The healthcare experiences of formula feeding mothers: an interview with researcher Lisa Wirihana

Within its recently updated statement on breastfeeding, the American Academy of Pediatrics (AAP) issued a plea for universal adoption of the Baby Friendly Hospital Initiative (BFHI). If you’re interested in my thoughts on the BFHI, click here, but here’s the Cliff’s Notes: While I love the idea of better support for breastfeeding in theory, in practice, I do not think these “10 Steps to Successful Breastfeeding” will be all that successful. More urgently, I’m concerned for the parents who have made an informed choice to formula feed, and for the women who go in intending to breastfeed, but who have an unexpected, dramatic, physical or emotional reaction to the act itself (i.e., D-MER, flashbacks of sexual abuse, nerve damage). And I’m concerned for their babies. Because if formula feeding parents are not given proper support and guidance, mistakes can be made, and there can be serious consequences.

That said, I was pleased as punch to stumble across a study entitled “Women’s perceptions of their healthcare experiences when they choose not to breastfeed”, which was published in the March 2011 edition of the journal Women and Birth. “The purpose of this study was to explore the postnatal
experiences of women who do not breastfeed and to gain an understanding of women’s perceptions of their care and support in their choice not to breastfeed their baby. The research focused on a group of women who are representative of those who have made the decision not to breastfeed by the time they are discharged from hospital. This demographic is often excluded by the current health care focus on
breastfeeding,” the study begins. While this qualitative research study only examined a small group of women in one hospital, the authors speak to significant need for further exploration of this topic:

If women are not supported, and educated in their choice not to breastfeed, both mother and infant are put at risk. The realization of this risk may result in future hospital admissions. If the correct preparation and storage of infant formula is not followed, infants are compromised from bacterial infections, diarrhoea, hypernatraemia or hyponatraemia or under nutrition. Mothers who do not breastfeed and do not feel they were supported in their choice are also at risk. The potential risks for the mother involve feelings of guilt, anger, worry, uncertainty and a sense of failure.

Once I’d pinched myself sufficiently to ensure that this wasn’t just a fantasy – that there was actually a published study which not only acknowledged formula feeding mothers as something other than truants or morons, but also addressed a very real, and very current need for formula education – I contacted the lead author, Lisa Wirihana. She very kindly agreed to answer some questions for us about her study, as well as offering some thoughts on the BFHI and how formula feeding mothers are being approached. I hope Lisa’s work will begin a healthier conversation about how breastfeeding can be encouraged and protected without throwing the formula fed baby out with the bathwater.


FFF: Why did you become interested in this topic?

LW: When I had my children, I breastfed, because that is what my mother and sister did and what I thought I should do.  I enjoyed breastfeeding, and I did not experience any problems with it.  I had friends who bottle fed their children and I was interested in their stories of how they felt they were treated.  Many years later, when I was working nightshift as a midwife on a Maternity ward, one of the other midwives came into the office.  This midwife was concerned because she had just spent a lot of time with a bottle feeding mother who had been upset by what she called ‘breastfeeding nazi’s’.  At the time I was studying for a Master of Nursing and was searching for a topic for a research project.  I was really interested in the topic, because for me, I think it is a matter of equity.  All mothers and babies should have their needs met, regardless of their choice of infant feeding.

FFF: How is the system currently affecting women who decide not to breastfeed? What are the possible detrimental effects of the current status quo, both to mothers and babies?

LW: I think it is important not to underestimate a woman’s desire to be seen as a good mother.  When women are made to feel that they have made a poor decision regarding infant feeding it puts them at risk psychologically.  By not arming a woman with the correct information on how to sterilize feeding equipment and how to make up a formula safely, babies are being put at risk for gastrointestinal illness and other forms of sepsis.

FFF: Did your findings support your initial thesis, or were you surprised by what you discovered?

LW: When I started interviewing women and asking them to describe their experience with bottle feeding in a maternity hospital setting, I was actually surprised by one factor.  Almost all of the women really liked the hospital and really liked the care that they had been given.  They expressed a great respect for most of the midwives.  In the next breath they would say that they got no information about how to make up a bottle and were not permitted to obtain their own bottle from the milk room.  They felt that they were not supported in their decision to bottle feed.  I am surprised that those two factors can go together.

