Your delivery experience is something you think upon, dream up and form in your mind, far before it ever occurs.
You hope for the mode of delivery you feel most comfortable with.
You desire for as minimal pain as possible and that you deliver within a reasonable time frame.
You think of who might be most important to you to be in the room as you welcome your baby.
And if you choose to breastfeed, you hope for success and ease as you begin that journey.
Some may take a class.
And others may inform themselves by reading breastfeeding blogs,
watching popular Youtube influencers videos
and asking other friends' experiences as they began their personal feeding journey with their baby.
But in today's world - you may find yourself coming across the buzz words 'Baby Friendly' and wonder what that entails, if it is a positive or negative experience to encounter and if your hospital has made it a priority to receive that prestigious designation for the sake of your family and others within the community in which you live.
The words 'Baby Friendly' are now found to be a common topic of discussion in the pregnancy and obstetric world - and you will find, based on who you talk to, that you either receive a positive review of the Baby Friendly designated facilities ways in providing care, or at times, you will unfortunately experience the opposite and worry how it will affect your experience once your baby arrives.
As a labor and delivery nurse for the past 8 years, of which the past five years have been in a Baby Friendly USA designated labor and delivery facility, I want to describe to you -
Why we do what we do.
The importance of it.
And most importantly,
how you can potentiate the experience for yourself in understanding prior, the idea behind Baby Friendly interventions.
The Behind the Scenes Info You Need to Know
In 1991, the World Health Organization and UNICEF initiated a movement to provide cause for healthcare providers to properly, completely and fully inform and educate a mother upon the benefits and ways in which to successfully breastfeed her baby.
Within the past 10 years especially, the United States has taken a large amount of initiative to get on board with this idea and instill good principles in each hospital who so desires to help mothers be successful in their personal decision to breastfeed.
There has been widespread success as hospitals within each state move through the lengthy process of becoming designated, which in turn has drawn mothers to particular hospitals to ensure they receive the most beneficial experience allowing them to feel equipped and ready to embark on a completely new phase of life after baby has arrived.
Within New Mexico in particular, there are 16 facilities in which you can choose to deliver your baby that is designated as Baby Friendly. This is a huge accomplishment for our state and we continue to grow and learn along the way! Should you find yourself within one of these hospitals, I can assure you - you will be well informed, cared for in a top notch way and sent home ready and equipped with resources for continued success as you nurse your baby with your own breast milk.
The Meat & Potatoes of Baby Friendly
The ten steps to Baby Friendly success are listed on their website - I would encourage you to run over to babyfriendlyusa.org and immerse yourself in the culture and understanding of these steps as they have formulated the steps so that healthcare providers can follow and remain consistent in care provided patient to patient via one nurse to another.
However, there are a few I want to review that are the underlying themes you will find your experience is based upon during your hospital stay. They are carefully thought through and intentional, but sometimes can seem rigid or harsh in the thick of your postpartum fatigue and newness to parenting.
- Skin to Skin Contact- the Golden Hour
Skin to skin means that once baby comes out of you and is deemed stable by your delivery team, your baby's bare skin should be placed in direct contact with as much of your skin as possible. Often times, a new mama's concern vocalized to me as a delivery nurse is that their baby be cleaned and dried off before allowing baby skin to skin for an indefinite amount of time ahead. I can assure you that drying and cleaning them (to an extent) is part of the process to ensure their temperature begin its regulation process and so that it is a comfortable experience for both mom and baby alike.
So... WHY skin to skin - other than that it helps with breastfeeding initiation and longevity?
Well, the evidence is copious and benefits innumerable but to keep from being longwinded, the following reasons are the "short, sweet and to the point" bullet points in why you should bask in the experience and let it last as long as it can.
Baby Mom
-Temperature Regulation -Uterine Shrinking
-Blood Sugar Stabilization -Decreased Bleeding from Hormone
Release
-Decreased Respiratory Effort -Calming Effect from Stress During
Delivery
-Expedited effort to Initiate -Sense of Immediate Bonding
first breastfeed -Increases Milk Supply
-Colonization of Mother's
skin flora
But truly, the benefits extend far beyond these reasons alone and above all, the feel of your baby's skin that you have awaited the feel of for nine to ten months laid directly on yours - is an experience you will NEVER forget.
Some Helpful Hints:
- If your doctor determines you need a c-section at some point in your labor, that does not indicate losing your chance at experiencing skin to skin. Most hospitals that are Baby Friendly designated are experienced in providing skin to skin in an OR suite, just as much as on a delivery bed after a vaginal birth.
