Breast intentions gone wrong: new paper shows Baby Friendly Hospital Initiative harms babies

Baby Tombstone at Rose Hill Cemetery in Macon, Georgia.

I have been arguing for years that the Baby Friendly Hospital Initiative (BFHI), designed to promote breastfeeding, ignores scientific evidence and leads to preventable deaths of babies.

A new paper in JAMA Pediatrics confirms what I have been saying.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]A practice designed to promote breastfeeding is injuring and killing babies.[/pullquote]

It’s entitled Unintended Consequences of Current Breastfeeding Initiatives. Breastfeeding is a good thing and should be vigorously supported, but:

Unfortunately, there is now emerging evidence that full compliance with the 10 steps of the initiative may inadvertently be promoting potentially hazardous practices and/or having counterproductive outcomes.

The authors note a variety of serious problems with the BFHI:

1. Enforced prolonged skin to skin contact leads to deaths from Sudden Unexpected Postneonatal Collapse (SUPC).

Reports of SUPC include both severe apparent life-threatening events (recently referred to as brief resolved unexplained events) and sudden unexpected death in infancy occurring within the first postnatal week of life. A comprehensive review of this issue identified 400 case reports in the literature, mostly occurring during skin-to-skin care, with one-third of the events occurring in the first 2 hours after birth …

And inevitably:

…[A] recent publication from the American Academy of Pediatrics observed that lawsuits have surfaced in US hospitals attributed to unexpected respiratory arrest in apparently healthy newborns during early skin-to-skin care …

In other words, a practice designed to promote breastfeeding is injuring and killing babies.

2. Infant injuries and deaths as a result of enforced 24 hours rooming in and closing well baby nurseries.

An overly rigid insistence on these steps in order to comply with Baby-Friendly Hospital Initiative criteria may inadvertently result in a potentially exhausted or sedated postpartum mother being persuaded to feed her infant while she is in bed overnight … This may result in prone positioning and co-sleeping on a soft warm surface in direct contradiction to the Safe Sleep Recommendations of the National Institutes of Health. In addition, co-sleeping also poses a risk for a newborn falling out of the mother’s bed in the hospital, which can have serious consequences.

3. The ban of formula supplementation is contraindicated by scientific evidence.

…[W]hen supplementation was given for a medical indication, there was no adverse effect on the duration of breastfeeding.

4. The ban on pacifier use is contraindicated by scientific evidence.

[The BFHI] requires that mothers be educated repeatedly that pacifiers may interfere with the development of optimal breastfeeding. Because there is strong evidence that pacifiers may have a protective effect against sudden infant death syndrome (SIDS), the American Academy of Pediatrics has suggested avoidance of pacifiers only until breastfeeding is established at approximately 3 to 4 weeks of age. Because a substantial number of SUPC events occur during the first week of life, this recommendation to proscribe the use of pacifiers is difficult to defend based on risk.

So the BFHI leads to preventable infant injuries and deaths and the ban on formula supplementation and pacifier use are contraindicated by scientific evidence and may lead to further injuries and deaths from dehydration. Yet, health organizations are promoting the deadly BFHI tenets.

Preventing the unintended serious outcomes from these practices has been made more challenging by the emphasis on breastfeeding exclusivity in the perinatal measures recently promulgated by The Joint Commission. Measure PC-05 requires documentation of the reasons for not exclusively breastfeeding, with no allowable exceptions for newborn conditions. In addition, the Centers for Disease Control and Prevention actively promotes the “10 Steps” and Baby-Friendly designation, and monitors “10 Steps” compliance in the United States. In Massachusetts, the recently enacted Massachusetts Health Quality Measure 3A requires increasing rates of breastfeeding exclusivity, with soon to be implemented financial implications.

Why have these deadly measure been promoted? It’s certainly not because they benefit babies (or mothers). They have been promoted because of extensive lobbying on the part of the breastfeeding industry and the lactivists who support it. The BFHI should more properly be called the Lactivist Friendly Hospital Initiative because that’s who benefits.

As the authors note:

If government and accreditation agencies wish to encourage and support breastfeeding, their focus should shift from monitoring Baby-Friendly practices and breastfeeding exclusivity to monitoring breastfeeding initiation rates coupled with evidence of lactation support both during and after the hospital stay. More attention should also be placed on ensuring compliance with established safe sleep programs, emphasizing the need to integrate safe sleep practices with breastfeeding. Hospitals should direct their efforts toward implementing practices that will promote breastfeeding safely, the common goal of both private and public groups with an interest in these issues.

If doctors, hospitals and public health officials truly care about the wellbeing of babies, they will end the BFHI.

207 Responses to “Breast intentions gone wrong: new paper shows Baby Friendly Hospital Initiative harms babies”

  1. Brisbanite
    September 4, 2016 at 2:23 am #

    This is sooo ignorant. I am truly sick of tired of all this judgement about formula feeding. I have a 2.5 week old and I have basically NO supply. All this rubbish about how most supply issues can be ‘overcome’ is incredibly frustrating to me. I have retained placenta which I believe is tricking my body into believing I am still partly pregnant. It is a medical issue which no magical lactation consultant can fix. Therefore I am not producing enough breastmilk to feed my child. I have had to supplement with formula from week one, and every day that goes by my supply decreases. I am not sure if once I have my placenta removed it will increase. But you know what, at least my baby isn’t hungry. STOP JUDGING.

