me vs. the nicu nurse

[msumomma]

I am not sure if this is the right place to post this...but here it goes.
So I went to see my new nieces today, my sil had twin girls via section on the 26th. Today they are 4 days old. One is home with mama, so we went to see her 1st. Then we went to the hospital to see the other one, she's still in the nicu because of low birthweight. (mama smoked 2 packs a day )
So anyways, this mean lady who called herself the nicu nurse first tells my mil that the hospital policy is that visitors cannot hold the baby. My mil is crushed. So my dh gets on the cell phone to call his sister to call the hospital to say we can hold her. Then mil gets to hold her and feed the baby her bottle. I look at what kind of formula they are giving her. It's some special high calorie Similac something. The nicu nurse starts to explain to me about how since the baby is low weight that she's on a "special formula" thats higher calorie than regular formula or even breastmilk! That caught my attention..... She says this formula is 24 calories per oz and breastmilk is only 20 calories per oz....does this sound right to any of you?
Then my mil chirps up and says "well not her breastmilk it must be 30 cal an oz it's super milk"
I then ask her what the hospital policy is on breastfeeding? and she says well they encourage it whenever possible. I tell her I was not happy with my nicu experience when dd was born and the manadatory ff schedule she was put on in the nicu and she says "well of course if your mild hadn't come in the baby has to get a little something" I basically told her that I disagreed with her and then I left before I got too upset by her ignorance so that my dh could see his sister's new daughter. Why oh why do these people get to influence so many new mothers and they don't even know what they are talking about!?!?!?! Then she says "well you're still bf your daughter so the formula she had in the hospital didn't discourage you any" All I could say was "I was lucky"
Sorry I just had to vent going to the nicu to see a newborn brought back so many bad feelings about my dd's experience with the nicu when she was born I guess I still have hostility about our experience.

[crissei]

Yep, 24 calories is standard nicu care. When my son was in the nicu HMF was added to my BM to increase the calories. And the few times I had to supplement with formula it was with 24 cal. similac.

[sapphire_chan]

I think she was asking about the calorie content of breastmilk, Crissei.

The quick search I did says that breastmilk is 20cals and that's what they aim to make regular formula. That said, I'm pretty sure someone did a study once that found that breastmilk has higher calories if a baby is preterm. Not sure if it can also compensate for a low birth weight due to smoking.

[CathMac]

Human pre-term milk contains greater amounts of certain components than human term milk, including fat and calories. The article linked below lists all of those components and also gives guidelines on when and how to “fortify” human pre-term milk. It doesn't give the specific amounts of the fat, calories, or other components in human pre-term milk; however, even if the fat and calorie content of human preterm milk is lower than preemie formula, the article implies to me that fortifying human pre-term milk is preferable to giving preemie “formula”. I have included a quote from the article.

Of course that assumes that the mother is producing enough milk to fortify.

Breastfeeding the Premature Infant Infant http://www.leron-line.com/PrematureInfant.htm
“Fortifying Breastmilk -- The composition of preterm milk is higher than term milk in : Protein, Non-Protein Nitrogen, Fat, Calories, Sodium, Chloride, IgA, Lactoferring, Lysozyme. Although preterm milk is higher in the important components that premature infants need, it is generally recognized that for VLBW and ELBW infants, breastmilk needs fortification to meet the needs for protein, calories, calcium, phosphorus and other trace minerals. Fortifiers are used until infants are about 4# 6 oz to 5# 8oz. The neonatologist and dietician determine how much and what type of fortifier is needed for each infant.”

~Cath

[sapphire_chan]

Even putting a couple of expressed drops of colostrum into the preemie formula would be an improvement if that's all that can be gotten.

And since the hospital doesn't seem to support that, let alone fortifying the mother's own milk, it's no wonder you're feeling mad at them, Msumomma. Here they're supposed to be helping babies and they aren't even taking 5 seconds to see how to give the babies the best possible nutrition.

[ChattyCat]

Luckily, our dd is big enough that the NICU she's in doesn't worry about her weight. They are super supportive of bfing, but for really little babies, I've overheard them telling moms that the babies get 2 bottles of high calorie formula a day. Other than that, they bf. It's just to give them an extra boost. I'm not sure if it's really necessary, but considering how supportive they've been with us bfing dd, I have to think there's a good reason for it.

Maybe, you didn't get the whole story? Every NICU is so different. The one that my sister's twins were in sucked. They totally tried to sabatoge her bfing efforts. Yeah for her that she didn't let them get her down.

[MamaFae]

I feel your pain! My daughter was in the NICU for 4 days due to late onset rapid breathing that could have "possibly" been caused by an infection, and which in truth was due to my being dehydrated from so much damn vomiting during labor! So through the whole episode I pumped like a mad women, nursed her every hour or so, and still got the "until your milk comes in, she needs supplemented" speech. I refused, and told them if she needed anything by mouth it would come from me or my pump. I went round and round with one NICU nurse, until I finally requested to speak with the attending NICU doc. After another round of them trying to tell me what's best for my daughter (3rd child for me btw) I convinced them to let me feed her.
I mean, think about this, she could have an infection and they want to ruin her virgin gut by giving her formula that could cause intestinal upset? She had an IV to get antibiotics (don't even get me started on that!) so I felt she should get fluids that way if they were so concerned. It took what seemed like forever to get them to see it my way.
I swear I get so darn upset over the "we are gods" and "we know it all" attituded of doctors and nurses. Especially toward mothers and babies.