As far as the need for more teaching and support and the desire not to be pressured into feeling like they should breastfeed, I was expecting those results.

FFF: Did you speak to any healthcare workers while conducting your research? What was their take on the situation?

LW: I had a mixed reaction.  There were some midwives who were very in favour of the research and even helpful to find participants and show me posters that they were concerned with.  There were a few that were less helpful.  I was told subtly that I needed to be careful as midwives who appear to be pro bottle feeding could be at risk of losing their midwifery registration.

FFF: In your opinion, how do you think healthcare providers should approach the infant feeding decision? If a woman has expressed an interest in formula feeding, how should this be handled?

LW: I think when a woman expresses the desire to formula feed a gentle questioning of what her reasons behind that decision should be explored.  It may be from lack of information that the decision has been made.  If the woman fully understands and can make an informed decision to formula feed, (for reasons that are important to her) all efforts should be made to support her in that decision.  This should include documentation that she has made an informed decision, so that she does not need to be questioned again.

FFF: How has the BFHI changed women’s experiences in the hospital?

LW: I believe the introduction of BFHI has had an effect on women’s experience.  For breastfeeding mothers, I think that effect is a positive one.  Much more support and education has been developed to promote, protect and support breastfeeding.  For mothers who are bottle feeding, I believe there has been a less than positive effect.  All information regarding formula feeding is seen as a risk to mothers who are breast feeding.  The policy is that no breastfeeding mother should be exposed to anything related to bottle feeding.  This has had an effect on the treatment of all mothers.  I believe that not only is this detrimental to the psyche of bottle feeding mothers, it also contributes to the lack of knowledge that they receive.   However, it must be said that BFHI guidelines clearly state that once a woman has made a decision to bottle feed she should be educated and supported in that decision.  I think there are variations on how that is interpreted.  Also, the promotion, protection and support of breastfeeding is incredibly important.  However, that should not be done at the detriment to those who do not breastfeed.

FFF: Has this study been well received?

LW: The study has stimulated a lot of discussion. If it achieves nothing more than making people aware of the needs of bottle feeding mothers, it will have been a success.

I want to thank Lisa once again for participating in this interview. She tells me she is currently looking to enroll in a PhD study to examine the culture of infant feeding within western society, and I seriously hope that she continues down this path. We need more people with this level of sensitivity, nuance and intelligence contributing to the infant feeding discourse. 

And what about you, FFFs? How would you envision a truly baby – and mother – friendly hospital operating? How would you have wanted to be approached by healthcare providers when it came to your feeding decisions (or lack thereof)?

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.

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48 thoughts on “The healthcare experiences of formula feeding mothers: an interview with researcher Lisa Wirihana

  1. I think that offering formula samples would be nice (gasp!). It would be awesome to have the pediatrician in the hospital come in and discuss the different types of formula, sterilizing and food safety. I also think that enforced rooming in should be done away with. It is not mommy friendly at all and it is hard enough to get sleep with all the bustling going on around you. I took advantage of it with my last kid and I loved it so much. With her in the room I would twitch at every sound.

  2. “BFHI guidelines clearly state that once a woman has made a decision to bottle feed she should be educated and supported in that decision.” This is an interesting factoid for me – on the surface, very encouraging, but one has to wonder how it fits in with the “gentle questioning” and probing as to why the mother has chosen to FF and whether it's the “right” decision made for the “right” reasons. How do you square this sort of pushing with a respect for the woman's decision? At what point are nurses/midwives/doctors going to accept or support the woman's decision as “made” vs one that she can be talked out of? I think there is a fundamental problem with the BFHI for this reason – if you have to present one option as the Good One and not discuss all others for fear of tainting a woman's ability to make the Right Choice, aren't you always going to go down the same path of making FFing women feel inferior?