  2. EmbraceYourInnerCrone
    September 2, 2016 at 3:23 pm #

    I chose formula right off the bat because I wanted to. Because I was working full time (active duty military) and I had 6 weeks maternity leave. Because we were going to be moving from LA to Guam with a 10 week old and with all the stress of moving I wanted to be able to have the peace of mind that she could be fed, on time and with food of a consistent quality. Because my parents, then his parents were going to be visiting and staying in our 2 bedroom apartment to see the baby before we moved and its nice for all the family to be able to feed the baby. because being able to have my husband take the night feeds sometimes, meant I could get more sleep and be a calm , happy mom when I was awake. The benefits of breastfeeding are small and for me were not worth the cost.

    The Spawn is graduating from college on scholarships next year so Yay formula?

  3. Rey
    September 2, 2016 at 2:50 pm #

    Let’s see…I bring in three quarters of a million dollars in income a year, I think I can afford $1000 in formula. And I don’t see the same push to make MEN give up all their free time when a baby is born, just the mother. Fuck the women, they don’t deserve to have 10 minutes for themselves lest someone call CPS. They have to spend the next 18 years not thinking at all about themselves.

    Take your outdated thinking and just go away. You’re probably one of the assholes I’ve had to deal with who see me walk into a conference room and think I’m the secretary because I have teh boobz. No, I’m actually the person who was going to suggest my company invest in your business, but you just screwed yourselves because if that’s how you treat the “peons” in a company, my bosses are not going to do business with you.

  4. Anne Catherine
    August 29, 2016 at 12:13 pm #

    I realize I’m way late to this discussion and maybe nobody will see my post, but I’d just like to add that the writers on this paper come from some pretty high places.

    One is head of Physician-in-Chief of MassGeneral Hospital for Children:
    http://www.massgeneral.org/children/doctors/doctor.aspx?id=16588
    And one is chair of Pediatrics at Newton Wesley:
    http://www.massgeneral.org/children/doctors/doctor.aspx?id=16588

    Hopefully someone will listen to them.

    • demodocus
      August 29, 2016 at 1:17 pm #

      Someone in a position to do something.

  5. corblimeybot
    August 27, 2016 at 8:29 pm #

    Where do you people get this list of “facts” that you all regurgitate every time you show up in these comment sections? You sound like indoctrinated clones.

    Also, the exact combination of nutrients, hm? I know two women whose children were diagnosed failure to thrive due to a myopic commitment to exclusive breastfeeding. One of them was a HUGE lactivist, so you can assume she did every single thing you would have suggested to her. Even she put her child on formula when it was clear that her breastmilk (which seemed adequate in volume) was starving her kid.

  6. Monkey Professor for a Head
    August 27, 2016 at 8:03 pm #

    I don’t think anyone here is opposed to breastfeeding. But we are opposed to judging women for not breastfeeding. We are opposed to exaggerating the benefits of breastfeeding/the “dangers” of formula in order to get women to breastfeed. And we are opposed to depriving babies of needed food in the pursuit of exclusive breastfeeding.

  7. demodocus
    August 27, 2016 at 7:59 pm #

    1, you’ll be paying to feed your kid before long, so why the hell does it matter if it’s from day 1 or day 345?
    2. I was getting *more* suicidal when I thought about breastfeeding my younger child. I breastfed my older child until I quite literally couldn’t take one more moment. My husband is still not allowed to touch me there, either.

  8. momofone
    August 27, 2016 at 7:50 pm #

    I spent much more than $1000 on breastfeeding the first year of my son’s life.

    • cyberbat
      September 5, 2016 at 6:42 pm #

      With the bras and breast pads and a pump?

      • momofone
        September 5, 2016 at 6:51 pm #

        And visits to IBCLC, and breastfeeding doctor, and fenugreek, and a variety of bottles, nipples, etc.

        • cyberbat
          September 5, 2016 at 8:47 pm #

          Good to know, thank you for the reply.

          • momofone
            September 5, 2016 at 8:50 pm #

            I was surprised by some of the the costs. I was also surprised by how challenging it was. I think I expected it to come naturally.

  9. Who?
    August 27, 2016 at 7:49 pm #

    So let’s get this straight: calling people ‘idiots’ isn’t shaming them?

    Next, it’s fine to wait a few months for the baby to be getting properly fed, on the basis that it’s really all about it ‘working for you’ ie mum? Who cares if baby is hungry in the meantime, right??

    And $20 per week is too much to pay for a child’s food, and is less than mum would pay for extra food for herself to sustain breastfeeding?

    You’re a total genius, you should be selling all this wisdom, not just giving it away for free!!

    • momofteens
      September 2, 2016 at 2:52 pm #

      The OP should wait until they are teens. $20 a week is dirt cheap, my teen son is eating almost $100 a week by himself and that is buying bulk with extreme couponing and watching sales.

  10. Montserrat Blanco
    August 27, 2016 at 7:31 pm #

    Well, I happen to be in the slim minority, actually not that slim, I would say that at least 5% of women is not a slim minority but well, let’s just go to the next step. i spent about 500 euros on different supplies for breastfeeding plus the formula. I had a preemie, so yes, in my case it was important to breastfeed even if I was not able to cover my son’s needs more than two weeks.

