing relationship, I highly recommend reading "The Motherly Art of Breastfeeding" which is La Leche League's publication.  It will give you all the information you will need to feel confident about breastfeeding and establishing your supply!

[Ms Rabbit]

Do you have the option to have baby with you 24/7? DS1 was born in a hospital and once my midwives left I was under the care of the nurses (due to hemorrhaging, we were stuck there much longer than expected) . DS1 spent nearly his first 18 hours in my arms and we nursed frequently (or more appropriately, tried to figure out what the heck we were doing!). He didn't leave my sight for a second, and usually when the nurses came in he was latched on. I'm not sure if they would have tried to suggest a bottle, but I was pretty territorial about him and didn't give them much space to intervene :) If you have the option to keep him with you at all times, would that perhaps reduce their involvement a bit and your need to fight for your wishes? I've also seen onesies and newborn caps that have instructions for hospital staff such as "No pacifiers or bottles!".

[fairyswizzle]

Thank you ladies for your help! I'm hoping it won't be an issue, but have heard that the nursing staff like to scare new mamas with the threat of ICU if baby's blood sugar drops...Anyways - having  a few extra tools in my toolbelt will be handy for standing my ground... My doula is a certified lactation consultant too, so I'm hoping that should provide some comfort to the bottle pushers that even if FTM-me is clueless, I've got someone on my team who has a clue about getting my nipples into the proper places, at the right times . Again, thank you for the input - it's amazing to have a resource like MDC. It stills my mind & warms my heart! (It's also wonderful to have the support of other folks when I feel outraged at ridiculous policies - I feel justified!).

xo

[birthjunkiemom]

If you are worried about them using scare tactics with you- the only way to prevent that is to do your own research and know enough that they can't scare you.  Just don't let them.  You can decide on a mantra, something like, "What my baby needs is my colostrum and breastmilk," and repeat it ad nauseum EVERY time they try to bully you into giving formula.  Matter of fact- you can NAME their tactics..."What my baby needs is my colostrum and breastmilk, and I do not appreciate being bullied into trying to give my baby something inferior."  If you say something similar as your response every time, they will get sick of hearing you repeat the same thing and eventually shut up. LOL

[tiqa]

I would ask myself first, "under what circumstances would I be OK with them giving the baby formula?"  If you had complications that didn't allow you to put the baby to your breast for a while, maybe?  Or if the baby was preterm/LBW?  Etc.  Think it through.  And then, when/if a nurse came in with a bottle, I would feel more comfortable refusing without sounding defensive.  Don't view the nurses as an enemy; let them know you appreciate their work but that for reasons abc your baby doesn't need it now.  Smile the first time, and if they threaten you, just refuse to argue.  It IS your baby.

That said, don't be so set on the idea of "no supplementationat all, ever" that you refuse what could be a reasonable intervention... With my first, I had a LC tell me that I shouldn't give the baby any supplements at all (even though he was early and LBW) because my milk would come in... Long story short, my milk NEVER came in, and I waited so long *on principle* (and the urging of various LC's and nurses to wait) to let him have formula that he *did* end up on an IV.  Extreme, drastic case there.  But basically, don't go in thinking you would NEVER let your baby have a supplement.  It's not likely at all to be needed, most babies don't, of course.  But just be a open to the idea of it in case you truly end up needing it.  :)

[fairyswizzle]

That's a really good point - I mean, at the end of the day, I just want what's best for my baby - and it seems like a really valid thing to consider, that sometimes, due to things beyond my control, that could end up being formula...And I absolutely agree about the nursing staff not being the enemy...My mom was a practical nurse for a number of years, and I think to have a better hospital experience, it's going to do me many favours to be diplomatic in my dealings with the nurses - as I understand they can really make or break a hospital experience. Which is not to say I will do whatever they counsel without question, but I think there are different ways to say the same thing to yield different results.

I really appreciate all the suggestions and feedback. It's given me lots to think about & I feel less worried considering a diversity of tactics to get the best result (which will hopefully be a happy baby with a tummy full of breastmilk)!

Thanks friends!