*Make sure, if available, you ask your labor nurse to put a "belly band" (typically used to keep the monitors in place on your belly to ensure baby's wellbeing during labor) over your chest area prior to heading to the OR. This is an easy way to tuck baby in so you can remain relatively hands free due to all the extra monitors you have on during surgery!
- Should you find yourself in an emergency procedure, such as an unanticipated c-section under general anesthesia or a D&C after a vaginal birth for increased bleeding - encourage your partner or spouse to initiate or continue skin to skin with your baby. It is just as beneficial for baby to experience the affects of skin to skin with dad - and gives a lot satisfaction for him to provide for baby's needs while you are separated under certain circumstances!
- Remind your nurse that the two standard baby medications given: Erythromycin ointment and Vitamin K shot can be given while you and baby are still skin to skin. This helps to keep baby calm and decrease sensation of pain while the shot is administered! Your baby friendly nurse will likely be glad you asked & will be happy to oblige.
- Your family present during or after delivery will always be very excited (and reasonably so!) to know what baby weighs, who gets to hold that sweet bundle next and when the footprints will be completed! Gently remind them the importance of skin to skin and that they will get to hold forever more but the first hour is so precious and important for mom and baby alike.
- Skin to skin does not have to stop after that first experience! Evidence shows that continued skin to skin for the first two weeks of life can help to instill familiarity for baby in their new environment, continues to establish a great milk supply for mom and baby and decreases stress of adapting to a new home life for everyone involved.
Exclusive Rooming In - No more nursery.
So you experience a two day induction, three hours of pushing and not to mention, the weeks of sleep you missed out on before baby was born from being so pregnant and uncomfortable.
And then. . . you get to the postpartum floor, beyond excited for them to take the baby for your three hour recovery nap and your nurse informs you - that isn't happening!
The biggest letdown right? The most confusing concept that in the midst of utter exhaustion, we allow your baby and actually have no other choice but to leave them right at your bedside in the bassinet so neatly put together for your sweet nursling prior to your arrival.
But... it's true, and though you may not understand at first- I do promise it IS what is best for baby, you and your new family as a whole. And the reason I can so confidently say this to you is because - rooming is shown to be the best way in which to allow you to get used to baby's hunger and feeding cues, meanwhile baby gets used to the presence of you and your spouse and understands that his or her needs will be met via their own new ways of communicating them when necessary.
I think there is nothing more unsettling than to spend little time with your baby next to you and then be released home to figure out: when they're hungry, how you can tell that they're hungry and when it's too late and what you now have to do to de escalate your over hungry baby before working to ensure a good latch.
Which is also a whole other feat of a process to endure together in those beginning days!
Which is also a whole other feat of a process to endure together in those beginning days!
In Baby Friendly Hospitals, a nursery with a window for passerby's to look at the fresh newbies around, simply no longer exists and has been transformed into a "procedure room". This room is now where circumcision occurs along with other emergency procedures needed if a baby begins to struggle with breathing or any other unexpected health issues on the postpartum floor. The concept and encouragement in this portion of the Baby Friendly experience is that cue based or on demand feeding occurs far more successfully when a parent is nearby to identify when baby begins to display the early signs of feeding time nearing such as: sucking on his her hands or lips, rooting around and gently moving his or her head back and forth searching for mama's breast.
Without being nearby, a busy nurse in charge of four to eight babies may simply miss those cues or not be able to return your baby in a reasonable amount of time before hunger escalates to the point of frustration for baby - taking you back to working extra hard on that latch you are trying so diligently to master before being released into the world outside of your hospital room so full of help, assistance and extra hands!
Some Helpful Hints:
- Work on a schedule to where you and your partner can be up at certain parts of the day and night to ensure you both are getting small naps as often as possible. This will help you feel less overwhelmed by the lack of sleep and ensure you both are learning the hunger and feeding cues for your quickly approaching release to home! And if baby allows you a four hour stretch at night, both of you should take advantage and "sleep while baby sleeps!"
- Rooming in also means that bath's are performed in the room, pediatrician visits and exams are completed at the bedside and any health screenings for baby should be done while you are nearby! This increases parent satisfaction in knowing that baby is cared for and that he or she is not becoming hungry during a procedure that could be continued later on after a successful feeding has been accomplished.
- When baby boy leaves your side for circumcision, take advantage of this time to shower, catch a cat nap or grab your next meal before he returns and needs some comfort via nursing and skin to skin!
- Should you be having a tubal ligation (getting your tubes tied) done during your postpartum stay, hand express some colostrum before leaving for your surgery so that dad can feed baby that expressed milk while you are gone! No formula needed - when dad identifies the hunger cues you've been learning as a family, he will have the supplies right at his fingertips to provide for babe until you return!