    In any case, it was not for free. It was not easy. It was not convenient. And I live in Europe with a decent maternity leave.

    If I would be pregnant again I would give it a try and forget about it if it did not work out again (highly likely).

    And, by the way, your lack of empathy to see why someone would not prefer breastmilk in the first place seems unbelievable. I will give you some reasons:
    – some women have to work
    – some women prefer to work!
    – some women prefer their breasts to be used for other things than feeding a baby
    – some women prefer to take turns with other family members to feed their child
    – some women need medications that are not compatible with breastfeeding

    And I do not expect to stop being a mom in 18 years. I expect it to be a lifetime commitment. Strange, I know. Even more strange if you think that I was not able to do skin to skin inmediately after birth (preemie, remember?), was not able to breastfeed directly until he was 6 weeks old, was not able to take him home until he was two months old and somehow we have bonded perfectly!!!! Unbelievable, I know.

  11. Heidi
    August 27, 2016 at 6:12 pm #

    No, you are the ignorant one, and that’s about the nicest thing I can say about you.

  12. Azuran
    August 27, 2016 at 5:32 pm #

    How about a woman’s right to bodily autonomy? This is freaking 2016, Women have the right to do whatever they want with their breasts.

    The actual benefits? Yea we know them: a few less colds and a few less diarrhea episodes in the population (and a potentially higher risk of asthma) You can’t, in ANY way, try to guess who was breastfeed and formula feed. Compared to everything else that will influence the outcome of a baby as it grows up, it’s practically nothing.

    And breastfeeding is NOT free. The mother needs and additional 500 calories on average to produce this breastmilk. This is obtained by eating more food that you have to pay for. Also, I might have paid maternity leave, but it’s not 100% of my usual salary. I would make MORE money by going back to work and formula feed (even after deducting all the expenses of formula) than I would by either pumping at work or staying home and breastfeeding. And also, you are taking for granted that you need 0 tools to help you breastfeed. What about BF bra, nipple shield, cream, pillows and whatever else you might need?

    You are the uneducated idiot here.

  13. Box of Salt
    August 27, 2016 at 5:04 pm #

    PeckishLlama, your entire comment seems bizarre to me.

    First of all, once you become a parent, you are a parent for life. You don’t get to quit just when your offspring become eligible to vote.

    You post “If you don’t know a bunch of the benefits of breastfeeding, then you’re an idiot” yet you also believe the amount of alcohol that goes into breastmilk is inconsequential to an infant’s developing brain?

    If you’re going to push breastfeeding, put away your daily wine. Your kid would be better off sober on formula. Deal with it.

    P.S. My kids were breastfed.

  14. guest
    August 27, 2016 at 3:43 pm #

    NO ONE should have to “give up their life” for their child. The only way that makes any sense is if you think parents and parents alone should shoulder ALL of the burdens of childraising. That you expect parents to is pure selfishness on your part – you want all the benefits of a healthy society, with none of the responsibilities of caring for and about the generations that will follow.

  15. Amy Tuteur, MD
    August 27, 2016 at 2:48 pm #

    You think 5% is a slim amount?

    • Abby
      August 28, 2016 at 3:57 am #

      This is the thing I can’t understand about the lactivists rhetoric, 5% in medicine is a huge percentage to have a condition, if 5% of children had diabetes would they say this is a ‘tiny number’ ? if around 4000000 babies are born every year in the USA then 5% of babies not able to breastfeed is 200000 babies! That is a huge amount of failing to thrive babies!!

  16. The Rita
    August 25, 2016 at 9:01 am #

    I absolutely hate breastfeeding but the local hospital I’ve delivered at has mostly gone baby friendly so they shove it down your throat. My next delivery I’m bringing my own formula. Imo bfhi fosters resentment toward breastfeeding early on and stifle bonding because they shove mom aside for a child who will not recall those first days anyway.

    • PeckishLlama
      August 27, 2016 at 1:27 pm #

      It’s not about recalling those first days, it’s about the benefits of breastmilk. Formula can definitely be a life saver, I won’t argue that, but it also has its drawbacks—for example, I order to get the same amount of nutrients into your child as they would get from breastmilk, the amount is over triple the amount of fluid going into your child and stretching their tummy. They may not remember the first days, but their bodies will.

      • swbarnes2
        August 27, 2016 at 2:20 pm #

        You can’t possibly think that makes any sense. And if you have evidence from well-controlled studies showing long term benefits, present links to their abstracts in Pubmed. Plenty of people will have access to the whole paper, so we can confirm that the breastfeeding cohorts are well matched to the formula cohorts. Certainly you can see how if one cohort was whiter, richer and better educated, it would not be a fair comparison. So, links that prove your claim, or the honest thing to do is to retract it.

      • baileylamb
        August 27, 2016 at 4:35 pm #

        That’s hog wash. Besides I thought all ppl were individuals. My son drank the two onces of breastmilk, I pumped in the hospital, in 6 minutes. They had never seen a kid eat so much so fast. Eventually they gave him formula too.. which he promptly drank. He finished the 6 pack before we left the hospital. I breastfeed him for 15 months (exclusively from 3 months onward) mainly bc im cheap and lazy, and he refused the bottle after a while. But he would nit survive w/out that first batch of formula. He had already lost 9 percent of his body weight before we left the hospital.

