Nicu v. "regular" nurses on bf

[akmbloom]

I had the somewhat unique experience of having my daughter in NICU part-time while we were in the hospital.... I got a really high fever during labor and the baby had a fever too when she was born, and they never figured out what it was from, so they put us both on antibiotics just to be safe. This meant that Miri had to go stay in the NiCU... at first we thought she would have to stay there, but then the doctor decided that she would be able to come back to our room with us during the day, and only go to the NiCu at night and when she needed doses of antibiotics or monitoring.

I noticed a huge difference in the two nursing staffs in their attitude towards breastfeeding, and I just wanted to comment on it - the first night when Miri had to go to the NiCU I insisted on breastfeeding her before she went, and then the nurse told me she'd call me when she woke up, to feed again. Well, in the morning she called and I went to nurse her, and she had a pacifier that they'd given to her with some sugar water. They explained that this was given to her because she'd had to have a couple of painful procedures, and it was ok with me because of that, but they didn't even ASK if it was ok beforehand. So I went to nurse her that morning, and while they let me, they didn't have any sort of comfortable space set up for it and I had to do it in the middle of the room with a sort of makeshift divider around me.... they didn't offer me any help at all, even though it was only like 10 hours after her birth and I certainly didn't know what I was doing. The nurse on duty also really wanted to give her formula but I said I'd just come over as often as necessary to bf her.

Then they let her come back to our room, and the nurses there were like, what's she doing with this pacifier? She shouldn't have that! and would take it away from her. Very confusing! They were much more helpful about helping me bf though, and would try to assist me in getting her positioned and latched on properly.

Then the second night when she went back to the NiCU they were worried about her being dehydrated from the antibiotics (she hadn't had any wet diapers and didn't until right before we went home the 4th day), so the doctor prescribed formula supplementation. They sent us back to the room the next morning with some formula bottles but no instruction as to how/when to supplement, how to tell if she was getting enough, etc. They also didn't mention anything about pumping to work on my supply, etc.... I asked them about it, though, since I was concerned, and the regular nurses set me up with a breastpump.

We had a different NICu nurse the last couple of days and she was more helpful with breastfeeding and figuring out when to supplement.... and then our last night we had a nurse who was really very helpful and aggressive with getting the baby to stay awake, eat more, and be latched properly.

I had a couple of visits from lactation consultants right at the end of the hospital stay, and they were sort of helpful too, but I just felt like I got such conflicting information about pacifiers, bottles, breastfeeding etc that I didn't feel at all confident when I got home........... it didn't help that my (sorta anti-bf) mother in law was staying with us. But I just ignored her and listened to my totally pro-bf mom instead.

Anyway, just thought it was worth commenting on and wondering if anyone else has had similar experiences.

[becca011906]

how sad. I would have brough it to the attention of the staff. I would think that nicu nurses would have more training on BF since some required nicu infants to be breastfed since it helps them so so much. So how are you suplementing? are you at all? is the baby gaining well? wet diapers since being home? hope things are better now!!!

[edamommy]

yep... We hated the NICU nruses. They seem to think they are way to powerful and all-knowing to ASK the parents before making decisions about THEIR child!

[QueenOfTheMeadow]

I am so sorry about this, and unfortunatley this is very typical . In the NICU they are usually very "techinical" and want to measure everything. It is much easier to measure intake of formula than breastmilk. My mother was a maternity nurse for 25 years, she is now a IBCLC. She has stopped working "on the floor" because there is now a NICU unit at her hospital and the neonatologists are causing such horrible problems for breastfeeding mothers, and so many interventions that are actually leading to more sick babies that she just can't morally continue there. If the slightest thing looks unusual or the "possibility" that there is a problem, the first thing they do is to start an IV on the baby and start "supplementing" I've been through this myself, and it sucks. Luckily, it was with my second child and insisted on breastfeeding to the anger of one of the neonatologists, but the other neonatologist was pleased to see me breastfeeding and even helped out. So there are certainly NICU nurses and neonatologist that are supportive of breastfeeding, but it tends to be a very technical field. It is so hard to go through this, especially when you are so worried about your baby and tired from giving birth. I hope the breastfeeding goes well for you from now on, and I hope that your MIL will come along as she sees the beautiful bond and health flowing through you to your baby.

[earthchick]

I'm so sorry you had to go through all that. One of my twins was in the NICU for the first 8 days of his life and from a bf'ing perspective it was a total nightmare. Like the PP said, the nurses there want to be able to measure everything, and I always felt like they were aggravated that I was complicating their lives by trying to bf. they certainly didn't help me very much, yet they would hover over me and the baby while I tried to nurse. There was never a comfortable place to bf and I, too, had the makeshift divider thing. We were never able to fully overcome the terrible start we got off to, and I still grieve the whole experience.

I hope things are going better for you now. Good luck to you!

[ZeldasMom]

A friend of mine had a similar experience with her son who was premature. The NICU nurses would give her a narrow window of time in which she could try to get her son to nurse and they would sometimes actually stand there looking at their watch! She felt like their attitutude was "hurry up and fail so we can bottle feed him." Her son just wasn't gaining weight very fast (surprise, surprise) so she gave in and let him be bottle fed for a few days so he could gain enough weight to go home. Happily, she was able to bf once they got him home.