/rant off

Blessings,
N~

[mhenry]

I know all nicus are different, but you can put me in the club of having a successful bfing relationship in spite of the nicu my son was in. Nurses constantly sneaking formula into his bottle, despite that fact that he had a freezer of ebm. I wrote a lot more, but deleted it, because I didn't want to hijack. I feel your pain mama, ds is almost 11months and I am still angry about our nicu experience.

[crissei]

Originally Posted by CathMac

Breastfeeding the Premature Infant Infant http://www.leron-line.com/PrematureInfant.htm
“Fortifying Breastmilk -- The composition of preterm milk is higher than term milk in : Protein, Non-Protein Nitrogen, Fat, Calories, Sodium, Chloride, IgA, Lactoferring, Lysozyme. Although preterm milk is higher in the important components that premature infants need, it is generally recognized that for VLBW and ELBW infants, breastmilk needs fortification to meet the needs for protein, calories, calcium, phosphorus and other trace minerals. Fortifiers are used until infants are about 4# 6 oz to 5# 8oz. The neonatologist and dietician determine how much and what type of fortifier is needed for each infant.”

~Cath

Thanks for posting that. There have been times where I have had to "defend" adding fortifier to my sons BM gavage feedings. People sometimes don't undestand that there is a BIG diffrence in the prematurity levels.

[mykdsmomy]

I had a similiar experience in the NICU when my son was born. Looking back, it's much easier for nurses to grab a pre made bottle of formula than to go to the freezer, heat up some water, defrost the bm. I'm starting to think it's a matter of convenience :

[ChristaN]

I doubt that any of you are in my neck of the woods, but if anyone is having this problem in Northern Colorado, feel free to pm me. I work at a hospital up here and, while I think that our nurses in SCN/NICU are pretty supportive, I have heard a few negative things occassionally. I'd be happy to personally speak with any of our nurses as I teach classes for them (I work in Education) and have a pretty good relationship with the nurses.

[stockingup99]

Just reading it makes me hopping mad. Breastmilk is so much more important for premies. Polluting with formula would only promote the infection.

Fending off formula is a full time job. I hate it when other moms tell me that formula wasn't pushed at me.

Please write a letter, and let the NICU staff know how destructive those policies are.

[Momtwice]

Have you looked at http://www.kellymom.com
?

[MandyWelch]

I'm so sorry for all the bad NICU experiences. I am an extended b'feeding, cd'ing, pro-NCB, NICU nurse and I feel like I am the minority. I frequently will give parents tips on how to breastfeed sooner if they have a tiny baby or baby with breathing problems. I've gotten vent babies up to Kangaroo (very rare in my hospital).

I just wanted to say that all nurses and all NICU's are different. Unfortunatley you often have to become a broken record or refuse some treatments in order for your wishes to be honored.

Just remember that you can refuse treatments and you don't have to go along with something if you don't agree. Neonatologists are generally pretty knowledgeable about infant nutrition though, especially preterm nutrition. I am lucky in that I work with a doc who tells all preterm moms that they *should* pump for their babies unless they have a medical condition which prohibits them doing so. He is also anti-circ.

(((HUGS)))
Mandy

[crysmomofthree]

Originally Posted by momma2emerson

Luckily, our dd is big enough that the NICU she's in doesn't worry about her weight. They are super supportive of bfing, but for really little babies, I've overheard them telling moms that the babies get 2 bottles of high calorie formula a day. Other than that, they bf. It's just to give them an extra boost. I'm not sure if it's really necessary, but considering how supportive they've been with us bfing dd, I have to think there's a good reason for it.

Maybe, you didn't get the whole story? Every NICU is so different. The one that my sister's twins were in sucked. They totally tried to sabatoge her bfing efforts. Yeah for her that she didn't let them get her down.

I have had 1 baby in a nicu for 2 weeks and two mildly preterm babies since (one of which went back to peds for 3 days)

I just have to say that the care babies receive is heavily influenced by the staff on that day and their personal opionions and education regarding breastfeeding and attachment parenting (or lack thereof) and the moms desire to fight for what she wants.

A nicu stay is terrifying and overwhelming for a new mom not to mention the teeny baby. And I still haven't gotten over my son's nicu stay 7 years later, I am sure other moms would say that that nicu was "supportive" and to a degree it was, but I felt like I had to fight for what I wanted.

[crysmomofthree]

Originally Posted by MandyWelch

I'm so sorry for all the bad NICU experiences. I am an extended b'feeding, cd'ing, pro-NCB, NICU nurse and I feel like I am the minority. I frequently will give parents tips on how to breastfeed sooner if they have a tiny baby or baby with breathing problems. I've gotten vent babies up to Kangaroo (very rare in my hospital).