        • Monkey Professor for a Head
          August 27, 2016 at 6:28 pm #

          When my son was 3 days old I spent a night hand expressing and syringe feeding because my nipples were so painful (which was a result of mandatory rooming in and extreme sleep deprivation- my story is in the comments below). I gave him as much as all the resources out there said he needed at that age, and guess what – he was still hungry. I had to feed him twice what he was apparently supposed to need and still had to repeat every two hours.

      • Azuran
        August 27, 2016 at 5:15 pm #

        Oh sorry, I thought he stomach was made mainly of muscles and was an organ with the ability to stretch.

        Do you really think that they didn’t think about making the nutrient density of formula about the same as breastmilk? You are basically saying they said: Ah fuck it, let’s make it a thirds as nutritive and force those baby to drink a ridiculous amount of water, just to watch those little tummy stretch.

        And yet, at the same time, this super watery formula is also causing obesity?

      • Charybdis
        August 27, 2016 at 5:36 pm #

        Bullshit. Pure and simple. If babies only need “drops” until your milk comes in, then how come babies are being damaged due to starvation? Crying, not settling, dehydration, jaundice, hypoglycemia, hypernatremia, brain damage, all these can and do happen with early insistence on EBF.

        If babies need so little food, then why will they happily and hungrily suck down an ounce plus of formula when it is offered? If they aren’t hungry, they won’t eat AND they will stop eating when they are sated.

        • corblimeybot
          August 27, 2016 at 6:20 pm #

          Formula bailed my kid out of jaundice and poor weight gain in the first two weeks of life. Her pediatrician told us to increase the amount of formula she drank, and never once endorsed that we force her to live on the tiny amount of breastmilk I made in the beginning.

          His practice is annoyingly heavy on breastfeeding promotion, so he didn’t recommend more formula because he was in the pocket of Big Enfamil. I suspect he probably just hates seeing babies suffer.

      • demodocus
        August 27, 2016 at 7:49 pm #

        my milk doesn’t come in for 5 days. my ebf son probably had nearly nothing and dropped 12% of his birthweight. We gave formula to his little sister right away and within 2 days she was drinking 3.5 ounces as a shot. and yes, she’s very clear about when she’s done

      • momofone
        August 27, 2016 at 7:52 pm #

        Huh. You may find this surprising, but some people prefer to decide for themselves what it’s about.

      • Who?
        August 27, 2016 at 7:53 pm #

        So tell me-with all these clear and obvious benefits, can you tell, by looking at a baby, toddler, child and young adult, whether or not they are breastfed?

        • corblimeybot
          August 27, 2016 at 8:06 pm #

          Anecdote:

          A lactation consultant taught our infant CPR class. She told me she could tell my daughter was exclusively breastfed, because her skin was so nice.

          My daughter was never exclusively breastfed. She was mostly formula fed in the beginning, and later transitioned to being mostly (but never fully) breastfed. I think her skin was nice because she was 5 months old.

          • Monkey Professor for a Head
            August 27, 2016 at 8:16 pm #

            In my mums group, some kids are breastfed, some are formula, and some are combo fed. They all have beautiful skin. It’s probably something to do with the fact that they’re babies.

            I can only think of one child whose appearance changed with feeding method. One little girl was very slow to put on weight, and had a bit of a pinched look to her. Her mother told me later that her breastmilk was always extremely watery in appearance, so I wonder if that was the reason. When she was switched to formula, her cheeks filled out, and she just seemed to bloom. I don’t know for sure, but she seemed so much healthier in appearance after switching to formula.

          • D/
            August 27, 2016 at 8:54 pm #

            Any time I see a waif-thin baby, my first guess is that it’s inadequate feedings in an effort to exclusively breastfeed … and blooming is an apt description of what happens to those kiddos once they’re fed.

          • Who?
            August 27, 2016 at 8:55 pm #

            Well that would be an obvious change, and a very pleasing one to see.

            I often ask that very question, and most regularly get ‘don’t be silly’ for the answer: so there are no visible benefits, no measurable benefits, but it’s better?

            Hmmm, I say. And hmmm again.

          • Amazed
            August 28, 2016 at 6:06 am #

            To my SIL, the benefits are very visible. She’d be quite disappointed if it turns out that she went through all the pains of oversupply just to have the kid self-wean at age 7 months or so.

            However, she’s well aware that those benefits are about her. Even a successful breastfeeder, a SAHM like her, went though significant pains to accommodate this oh so easy breastfeeding in her life. She wouldn’t have been pleased if she had had to quit soon after that.

            Anyway, she wouldn’t have starved the kid.

          • Amazed
            August 28, 2016 at 6:02 am #

            Anecdote from just yesterday: Amazing Niece arrives with her parents who throw her onto other people heartlessly over her pitiful cries, aka leave her with Auntie and Granny whereupon she screams at being held by Granny (they had been interchangingly ill throughout the summer, so the little one has mostly forgotten her) and brightens up when she finds herself in Auntie’s arms. Mom and Dad leave. I carry her to the bed and her (army of) toys, take her over me and she starts piling toys on me so she can play in her new place. I inhale the scent of her head and say, “Hey, they must be using some new shampoo. Look how nice she smells!”

            Clearly, I have been perceiving the smell of breastmilk WRONG.