My in-laws were telling me about an acquaintance with an older baby who had some problems with supply when she went back to work. She saw a lactation specialist or a pediatrician (I wasn't clear on this--my guess is ped) who would weigh the baby before nursing, have mom nurse her, then weigh the baby after nursing to see how much she got. I wonder why they can't do this in the NICU?

[crazy_eights]

I think it depends very much on the institution and the protocols of the neonatologist. I worked in one place where they were WONDERFUL about supporting breastfeeding. They had a 'no artificial nipple' policy for babies that were planned to be breastfed. This meant that premies got expressed milk through an NG tube and even once they were breastfeeding, if they were too weak at sucking - they nursed first and then got expressed milk 'through the tube'. It really was amazing to see babies that had been born at 29-30 weeks go home totally breastfed (babies under 29 weeks were transfered a NICU at a Children's Hospital). So some places are not so horrid!

[loomweaver]

Originally Posted by ZeldasMom

She saw a lactation specialist or a pediatrician (I wasn't clear on this--my guess is ped) who would weigh the baby before nursing, have mom nurse her, then weigh the baby after nursing to see how much she got. I wonder why they can't do this in the NICU?

I was very worried that my DD was not getting enough because she was sleeping so much in the first few days after birth so I took her to the breastfeeding store in our town and that is what the LC did for me. My baby was doing fine but my confidence was shakey and when I saw how much she was getting, I was relieved, probably prevented me from thinking I needed to supplement....

[darwinphish]

My experience was mixed. I was separated from DD for most of the time in the week following her birth (her NICU, me ICU) but I did go in as much as I could, and when I went home before her I went into the NICU often to try to initiate BFing.

The pro was that the NICU was equipped with gliders and screens at each bed. I was given privacy and time to BF when I was there. However, a few times they called me to say that she was hungry, and by the time I arrived (I moved slow, in horrible pain) they had already fed her.

I also got no instructions on how to pump (my attempts led to bloody, torn up nipples), and the NICU nurses formula-fed her with fast-flow nipples and relied heavily on the use of pacifiers, so much so that she is still very impatient with my breasts. No one ever asked me if either was OK, and I didn't think to ask to bring in my own bottles or ask for an LC. No one ever mentioned finger or syringe feeding, no one caught her shallow latch, and they didn't use banked milk even though they are literally down the block from a milk bank.

All that said, I really liked all the NICU nurses. They were hard-working and caring and saved my daughter's life. I wish they knew more about preserving the BFing relationship, it would have saved me a lot of grief down the road. I still need to write 2 letters to the hospital: one to thank the NICU nurses, the other to the administration about the NICU's policies regarding feeding practices.

[akmbloom]

I should mention that, although the breastfeeding part of it was hard, i liked most of the nicu nurses and felt grateful for their help (except for one of them who was really pushy). And our baby was definitely in much much better health than most of the babies in the NiCU - she was born at 42 weeks, was 8 lbs 2 oz, and didn't need heart monitors etc - so I felt grateful for that too. Although of course one of the hard things about breastfeeding in the middle of the room was being surrounded by poor tiny preemies and feeling so concerned for them!

The hospital where I gave birth had pumps for nicu moms, and a couple of little rooms where they could go, but they never offered them to me, I guess because miri was only going to be there a few days. Maybe they worked harder to get the bf relationship going with moms whose babies were there long term? But I still felt those first feew days were crucial.

Miri is doing well now - gaining very rapidly!! and our nursing is going pretty well for the most part.

[Periwinkle]

Oh I dunno. I see what you're saying but the NICU is very different from the regular baby nursery. Babies are there because they are very sick or even walking the line between life and death. That's what these nurses and neonatologists are used to and trained to handle, and thank G*d they are the highly trained angels they are because they work miracles. That being said, I know BFing was a lot more challenging than it had to be when my twins were in the NICU for a month (due to prematurity). The experience in no way could compare to my experience with my latest baby, who was healthy and full term and roomed in with me the whole time. But the thing is, comparing the two (and comparing the NICU nurses' and the well baby nurses' behavior) isn't exactly fair... apples vs. oranges. I guess what I'm saying is that there would be some improvements made, but I'm so darn grateful for the amazing work they did with my twins that it's hard for me to gripe about it. I guess if your baby didn't really need to be in the NICU that would be a different story and I could see being really bugged by that.

[akmbloom]

the main thing that irked me was the inconsistency and mixed messages between the two nursing staffs.... I guess they haven't developed a consistent policy because most babies don't go back and forth between the two. I definitely understand the need for the nicu nurses to do things differently (using pacifiers for comfort during painful procedures, tending toward supplementation to be sure the babies are hydrated, etc) but it was hard to get totally opposing comments from the two nursing staffs...one would tell us to do one thing, and then we'd go back to my room and be told to do the exact opposite. i think it was really unusual for the baby to be allowed back "onto the floor" as they said, so they probably didn't know they were giving me mixed messages, there didn't seem to be much communication between the two. I just thought the differences were very interesting and worth commenting on.

Two pro-bf things happened as a result of my daughter being in the nicu - I just learned that the lactation consultants don't regularly visit all the patients but they do visit those moms whose babies are in the nicu and plan to breastfeed; and also since I'm on medical assistance/WIC I got a nice Medela breast pump for free. That has been majorly helpful.