  3. Ideally, I think infant feeding should be discussed before the mom goes into labor. I think she should be given the pros and cons of each method (orally and/or in writing) at one of her prenatal visits and asked what she wants to do. Then her care provider should give her instructions and/or refer her to a class on how practice the method she has chosen. Her choice and instruction should be noted in her chart… which should also be filed at the hospital or birthing center where she plans to deliver. When the big day came, it would be one less thing to deal with. (If a woman had had no prenatal care, the matter would obviously have to be addressed in the hospital.)

    I too have reservations about asking a woman why she made the infant feeding choice she did. I suppose it's possible she decided to bottle feed because of some misconception and would breastfeed with better information. But asking why is often a segway to trying to change someone's mind. The BFHI does indeed seem to espouse BFing the “Right Choice” as you put it. And extreme lactivists will say practically any reason not to BF is uninformed. If office/ hospital staff held that opinion, whatever answer a bottle- feeding mom gave would be “wrong” and she would be “educated”. And I'm guessing brand new parents don't want to be having this debate in the hospital. Or during a prenatal visit, for that matter (but at the hospital would be worse, IMO.)

  4. I agree with this, and it doesn't seem too hideously complicated. It seems that hospitals often like to have a one-size-fits-all policy regarding whatever–this isn't limited to infant feeding. BFHI moves from a one-size-fits-all bottle feeding policy, where formula is routinely given in the nursery, babies get pacifiers, formula samples are sent home, etc., to a one-size-fits-all breastfeeding policy where bottle-feeding mothers get shortchanged. Why would it be so difficult to have two sets of protocols, and even *gasp* deviate from them where necessary? Sheesh.

  5. Totally – it's something I advocate to anyone I meet now who is preg. My experience was one of docs simply asking if I planned to BF or FF, hospital folks and LCs helping with BFing, then sending you home…and I never thought much support or information would be necessary as BFing is so natural, right? I'd love for women to be given charts pre-natally on what to expect with various feeding methods – how often baby will feed, what frequency of poops, weight gain/loss, what is likely to happen to milk supply if you introduce bottles (how many bottles), how soon you can begin pumping, etc. Some of this info was given to me in a booklet put together by the hospital with LLLI input, but right after you've given birth and are exhausted and sleep-deprived and trying to get new baby to latch is not the time to process it all. If only this kind of information could be delivered without being part of some sort of lactivist/other agenda…

  6. The baby friendly initiative quite honestly scares the hell out of me. I agree that supporting moms who WANT to breastfeed and providing unbiased facts to those who are on the fence is a great thing, but I think the BFHI takes it entirely too far. Does anyone know (or even better given birth at a BF hospital) do they actually require you to breastfeed? Do they require rooming in regardless of feeding choice or can you opt out of the rooming in? I mean if you tell them point blank, I do not WANT to room in, if you leave the baby here I am falling asleep for the night and will not tend to him/her when he/she cries, what would they do? Extreme, I know (and I'm not saying I condone this action, but just curious what their solution is if a mother flat out doesn't want to room in).

    Can they stop you from bringing your own formula if you chose to bottle or combo feed? How far does this go? The reason I'm asking these questions is that I've read the actual UNICEF site guidelines and this language is very absolute and frightening and makes virtually ZERO acknoledgement of the mother (parent's) personal choice and autonomy when it comes to feeding. How can we allow something like this in a free country like the USA?

  7. At the hospital where I had my babies, they asked before labor (pre-reg) if you wanted to BF. If so, they would put a sign on the baby's bassinet and give you pumping equipment and send an LC or nurse to help. Either way, I got formula samples and they would take the babies to the nursery if you wanted. One nurse actually suggested she do a finger-feed in the nursery so I could get some sleep, which was so kind of her. This is in America, not UK, so I can see why there would be differences, but even within America, I don't see why hospitals would deviate from that model, except as a cost cutting device.

  8. I have to say a big thank you to Lisa as well, because to get any acknowledgement of how badly formula-feeding parents are treated out of the research world is tremendous. I hope you can take this research as far as possible, because plenty of us here have lived the negative outcomes of not supporting bottle-feeding parents you have described, and would not wish it on anyone.

    “There were a few that were less helpful. I was told subtly that I needed to be careful as midwives who appear to be pro bottle feeding could be at risk of losing their midwifery registration.”