          • Hilary
            August 28, 2016 at 1:21 pm #

            I’m still nursing my 2 year old twice a day. I doubt he’s getting more than 2-3 ounces at most. He’s also on Pediasure due to his feeding problems. His OT recently told me, “He must be getting more breast milk than you think, he looks so good!” Right. Because that’s the only possible explanation for why he “looks good.” ????

          • pearl
            September 2, 2016 at 2:54 pm #

            I had someone tell me my then 2 year old son must have been exclusively breastfed AND unvaxxed because of how lively and bright his eyes were and now nice his skin looked. Joke was on them, he’d never had a single drop of breastmilk and had each of his jabs on time.

      • corblimeybot
        August 27, 2016 at 8:43 pm #

        You believe deeply in very nebulous, disproven “benefits” of breastmilk, because you have to. You already devoted yourself to it. If you admit now that it doesn’t matter, you have to admit that you let yourself passionately advocate for a cause that’s essentially unimportant. That’s hard to do.

        So you have to tell yourself vague, baseless, truthy-sounding things like “they may not remember the first days, but their bodies will.” The cognitive dissonance is too strong.

        I breastfed my child even when my PPD was killing me, thanks to liars like you. I missed the first 9 months of her life due to suicidal depression that only abated when I stopped breastfeeding. I thought the magic nutrients in my breastmilk were more important than my daughter having a functional parent, thanks to people like you.

        My daughter is now being treated for a genetic disease that is very serious, and is sometimes fatal.

        Now, I’ve learned to despise people like you even more. Nonsense breastfeeding advocacy cost me 9 months of happiness with my child. She is expected to survive, but what if that’s not what happens? I’ll have lost all that time with her for NOTHING.

        For LIES.

        • Empliau
          August 27, 2016 at 10:13 pm #

          I am so sorry that you suffered like that, and that your daughter is ill. Hugs from another mother of a sick child (probably not fatal, but watching a child suffer is a special circle of hell). I will be hoping for the best outcome for you both.

        • demodocus
          August 28, 2016 at 9:07 am #

          i’m sorry you guys have to deal with this.

        • BeatriceC
          August 28, 2016 at 12:56 pm #

          Giant internet hugs. It’s for people like you that I’m so passionate about these issues; supporting all moms and calling out the lies when they’re presented. You deserved better. All moms deserve better.

      • AnnaPDE
        August 27, 2016 at 10:47 pm #

        Oh, you mean they’re also properly hydrated when they get to drink formula? Well, that’s certainly something to avoid. We all know how wonderful it is to be really thirsty.

    • KeeperOfTheBooks
      August 28, 2016 at 10:46 am #

      I hope your hospital is as chill as my BFHI hospital was. While I found the lack of a nursery despicable, the nurses, LCs, etc were actually more respectful of my decision to FF from the start than they were the last time I was there, when they were still in the accreditation phase.
      A LC showed up in recovery and introduced herself, I said, “Thanks, but I’m planning on FFing.” All she said was, “No problem! If you change your mind, here’s my card; please feel free to call me. Otherwise, congrats on the cute baby, and have a great day!” Fair enough. One of the nurses checked my breasts, and said that I was producing milk and that I could try breastfeeding. I said, “Nope, it went pretty badly last time with a lot of mastitis and an abscess while never making enough anyway, so I’m not trying again.” She immediately backed off, gave me a couple of suggestions to help with comfort/milk reduction, and that was that.
      TBH, the only really annoying bit was the movie we had to watch before discharge that was all about nursing without a single word on safe formula prep.
      In short, while I utterly loathe the BFHI, some hospitals and nurses aren’t too rabid about it; may your experience be similar!

  17. Roadstergal
    August 24, 2016 at 5:06 pm #

    OT: I can’t remember which one of you lovely folk recommended The Katering Show, but they recently took on Mommyhood, including placenta eating:

    https://www.youtube.com/watch?v=-LhgJjicMz8

    • Azuran
      August 24, 2016 at 6:08 pm #

      Oh man, this was priceless. I laughed so much (and gagged a little). I didn’t know season 2 was out, I know what I’m doing tonight XD

    • BeatriceC
      August 24, 2016 at 9:48 pm #

      MrC thinks I’ve officially gone off the deep end and Leo and Charlotte are looking at me with this look that seems to say “um, are we gonna get breakfast tomorrow? You don’t look so good.”

    • Who?
      August 27, 2016 at 7:55 pm #

      I felt this one went on a bit long, but they did take it all the way to its conclusion. The breastmilk bechamel was a nice touch.

  18. mayfly
    August 24, 2016 at 2:28 pm #

    I’m due with my third baby in 12 days. Thankfully, my hospital is not “baby friendly” (yet). Still, I’ve included formula and pacifiers in my hospital bag just in case. Based on previous experience with the grabby LCs and awful BF advice from post-partum nurses, I suspect they are creeping towards BFHI status, though not officially there yet.

  19. Lurker
    August 24, 2016 at 5:27 am #

    On the bright side, Slate picked this up: http://www.slate.com/blogs/xx_factor/2016/08/23/baby_friendly_hospital_initiative_criticized_as_unsafe_in_new_jama_paper.html

    I haven’t dared check the comments yet.

    • T.
      August 24, 2016 at 5:35 am #

      Actually most of them seems to be quite logical and most people seems to agree “Baby Friendly” has gone too far. But I fear soon the Lactivist Brigade will find it.

    • Lurker
      August 24, 2016 at 5:36 am #

      Huh. The comments are remarkably sane.