I just wanted to say that all nurses and all NICU's are different. Unfortunatley you often have to become a broken record or refuse some treatments in order for your wishes to be honored.

Just remember that you can refuse treatments and you don't have to go along with something if you don't agree. Neonatologists are generally pretty knowledgeable about infant nutrition though, especially preterm nutrition. I am lucky in that I work with a doc who tells all preterm moms that they *should* pump for their babies unless they have a medical condition which prohibits them doing so. He is also anti-circ.

(((HUGS)))
Mandy

I am sure you are a breath of fresh air to some moms during their nicu stay

I had one nice nurse in the nicu who was very friendly and supportive and even took a picture for me of my vented baby, she made a real difference to me.

And you can totally refuse treatment, I always repeated the mantra, "the baby needs to eat that is top priority, but I get to choose WHAT and HOW the baby is fed" I think it lets the staff know you don't want to sacrifice your babies growth for your "breastfeeding cause" but that you know your rights and that the baby is "yours" not "theirs"

Crystal

[writermommy]

Originally Posted by MandyWelch

I'm so sorry for all the bad NICU experiences. I am an extended b'feeding, cd'ing, pro-NCB, NICU nurse and I feel like I am the minority. I frequently will give parents tips on how to breastfeed sooner if they have a tiny baby or baby with breathing problems. I've gotten vent babies up to Kangaroo (very rare in my hospital).


(((HUGS)))
Mandy

You are in the minority and the families are lucky to have you! I dread having this baby in the hospital because of the nurses. I've had three babies and only one nurse who wasn't a total b*tch. Very few are knowledgeable about breastfeeding. Personally, I don't think a nurse should be allowed to work in maternity or NICU or anywhere else where they come in contact with new moms without being required to take courses in breastfeeding. The ignorance out there is astounding! I've even heard of nurses telling moms of FULL TERM infants that they "need" some formula until the milk comes in. UMM... what did they do for THOUSANDS of years before formula??? :

[msumomma]

Originally Posted by crysmomofthree

And you can totally refuse treatment, I always repeated the mantra, "the baby needs to eat that is top priority, but I get to choose WHAT and HOW the baby is fed" I think it lets the staff know you don't want to sacrifice your babies growth for your "breastfeeding cause" but that you know your rights and that the baby is "yours" not "theirs"

Crystal

That is exactly what I struggled with. My dd was MY baby, they acted as if she was THEIR baby. Now I see it happening again with my new niece.

[msumomma]

Originally Posted by writermommy

You are in the minority and the families are lucky to have you! I dread having this baby in the hospital because of the nurses. I've had three babies and only one nurse who wasn't a total b*tch. Very few are knowledgeable about breastfeeding. Personally, I don't think a nurse should be allowed to work in maternity or NICU or anywhere else where they come in contact with new moms without being required to take courses in breastfeeding. The ignorance out there is astounding! I've even heard of nurses telling moms of FULL TERM infants that they "need" some formula until the milk comes in. UMM... what did they do for THOUSANDS of years before formula??? :

My dd was born at 37 weeks exactly, and I was most definately told my dd needed the formula until my milk came in, and I was told that more than once. I was told to offer a bottle after nursing apon discharge, and when I questioned why all the sudden I was told to "look at her color, that baby is JAUNDICED and needed the hydration to flush out the jaundice".

I am scared to death of the pain of childbirth (I was induced and had a epi....boy that pitocin kicked my a$$.....never felt what natural labor pains feel like ), but am seriously considering if I am to have another baby maybe a midwife assisted homebirth might suit me. I hate the drs, the hospitals, the nurses, where on Earth do they get off telling you what you HAVE to do? Aren't we the consumer, choosing to have our babies in their establishments....shouldn't WE be telling THEM how it's going to be?

[crysmomofthree]

Originally Posted by msumomma

My dd was born at 37 weeks exactly, and I was most definately told my dd needed the formula until my milk came in, and I was told that more than once. I was told to offer a bottle after nursing apon discharge, and when I questioned why all the sudden I was told to "look at her color, that baby is JAUNDICED and needed the hydration to flush out the jaundice".

I am scared to death of the pain of childbirth (I was induced and had a epi....boy that pitocin kicked my a$$.....never felt what natural labor pains feel like ), but am seriously considering if I am to have another baby maybe a midwife assisted homebirth might suit me. I hate the drs, the hospitals, the nurses, where on Earth do they get off telling you what you HAVE to do? Aren't we the consumer, choosing to have our babies in their establishments....shouldn't WE be telling THEM how it's going to be?

I don't want to throw the thread off track but I think you would find if you chose the homebirth route with a trusted caregiver (whether that's yourself, your midwife or your husband) you would find your labor pains much more tolerable if you were at home and able to do what YOU chose. And yes pitocin contractions are much much worse than regular contractions (personal experience talking here) Keep repeating your last post to yourself I think you know you would be better off with homebirth care