    I find this so sad. That there is such a mandate for one-size-fits-all care that you can lose your job for being pro-bottle-feeding. I'm pro-bottle-feeding. I'm pro-breastfeeding too. Does that mean I'd lose my job if I were a midwife? In what other area of medicine would treatment like this ethical?

    “The policy is that no breastfeeding mother should be exposed to anything related to bottle feeding. This has had an effect on the treatment of all mothers. I believe that not only is this detrimental to the psyche of bottle feeding mothers, it also contributes to the lack of knowledge that they receive.”

    I've noticed this too, whether it's Piri Weepu's 2-second bottle-feeding shot in NZ or people going hysterical that formula companies are allowed to advertise in the States. What a horrible commentary about women. I find this sickeningly misogynistic. Again, in what other area of medicine is it considered ethical to completely withhold a valid medical option to a patient? I can think of no comparison in medicine or society in which it is so acceptable to deliberately withhold information (who's the uninformed, around here?!) and thus relegate those who don't do what others are trying to force upon them to second-class citizen status.

    Once again, I find myself in agreement with bethrnich, especially in this: “The BFHI does indeed seem to espouse BFing the “Right Choice” as you put it. And extreme lactivists will say practically any reason not to BF is uninformed. If office/ hospital staff held that opinion, whatever answer a bottle- feeding mom gave would be “wrong” and she would be “educated”.”

    Just a casual stroll around Best for Babes shows that attitude is healthy and well among a LOT of breastfeeding moms, and it was certainly healthy and well among some of the professionals I consulted. As if there needs to be a judge, jury, and executioner panel of some of BFB's commentators to determine who really “tried hard enough” and who has a “valid excuse.” There are never good reasons not to breastfeed to some of these commentators, there are just excuses. And that's just among the regular janes, it trickles down from the “breast is best” mandate so prevalent in government and health care.

    The reality is, according to a significant chunk of the breastfeeding world–buttressed by hospital policies that seek to hide away non-breastfeeding moms as if they are a plague on the rest–nothing a bottle-feeding mom can do is good enough for her to be considered educated, informed, and right in her choice. She is condemned to be a second-class citizen in the mom world.

  9. I am thinking about the people who think there are no valid reasons to avoid BF, and that all reasons given are excuses.

    Attempting an analogy to state my point:

    Back in the day, girls might try to be excused from gym class, maybe by claiming bad cramps. She did this because she didn't like gym class. In fact, none of her friends liked gym class either and were jealous that she made up an excuse to avoid it.
    If these lactivists are seeing the other women's avoidance of BFing as excuses, perhaps some of them find BFing difficult, painful, etc and wish they had an out too. (I wouldn't say that all of them think like that, but I always suspect some of them do.)

    With the Baby Friendly initiative, that takes the judging to another level—now it's not just sanctimommies deciding everyone can and should BF, it's the hospitals that partake of those programs too.

    And of course, as we all agree: it doesn't matter what reasons a woman has for choosing how to feed her infant. It is her business.

  10. I totally agree! Asking women why they aren't breastfeeding invites the feeling of a need for explanation (especially in first time moms who might be more insecure). In cases of abuse or women whose previous negative breastfeeding experiences caused depression, I worry about the qualifications of the person asking such an emotionally charged question. Are they aware and prepared to councel abuse victims? Do they have knowledge of depression triggers? I think that it would be smarter to give women UNBIASED information packages ahead of time and when they enter the hospital the only question asked is “How do you want to feed?” Then support them and leave it at that.

  11. I'm VERY glad to hear about the new research being done. I hope it helps to educate the public that breast isn't best for everyone. I'm due with my daughter in June and am having a doctor-assisted homebirth I chose that partly because my local hospital is a certified baby friendly one. I had a terrible experience at another hospital in regard to my first breastfeeding experience, and they weren't even baby friendly. There's no way I want to chance repeating that!

    I was treated poorly by one doctor in particular (not my OB, thankfully), who told me that his wife was able to stick it out despite pain and I should do the same. Between him and a male doctor I met later, who questioned whether my chunky son (10 lbs, 2 oz at birth) was actually digesting the formula, I felt like a failure.