      • Gatita
        August 24, 2016 at 10:09 am #

        Lots of comments from people who experienced BFHI first hand and were horrified/appalled by the experience.

        • BeatriceC
          August 24, 2016 at 11:41 am #

          And a few that aren’t. I like how the one woman diagnosed the ER doctor’s (can’t recall her name right now) kid with autism because she can’t seem to reconcile her lactivism with the idea that breastfeeding doesn’t always work out. So of course the baby didn’t have brain damage from starvation, the child is autistic. Of course this diagnosis was made without ever seeing the baby in question and completely at odds with what actually happened.

          • BeatriceC
            August 24, 2016 at 12:06 pm #

            Here’s a screen cap of the comment that made brought out a murderous rage.

      • The Rita
        August 26, 2016 at 4:17 am #

        The hospital I deliver at is most of the way baby friendly. It’s freaking horrible. I resented being forced to nurse. I’m not good at it. The baby always is but I always hate it. I hate to sound selfish but nursing makes me feel like a prisoner. I already sacrificed 9 months for my baby and then I’m told “f your dreams of having a glass of wine at dinner because baby!!” If I give up allll the things for 9 months then the baby will be just fine on formula. I never produce enough anyway. The baby ends up feeding every 45 minutes and I’m even more resentful. Not at the baby at all but at the need to constantly be attached. I love and never resent my kids. But breastfeeding was always traumatic for me. And my kids always ended up at their first well baby not gaining enough from nursing so the dr writes failure to gain weight on child in their well baby chart. Then I look like I’m intentionally malnourishing my infant when they were the ones who shoved the boob thing all along and all I wanted was formula. Then you’re guilted into keeping the baby in room. Im recovering from the epidural you said I could damn have! And I’m exhausted did you not just see an 8 lb kid come out of there? They are sooo rude to moms. I’m a patient too. And there aren’t any mom friendly hospitals anymore where I live. Even though hospitals are still way safer than home births it almost makes being at home appealing. If I can’t recover in the hospital then why keep me 48 hours? Make sure I’m safe and send me home. Oh you want me to recover more? Then goddamn let me rest!!! /end rant

        Oh and my healthiest infant was the baby I supplemented early on and wasn’t nursing constantly. Yep he had good weight gain and still does. I have never gotten a lecture about his weight from the pediatrician. Thank you formula!

        Eta This meant to be a reply to something else. But the point stands. Lol sorry

  20. Shadyrose
    August 24, 2016 at 3:22 am #

    “A omprehensive review of this issue identified 400 case reports in the literature, mostly occurring during skin-to-skin care, with one-third of the events occurring in the first 2 hours after birth …

    Could you provide a link to this review please?

    • J.B.
      August 24, 2016 at 11:18 am #

      It looks like the review is linked at the top of the article, and all the quotes are exerpts. Presumably you could find the specific study including the 400 case reports from the references.

      • Shadyrose
        August 24, 2016 at 11:51 am #

        It’s paywalled unfortunately.

    • swbarnes2
      August 24, 2016 at 4:35 pm #

      The citation for that sentence points to this paper here

      http://www.ncbi.nlm.nih.gov/pubmed/23518795

      Not paywalled.

  21. MaineJen
    August 23, 2016 at 11:37 pm #

    “…soon to be implemented financial implicaitons” So these hospitals will begin to lose money unless more mothers breastfeed. Gee, what could possibly go wrong?

    • Maud Pie
      August 24, 2016 at 9:10 am #

      If ever there was an occasion to zealously pursue malpractice actions as a public policy, this is it. Every injury should be claimed to the full extent of legal recovery. The costs of caving into lactavists’ demands should exceed the savings.

      • Young CC Prof
        August 24, 2016 at 4:59 pm #

        Encourage insurance companies to pursue subrogation claims against them, too. Even for babies who come through without lasting harm, a couple days in NICU costs a lot of money.

        • MB
          August 29, 2016 at 9:48 am #

          I kind of caught this late, since it was posted 5 days ago, but THIS. I think I might contact my insurance company to go after my hospital and the midwives

          To rehash: They did not monitor my “borderline” gestational diabetes and subverted me into having a vaginal birth even after I was demanding a doctor to perform a c-section during labor. The labor was long and stressful and my son was born with hypoglycemia. I believe it was a combination of un-monitored, un-treated GD coupled with a long, barbaric labor. They ignored warning signs of no less than 4 ultra-sounds showing my child was LGA (large for gestational age). He spent the first days of his life in special care unit on a glucose drip. It is my belief that my midwives isolated and manipulated me out of the care of an OB who would have more closely monitored my pregnancy, possibly treated my GD, and offered a more realistic catalogue of the risks involved in having a large baby by vaginal birth, but they flat out lied to me and assured me that I was having a 7 lb baby (try 9 pounder).

          ANYWAY – I’ve talked about all this before, and someone here, Dawn, i think it was suggested I file a complaint. So I did! Although this was a year ago, I filed a formal complaint against the midwives. I received a formal apology phone call from the head of the midwives at the BFHI that I went to, but I don’t think that’s enough. I think it should sting more on their end. I don’t even want the money for myself, but money is the only thing these people care about. Maybe my insurance will feel like they can get money out of it?