Skip the pacifiers, bottle nipples & formula.. please!
The concept of exclusive breastfeeding is the largely identified theme in the Baby Friendly world. When your baby is hungry, the offering of your breast only is shown to be most beneficial and necessary to make the whole process work the best way your body and your baby know how. The mere contact of your baby's mouth on your breast sends automatic and naturally based signals to your brain regarding exactly how much milk to make, what antibodies your milk should include and how frequently your breasts need to be filled with the most important and nutritionally sound substance your baby can receive for nourishment.
But what this means for the "ease" aspect of things is that we as staff on your labor and delivery and postpartum units, cannot and should not offer or suggest use of pacifiers, artificial bottle nipples or formula - unless there is a direct and sound medical indication.
Aside from instilling the best and most established milk supply specific to your babies needs - there is evidence that suggests the feeling of an artificial nipple or the material of a pacifier causes baby to become confused regarding the different feeling in their mouth from skin to plastic. Additionally, a bottle nipple or pacifier can lead to contributing to an eventual preference in receiving nourishment or comfort via a nipple that delivers faster and more constant presence within his or her mouth.
Does this mean that you can never offer baby a pacifier or return to work leaving your baby in the care of someone else who needs to give a bottle of milk to sustain your babies needs while you are gone? Absolutely not.
The recommendation is that for the first four weeks of life or until breastfeeding is well established, you seek to not offer anything artificial unless medically indicated or suggested by your baby's pediatrician.
And then - should they take to a pacifier or need a bottle while mom and baby are separated, by all means do so to support ease and flexibility in your nursing journey!
Some Helpful Hints:
- When you introduce a pacifier after the first four weeks: Philips Avent Soothie pacifiers are generally well accepted by breastfed babies and can be found at most stores that supply all things 'baby"
- When introducing a bottle to baby, Comotomo is a great bottle to utilize as it mimics the breast and what it feels like for a baby to remove milk from their mom. This will work to promote consistency and help to not cause confusion or frustration for baby when having to switch between the two while mom is gone at work
- You cannot spoil a baby by allowing them to nurse on you for comfort - in essence, breastfeeding is the most natural and ideal way to ensure baby receives and understands long term the component of comfort, nourishment and maternal care you have for your baby in the beginning and throughout your entire breastfeeding journey. Don't be afraid to show them that YOU are their primary source of comfort!
- Should you need to provide supplementation to your baby in the hospital related to weight loss, jaundice or delayed onset milk supply - ask your nurse or lactation consultant about use of a pump to establish increased milk availability for the supplementation (if possible) and a supplemental nursing system
Why do some feel negativity or frustration towards the Baby Friendly process and movement?
Like with all things in life, opinions vary vastly from person to person and perspective is everything.
Your commitment to the process of and partaking in the experience of breastfeeding your newborn will NOT be without challenges and new things to experience, get used to and make your own. With that being said, some patients feel the encouragement to incorporate the previously discussed concepts into their new parenthood journey to be pressuring, unrealistic or unfair after what they've been through to get to where they are.
But there is also something vastly important to be said about the instant and constant state of *giving* to your baby that begins the minute your baby enters in this world. And though the adaptation of becoming a parent and enduring newborn-hood is purely exhausting, sometimes confusing and deeply challenging -
the Baby Friendly experience is meant to enhance the longevity and meaningfulness you can experience should you find yourself successfully enduring the speed bumps along the way while establishing what can and will hopefully be one of the most fulfilling things you have personally ever accomplished and one of the best first steps you have gifted your baby, from the very start.
Your commitment to the process of and partaking in the experience of breastfeeding your newborn will NOT be without challenges and new things to experience, get used to and make your own. With that being said, some patients feel the encouragement to incorporate the previously discussed concepts into their new parenthood journey to be pressuring, unrealistic or unfair after what they've been through to get to where they are.
But there is also something vastly important to be said about the instant and constant state of *giving* to your baby that begins the minute your baby enters in this world. And though the adaptation of becoming a parent and enduring newborn-hood is purely exhausting, sometimes confusing and deeply challenging -
the Baby Friendly experience is meant to enhance the longevity and meaningfulness you can experience should you find yourself successfully enduring the speed bumps along the way while establishing what can and will hopefully be one of the most fulfilling things you have personally ever accomplished and one of the best first steps you have gifted your baby, from the very start.
It is never meant to instill the idea that breastfeeding is the ONLY way to go but rather to ensure that you are given every proper avenue, resource and understanding as to *how* to make it work - so that if you have reached an endpoint and have done everything you've been asked to do, you can know in the end that you gave it your all and that ultimately, when all else does not provide ultimate breastfeeding success...
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