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While a few wrote in to say a specific hospital (notably, Boston Medical Center and Mt. Auburn in Cambridge) did a great job helping them figure out the tricks of breastfeeding during those hazy, hormonal, sleep-deprived first days postpartum, many, many more remained angry about their lack of support.
Keyne, for instance, wrote that Beth Israel Deaconess Medical Center in Boston, "did everything in their power to sabotage my nursing relationship with my firstborn in 1998:"
They cut his cord immediately, took him away and refused to allow us to touch him for fourteen hours (during evaluation for moderate transient tachypnea); gave him artificial nipples and formula (!) in NICU, in direct opposition to our written wishes; declined to make a lactation consultant available during our stay; and then sent us home with a Peter Rabbit bag full of formula coupons. :( The experience soured me on ever birthing in a hospital again, and I went elsewhere in subsequent pregnancies."
Summermoon added: "I give my hospital an "F" for failing to back up their claims that they support breastfeeding. Their "support" included continued badgering to allow a bottle of formula, a personal visit from the pediatrician to tell me 'nature makes mistakes', lactation consultants too busy to ever show up for more than a few minutes, and the infamous take home bag of bottles and formula. I thought, what is this?"
Even though a hospital birth means, de facto that the new mom is a visitor on foreign turf, with all of the traditions and cultural habits that go with that, it's still critical for mothers to be supervigilant about what they want re: breastfeeding, to know what to ask for and to get help when things aren't going right, several commenters noted.
Holly Johnson writes: "I believe the key for moms is being sure they have a strong support system upon leaving the hospital. Instead of giving breastfeeding moms packs of formula and disposable diapers when they leave the hospital how about UP TO DATE information on area lactation consultants and support groups. The postpartum packet I received included very dated information and upon calling a number of places most were out of service or not in our area. And also, many OBs are not even aware of what is being given to their patients. Upon my latest visit to my OBs office I recieved coupons from Sears, Enfamil, Similac, Cord Blood Centers, Luna Bar, JCpenney and more. When I visit my regular doctor I don't get coupons for stores or carwashes etc. Why on earth would they decide to give these out? It baffles me. "
Even when women demand help, it can sometimes elude them, as demonstrated by this sad story by Katie Karpenstein:
I had my son in 2006 at St. Luke's Roosevelt Hospital in New York City. After an unmedicated labor where everything seemed to be going beautifully, I ended up with an "emergency" c-section after the doctor broke my water and the baby subsequently went into distress. They offered to let me hold the baby in the recovery room but I was in no condition to- I was shaking violently, in pain, and confused. I did try to nurse as soon as I got to a PP room. One of the nurses tried to help me initiate breastfeeding. It seemed to go OK, but that night my son cried and cried and didn't seem to be getting anything. The next day I asked for more help, and wanted a lactation consultant but was told the nurses had lactation training and that that was enough. The nurses were far too busy to sit with me for as much time as I needed. They kept giving me generic advice that didn't apply to my situation. One kept saying, "Make sure the tongue is down! Make sure the tongue is down!" which made no sense as he wasn't latching at all, so the whole tongue thing was like 3 steps away from where I was. Maybe 2 days postpartum I called an LC and got some advice over the phone, including asking for a breast pump (which hadn't been offered.) I got a few tiny drops of colostrum and fed them to my son with my finger.
By this time my son was jaundiced and very sleepy. Day 3 after my section they said he needed the bili lights. I told them I was breastfeeding and that I wanted to be called whenever he fussed so that I could put him to the breast. 45 minutes later my husband and mother in law went to check on him and came back to tell me he was screaming, alone in the tank. I went over to ask the nursery nurses what the heck was going on, and they told me I should feed the baby a bottle of formula so that he would quiet down and sleep. I wept as I fed him the bottle, thinking this meant the end of our nursing relationship. The next day I found another LC who was willing to see me, but it would have to be as soon as possible because she was sabbath-observant and it was Friday morning. We were still waiting for the results of his bili test the morning after the light therapy and they wouldn't release him til the pediatrician reviewed the numbers- they were in, she just hadn't looked at them yet. I tracked her down and explained that we needed to see the LC as soon as possible, and she was really nasty to me, asking in a condescending tone, "Didn't you get breastfeeding help here?" I simply said, "No." I got confused about some follow-up tests she wanted him to have and at one point she said "DUH!!!!" to me. My husband and I were just considering signing our son out AMA when they finally released him. They gave us a bag with formula samples and sent us on our way.
Still, JoannaB, a homecare OB nurse in Minneapolis describes the way she works with new moms, and says that the new federal mandate for insurance coverage for lactation support should improve the sorry state of things:
We call almost every mother who delivers in our hospitals a day or two after coming home and offer home visits to anyone who meets criteria (most breastfeeding mothers). We see them at home 2-4 days after discharge, just when milk is coming in and trouble starts. I can't tell you how many mothers tell me they were about to give up until I came. We refer them on to lactation consultants if they want it (WE make the phone call to the LC, then the LC calls them back so the new moms don't even have to worry about making the effort to call). I used to take it for granted that most moms around the US got this kind of support - I'm not so naive now, unfortunately. I am so incredibly excited about the mandated insurance coverage- my white upper class moms have usually had the money to get the support they need. My working class and minority moms have not been.
Or, as Jessica Mattingly puts it, change is slow, but it's coming:
Doctors and nurses are human and because breastfeeding information isn't considered particularly important in most medical schools (because instructors and administrators are also human) they are often just goingof their own experience and what is culturally supported. This is unfortunate, but is likely going to take a concerted effort of top down (legislative and/or regulatory fixes) and bottom up (consumer demand, legal action as necessary) to fix. However, neither the top nor the
bottom are going to apply enough pressure until those social barriers are dealt with. It is a big old mess of a vicious circle, but conversations like this, conversations regarding the now defunct PSA campaign, ban the bag campaigns, public breastfeeding promotion, all of it is part of the movement and we can only get there one step at a time.
This program aired on August 9, 2011. The audio for this program is not available.
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