  22. Amy
    August 23, 2016 at 10:29 pm #

    My daughter is one who’d be dead if we’d been in a BFI hospital. She stopped breathing one night while I was zonked out on painkillers and ended up in the NICU (for what turned out to be a bunch of negative tests and observation) for a week as a result. The fact that she was in a nursery while I slept, being watched and cared for by a group of awake, alert professionals, saved her life.

    Keep in mind that while she was born by c-section, the instant they were done stitching me up, she was on my breast and nursing away, even before they took her to get cleaned up. She was exclusively breastfed until 6-7 months (she pretty much hated all the solids we tried with her) and continued to nurse past age three. We didn’t NEED the BFI program to “help” us with anything.

  23. Maud Pie
    August 23, 2016 at 10:16 pm #

    I wish the lactavists would take up “better dead than formula fed” as their motto. At least then there would be no pretense about their stance. They are rigid ideologues who don’t give a shit about the well-being of mothers and babies.

    • August 24, 2016 at 11:17 am #

      OT but I love your username. Are you Pinkie’s sister?

      • demodocus
        August 24, 2016 at 11:37 am #

        i caught that reference; Dem’s a brony

      • Maud Pie
        August 24, 2016 at 12:12 pm #

        Yes, and I love rocks!

        Overhearing breastfeeding advocacy is a berserk button for me because it endangered my own child. The LC, my now-XH, and his wacko religious crunchy cohort all willfully ignored that my baby was not getting adequate nourishment, and that the LC’s recommendations were not helping, but were wearing me down physically and psychologically. They obstinately refused to grasp that if I got pushed over the edge, the baby would go with me. Formula saved my baby and me. Because of formula, I have a healthy, intelligent, wonderful teen daughter, who has brought me much joy–including introducing me to My Little Pony Friendship is Magic.

  24. BeatriceC
    August 23, 2016 at 9:43 pm #

    This falls under the categories of “no shit, Sherlock”, “and you were surprised, why?”, and “did we really need a study for this?”

    • Young CC Prof
      August 23, 2016 at 10:59 pm #

      I didn’t, you didn’t, but clearly some people did, or things would have changed before now.

    • Roadstergal
      August 24, 2016 at 11:42 am #

      Just like that Washington University free birth control study. The “Exactly what you’d expect, but apparently we need to give you people citations for the obvious now.”

  25. AA
    August 23, 2016 at 9:28 pm #

    I love how the defense of “practice rooming-in” always says “If mom is very tired, she can call the nurse and ask the nurse to look over the baby for a while at the unit desk” Hm..what if there was a dedicated place where nurses would watch over babies instead of hoping that someone at the unit desk can watch them….maybe we could call it a nursery! ;P

    I agree with Ms. Coogan’s statement (quoted from Chicago Tribune)
    “Coogan said she was pre-approved for a five-day hospital stay at Loyola
    University Health System in Maywood where she delivered in June, but she
    was so frustrated that she went home after two nights. “I figured if I
    was going to have to take care of the baby myself, I might as well do it
    for free at home,” she said. At home, she could also enlist the support
    of family members.

    Coogan said she received a bill for nursery care. Outraged, she fought it and said she ultimately had it reduced. “Not only do they not take your baby to a nursery so you can rest, but they charge you, even though you are the one actually caring for the baby,” Coogan said.”

    • CSN0116
      August 23, 2016 at 9:50 pm #

      Rest for a few while the baby stays at the nurse’s station? Fuck that noise. With all five of my babies, the nurses wheeled them away at 9pm and didn’t bring them back until around 7am. I passed out the full 10 hours every night I was there. An hour or two wouldn’t cut it for my formula feeding, sleep-needing ass 😛

      • LeighW
        August 24, 2016 at 9:58 am #

        And how many babies are they going to have in bassinets around the nurses station? Its ridiculous.

        • Sarah
          August 24, 2016 at 1:45 pm #

          Exactly. I was fortunate enough to be able to access this help from the midwives when in the postnatal ward for both of mine, and they did a brilliant job. But it seems it would’ve been safer and more efficient if they’d been in a dedicated, designated area designed for that purpose.

      • Kelly
        August 24, 2016 at 11:34 am #

        Finally learned to do that with my third child. It was amazing.

      • lawyer jane
        August 24, 2016 at 2:35 pm #

        Wow, if I had been able to do that, maybe I wouldn’t have an only child! Sleep deprivation, which started in the hospital and did not end for two years, is a huge reason I stopped at 1.