    It turns out I have Fibromyalgia (didn't know it at the time) and when pregnant my breasts become even more sensitive. I had involuntary muscle spams trying to get my son to latch properly and nearly knocked the poor baby off the hospital bed! I ended up being able to combo feed by pumping for short while, then switched entirely to formula. We had a great feeding relationship and I have a healthy, smart 5-year-old now.:-) If I need to use formula again, that's that. I'm VERY grateful to have a supportive doctor in my corner this time and I wish more women had that!

  12. “if you leave the baby here I am falling asleep for the night and will not tend to him/her when he/she cries, what would they do?”

    Not tending to your baby would result in a referral to social services surely?

  13. “perhaps some of them find BFing difficult, painful, etc and wish they had an out too”

    Couldn't they just make up an 'excuse' to quit too? Or do you mean they feel duty-bound by their obligation to their baby?

  14. Let me once again make myself clear. I am NOT condoning this action merely using it as an extreme example to try and understand what a Baby Friendly hospital does when a mom is dead set against rooming in.

    While I support offering the OPTION for a mom to room in with her newborn, I am staunchly opposed to a hospital FORCING a mother to room in if she does not want to. I personally think after going through childbirth (whether natural, epi, c-section, whatever), if a mother is tired and feels she needs a full night's rest to recover from labor/birth/surgery/whatever, that is her RIGHT and not the hospital's place to force her to do otherwise. The hospital works for YOU, not the other way around. I think forcing an exhausted mother who is possibly traumatized from a difficult birth to room in with a newborn and breastfeed if she doesn't want to is downright CRIMINAL. No male in this world would tolerate being treated this way by the healthcare system or anyone else for that matter. Why does UNICEF think it is OK to treat women (no less new mothers) this way and think they are helping them?

    Fortunately the big hospitals in my area are neither baby friendly nor have gotten rid of their newborn nurseries (they allow rooming in but to my knowledge do not force it). If I was ever unfortunate enough to have no choice but to give birth in a baby friendly hospital, I would have my mother or a hired night nanny (would gladly pay out of pocket for that) spend the night with me in my hospital room to care for the baby while I slept since the hospital would obviously be incapable of providing me the care and support I felt I needed. Could a baby friendly hospital stop a patient from doing that? If so that is INEXCUSABLE and this “initiative” is more of a totalitarian dictatorship than anything that will help anyone. This scenario has to violate some kind of patient bill of rights (many hospitals have right to refuse treatment clauses-can that not apply to lactation consults/breastfeeding as well?), not to mention some kind of civil tort law. I can't wait (and hope) for the day women have decided they've had it with this @#$% and someone gets the pants sued off of them and this bullying finally STOPS.

  15. Alpha Parent-I think you are seriously missing the point here. No one on this blog is against rooming in or breastfeeding for that matter-not in the least. What we are against is misinformation, scare tactics, bullying and FORCING women who do not want to breastfeed/room in into doing something that isn't right for them (against one-sized fits all approaches to these matters). As I stated in a previous response comment to you, a mother who has had a difficult birth or just feels she needs to rest (and makes an informed choice to allow her baby to be supplemented at night with a bottle/formula) has a RIGHT to make that choice without coercion from some “initiative.”

  16. Thanks Perfesser. This link you provided provides an even better take on this research! It seems like FINALLY the message is getting out there that maybe this isn't the right approach for absolutely everyone. Here's to hoping this continues and the pendulum finally swings to some happy middle ground with regards to breast/bottle/combo/pump/whatever. (I'm going to believe that given the close proximity to St. paddy's day, we have the luck of the Irish on our side with this… I know corny joke but I'm in a good mood, I just got my first new car ever last night…)

  17. I suppose they could (make up an excuse), but sometimes BFing women set goals and are determined to meet them regardless of how they feel about BFing. I have a friend who works full time and pumps for her baby, and the baby has been exclusively breastfed since birth. (I think she is 8mos old now). My friend has repeatedly told me how much she hates pumping and the baby doesn't really like nursing. I asked her if she could stop then, and she said “well, I've made it this far, I'll go to a year and then stop.” So that's fine, and also, despite her feelings about pumping, she's never made a comment about how formula feeders invent excuses.

    Other women may feel too much pressure, which could keep them BFing even if they don't want to/like it.

    Ultimately, the BFing mother who berates those excuse-claiming formula feeders is entitled to her opinion, but she is being downright nasty when she invalidates another woman's feeding choice.

  18. Teri, I just passed your comment here and the part about the guideline that no breastfeeding mothers should be exposed to anything related to bottlefeeding really caught my eye.

    I know this point has been made many times before but I can't help it… Wow, how stupid and weak do these people coming up with these initiatives think women are? Let's say hypothetically I'm gung ho on breastfeeding and determined to stick it out no matter what. Maybe I'm a little tired/sore on the first few days but overall I'm ok and want to keep going, and then BAM, suddenly I see a mom bottlefeeding or a can of formula and that's it. My breastfeeding goals, determination, dedication are all out the window because I'm so weakened by those images.

    Obviously I'm being sarcastic here. I think we, collectively, as females should be terribly insulted by this-that UNICEF thinks we have to have bottlefeeding images and info censored from us to keep us from giving up or “failing”.

    Sorry… end rant, but that just really struck me. As far as we've come we still have such a long way to go. 🙁

  19. Me too 🙂

    I'm also really confused as to how a hospital would comply with the whole not exposing breastfeeding mothers to any thing bottle feeding-related rule.

    Suppose the hospital nursery has a big picture picture window looking out to the hallway (very common in the States) or allows parents to accompany an/or visit their child in the nursery. Does that mean they can't have artificial feeding supplies or even bottle feed a baby in there? A breastfeeding mom could be “exposed” to bottles and formula. *Gasp*

    What about shared hospital rooms or open wards? Does the BFHI forbid breast and formula- feeding moms from rooming together? Again, breastfeeding moms would see bottles and formula. [Oh, the horror.]

    Heck, a nursing mom might see bottles and formula in the hallway when hospital staff are taking them to a formula-feeding family. What is the hospital/ birthing center supposed to do about that?

    Not exposing breastfeeding moms to anything bottle-feeding related is one aspect of the BFHI that is, IMHO: 1) ridiculously impractical and 2) anti-formula/ bottle.

    What if (a) major international organization(s) wrote the reverse (i.e., that bottle-feeding mothers should not be exposed to anything breastfeeding- related)? You can imagine the uproar. And rightfully so.

    Surely WHO and Unicef could have come up with a more reasonable set of guidelines on infant feeding for hospitals and birth centers. One that supported… and respected breast, formula and combo feeding and pumping.

    ARGH! Excuse my rant.

  20. Our hospital doesn't have a nursery, but the nurses will take the baby for several hours so a mom can rest. I took full advantage of their offer, and they only brought E back in the middle of the night because we started having issues with his blood sugar again and were trying to avoid a second trip to NICU.

  21. I'm also really interested in baby friendly hospitals and how babies with medical issues who need to go to the NICU fit into that. I'm really trying to get my story put together, but we had no choice but to formula feed in the first few hours because of medical complications for E, and this was at a baby friendly hospital. Are there exceptions made for those medical situations in the WHO guidelines? Not to mention it's pretty hard to avoid bottle feeding when the NICU nurse is jamming a bottle into your child's mouth to get him stable. Amazingly it was the child who was introduced to a bottle an hour after birth who is being successfully breastfed. I must be one strong woman to resist such temptation 😉

  22. Exactly. I would really like the option to either room in or send my baby to the nursery. I don't know how I will feel (physically and emotionally) when the time comes. (I have no kids yet.) I'd really like to wait and see. And to know I can send my munchkin away or ask for them back at any time.

  23. Where do the nurses take the babies while moms sleep if they have no nursery? And what do they do if if a mother is not physically capable of caring for her child (like when she has severe complications and the baby is healthy [read: doesn't need the NICU]) and doesn't have a responsible adult who can stay in the room?

    I don't mean to contradict you or be snarky– just genuinely curious.

  24. I know someone who was basically out of commission for a few days after her child's birth. It's amazing to me how people just assume that doesn't happen.

  25. The hospital where I gave birth to both my kids just became Baby Friendly. Fearlette was one of the last cohorts to be allowed in the nursery. Apparently how it works is that the baby has to stay with the mother; there is a “special care” nursery where babies are sent if they need extra help or attention (like a step below the NICU).

    Now, what I wonder is what would happen if a mother ends up in PPD hell hours after birth, as I did. If my husband hadn't been there I don't know how the hell I could've cared for my son. Fearlette stayed with us because she was easy, we had the feeding thing down cold the second time around, and I felt great physically and emotionally. But with FC? No way in HELL should i have been alone with him. When Fearless Husband left for 30 minutes to get food I was in a full on panic attack. Not to mention I could hardly move, I was in so much pain.

    I'm all for rooming in, but in the hospital, when you are often hooked up to IVs, had catheters or epidurals and can barely walk for hours, sometimes have no familial assistance (I'm thinking moms with husbands who can't stay overnight for whatever reason and no moms or friends who can do the overnight shift), it's just not practical. Why not just encourage rooming in rather than making is mandatory??

    I think it's really rotten to enforce rules which are founded in ideas about the “natural” when we are giving birth in unabashedly medicalized, regimented, cold environments. The irony astounds, doesn't it?

  26. Yeah, it sure is ironic. And disconcerting, if you ask me.

    As you and Teri pointed out, it is not always realistic for a woman who has just given birth to care for an infant. Other moms understandably don't want to be separated from their new baby. It's a personal decision that may be influenced by a lot of factors, IMHO. Hmmm, sound familiar? 😉

    I've heard stories, like Brooke's, where nurses in hospitals with automatic rooming in take babies for a few hours so their mommies can get some sleep. Somewhat reassuring. Even so, it scares me that moms in hospitals like this are at the mercy of staff to make an exception. i.e., It doesn't matter how overwhelmed/ exhausted you are or how craptastic you feel. Enough isn't enough until the nurses say so.

    Maybe I wasn't clear about the “healthy baby” part. I meant what happens if the baby is perfectly fine and needs no special care, but his/her mom is, say, listed in critical condition and could not possibly take care of her newborn? I assume there has to be a procedure in place for cases like these… at least I hope so.

  27. The nurses at our hospital LOVE being able to take the babies for a few hours since there is no nursery anymore, so they basically ask the moms if they want some time to sleep and take the babies to the nurse's station… of course once you asked this I started going through all kinds of scenarios about what happens if all the nurses are needed and such, but with both of my boys I've taken advantage of a few hours to sleep, though I am glad they were there the rest of the time.

    I have pretty moderate parenting philosophies, but I do find the idea of nurseries to be a little odd, but I've always needed my kids close by, probably because I'm over the top type A and also a little paranoid. However, you do raise some interesting questions, and I assume hospitals have a plan in those circumstances (the pediatric ward perhaps instead of the postpartum one – that's where E was going to go if he was readmitted at 3 days or if he had to stay at the hospital after I was discharged).

  28. Aw! It's nice to hear nurses love babies 🙂 And that makes sense.

    I'm pretty conflicted over the idea of sending my babies to the nursery, too. Part of me thinks I won't want to miss a second with them. And I might feel guilty about not spending the first night of their little lives together. On the other hand, I know I will probably be exhausted. I may be more able to take care of them at home if I rest up in the hospital. Time will tell.

  29. I wish I would have let my baby stay a few hours in the nursery. While I know I appreciated the time with her, you're not missing anything when both you and baby are sleeping, and a little extra sleep (especially after an exhausting labor while I was sick with bronchitis) probably would have helped cut back on the panic when we realized the jaundice wasn't getting better.

  30. bethrnich-I am right there with you. I don't have kids yet either but do know how I am without sleep and in order for me to be on my A-game as a new mom, I am sure I'm going to need absolutely as much of it as I can get and if that means putting my baby in the nursery for my hospital stay-then I want that option. The fact that there are some hospitals taking it away from new moms really scares and angers me.

  31. I was actually talking to my mother about this over the weekend. She is a nurse-although not in the nursery/maternity ward, she does post surgery nursing so she did occasionally get moms recovering from C-sections. I asked her about this whole baby friendly thing and what she thought of not having a nursery/forcing mom to take care of the baby all night after giving birth. She hadn't even heard of this whole initiative and was quite honestly shocked that hospitals even did that (didn't offer mom a chance to rest/recover after birth). She said she didn't know how they could get away with that and that it was dangerous for both the moms and babies, as the babies need to be watched by the nurses in the day or 2 after birth for jaundice and other kinds of things like that. So some perspective there from an actual health care worker FWIW…

  32. I'm not sure how it works at the hospital your mom works at, but at both hospitals I have given birth at, there is someone coming into the room every two hours the entire time you are there. You can room in with the baby, but it's not like no one at the hospital sees them again.

    In fact, every one that I know who has had a baby in a hospital has complained about how it is impossible to rest there because they are coming every four hours to check mom's vitals and every four hours to check baby's vitals, but they are offset so someone is coming in every two hours.

  33. Are the hospital actually getting rid of their nurseries?

    I'm the kind of mom that wants to have my baby with me at all times after birth. I think that you should have the option of rooming in or not. I don't understand why that would be enforced.

  34. I'm not sure the pediatric ward would be a good idea for a healthy newborn. My son's pediatrician's office has a separate waiting room for healthy babies 0-6 months who are just there for their well-baby visits to keep them away from all the germy kids. I realize that everyone would take all the necessary precautions, but it still seems like at least in the maternity/L&D unit the other patients that the nurses come in contact with are usually healthy.

  35. Tracie, that actually makes a lot of sense. The hospital she currently works at and used to work at are pretty big urban hospitals, one referred to as a “baby factory” so both sound unlikely to be adopting the baby friendly iniative anytime soon. I can see how risks associated with jaundice and other conditions are mitigated with nurses coming in to check through the night. However, I still find the cost cutting aspect of doing away with a nursery to be kind of a wash when you still need a night nurse staff and enough to be able to see every mother baby pair every 2 hours. And yes, someone coming into your room every 2-4 hours I'm sure disrupts the patient's sleep, but I would imagine mom would still get a better night's rest despite this if she wasn't having to worry about taking care of a brand new baby on top of getting the rest she needs to recover. Bottom line, I'm all for rooming in if a mom WANTS to, but absolutely against mandating it if she isn't comfortable/is fine with supplementary bottles via informed decision and decides she just needs as good a night's rest as she can get before going home.

  36. I can only speak to my experience and my desires. What happens in the large baby factory type hospitals is that mothers and babies are separated even when the mom WANTS to room in. And it is more convenient for nurses, sure, to have the babies in a nursery. But it's not nurses that are coming through, it's some type of medical assistant. I actually disagree that babies need to be checked every 4 hours for jaundice, etc., but that is not the point of this blog post. It is also not incompatible with breastfeeding for the mother and baby to be separated as long as the nurses are able to return the baby to the mother as soon as the baby starts showing signs of hunger.

    It was not ideal, but I was separated from my first child for two days while she was in the NICU and managed to breastfeed her for two years. The beginning was more difficult than it may have otherwise been, but well worth it in the end to me.

    I'm having a hard time reading what I'm writing here, so I'll just say, Kristin, I think we agree. If the mom wants to room in, she should be able to without facing trouble from nurses who are more accustomed to taking babies away and doing whatever they want with them and alternatively, moms should also be able to send the baby to the nursery and also expect that their wishes be met.

  37. Where do healthy newborns go if the mother is in critical care even if there is a nursery?? I doubt it's the post-partum wing to be quite honest. My son had severe jaundice at 3 days pp and was going to be admitted with “all those germy kids.”

  38. I would expect that exceptions would have to be made, for the baby to receive the standard of care. Some of those preemies need to be on monitors constantly, to make sure they are breathing and their hearts are beating correctly. Keeping the baby alive is more important than establishing breastfeeding.

  39. It's a good question, but it seems like a no-brainer. They wouldn't necessarily have to acknowledge that in print, because it is assumed.

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