    • Monkey Professor for a Head
      August 23, 2016 at 9:55 pm #

      The second night after having my son, I couldn’t get him to settle. I was badly exhausted, having had 7 hours sleep in the past 72 hours. I had also had a pretty bad PPH, which was bad enough that I needed a transfusion the following day. The midwife at the antenatal classes had already cast scorn on mothers asking for help (“we won’t be there to help when you go home”, that kind of thing) so I was already reluctant to ask for help, and the call bells set off a really loud buzzer that the whole ward could hear. I really wasn’t in my right mind I think, but I picked up my son and walked to the far end of the ward where the nurses station was. It took a long time. I was dizzy, and I nearly stumbled and fell multiple times. When I got to the nurses station and told them I couldn’t settle him, I was told to go back to my room and someone would be down in a minute. So back I went down the seemingly unending corridor. It’s a miracle I didn’t fall over with my son in my arms. I made it back to bed and about ten minutes later the midwife arrived. She swaddled my son, put him in the bassinet, and left. I spent most of the night sitting in bed in the dark holding my son and crying, trying to stay awake as I was terrified I’d roll on him if I fell asleep.
      Thankfully the following night, I was past caring about the other patients on the ward. I rang the call bell, and when the midwife who came saw me crying, she took pity on me and took my son to the nurses station so I could sleep for two hours. The whole experience nearly scuppered breastfeeding for me. I was so desperate to feed him so that he would sleep, so I stopped trying to correct his latch and just nursed through the pain. Predictably I ended up doing quite a bit of damage to myself, to the point that I had to hand express and syringe feed him the first night we left the hospital.
      That was one of the worst experiences of my life. If it had been for my sons benefit, I could have withstood it, but there was no good reason that I had to go through that, and that makes me very angry. Even so, I consider myself lucky – so many women have to go through that while recovering from abdominal surgery.

      • Young CC Prof
        August 23, 2016 at 11:05 pm #

        Won’t be help when you go home. That is such a stupid argument it’s unbelievable.

        Except, first off, most women DO have some form of help at home, spouse, family, neighbors, etc, someone to take the baby for at least a little while.

        And second, when you go home, you are no longer a freaking hospital patient recovering from a potentially serious medical event, you are actually considered well enough to take care of at least yourself.

        Finally, at least for the first time mothers, the hospital stay should be a training period, where you get to practice infant care with plenty of support and advice, not getting thrown into the deep end.

        • August 24, 2016 at 1:06 am #

          In the UK the midwife IS legally responsible for the mother and infant for 10 days after birth. Once the mother is discharged, the hospital midwife hands over to the community midwife, and after the 10th day, she hands over to the local health visitor.

          • Margo
            August 24, 2016 at 2:56 am #

            In NZ a midwife visits the mother and baby at home for up to six weeks and then is discharged to various agencies and a GP. Women are entitled to up to 12 visits within that six week post natal period. At six weeks women usually visit their GP to start the immunisation schedule.

          • Margo
            August 24, 2016 at 3:00 am #

            Ha, bad English….I mean the woman is discharged to various agencies, not the midwife. Also let’s hope more research comes out regarding BFI, because the BFI needs to change.

          • Monkey Professor for a Head
            August 24, 2016 at 3:01 am #

            It’s the same in Australia. For me, the community midwife visits were immensely helpful – she pretty much saved breastfeeding for me.

          • Dr Kitty
            August 24, 2016 at 3:32 am #

            After both pregnancies I was visited twice by the midwives.
            On day five for heel prick and initial visit with both babies.
            On day eight for removal of wound clips with first and on day 8 to check for jaundice with second (he takes after me and is a bit more tan than the average Irish baby- apparently they can’t tell the difference).

            It was helpful with the first baby, less so with the second, but think when I answered the door while breastfeeding and offered to make them a cup of tea they could tell I was coping and just went through the motions.

            The first health visitor was not helpful a spinster in her late 60s who gave highly impractical and very out of date advice about almost every topic.

            My current HV is a former colleague, so we just chat about our kids while she plays with the baby.

        • BeatriceC
          August 24, 2016 at 11:07 am #

          It’s also why women should be able to spend time in the hospital resting and recovering. The implications of that argument really are the opposite what they think they are.

        • Kelly
          August 24, 2016 at 11:33 am #

          When I finally got to sleep after having my first, I had not slept in 48 hours. Then because I was breastfeeding I got up every three hours. I was so tired by the time I went home that I almost dropped the baby while sitting on my couch. I vowed that I would not do that again and took every measure possible to get as much sleep as I could before I went home when I had more kids. These women need sleep and rest before they go home so that if they do have to do it by themselves they will be able to do it.

          • BeatriceC
            August 24, 2016 at 12:02 pm #

            I’ve said it before, but looking back, the one and only advantage to having all my babies go to NICU was that they weren’t in my room and I was able to rest. It’s amazing how an almost uninterrupted night of sleep that first night made recovery a breeze, even with a c-section. The only recovery that was awful was the last, and I was still on a lot of drugs for the pre-e for that. But that was me still being sick, not an issue of getting enough rest.

          • sad but true
            August 24, 2016 at 12:14 pm #

            The people pushing Baby Friendly Hospitals don’t want recovery from c-section to be a breeze. They’re against c-sections as much as they’re against formula.

          • Roadstergal
            August 24, 2016 at 1:05 pm #

            But women with VBs who have had long labors, tearing, no sleep, hemorrhage – they could recover so much more easily with a little rest, too…

          • Mrs.Katt the Cat
            August 24, 2016 at 1:25 pm #

            Aye! I should have used the nursery more when I was in the hospital, i dont think I got a solid block of sleep for a month. Zombie Mom

          • Kelly
            August 24, 2016 at 1:41 pm #

            That was the advantage of formula for the last one as I got 8 hours of uninterrupted sleep. It is not easy to recover from a sleep deficit after birth if you don’t have help. I never want to feel that tired again and so I grab sleep whenever I can after I give birth.

          • Sarah
            August 24, 2016 at 1:44 pm #

            Said this before, but I felt a great sense of relief when one of mine was in special care after being born by EMCS, for the same reason. It should not have come to that.

        • Roadstergal
          August 24, 2016 at 11:46 am #

          “And second, when you go home, you are no longer a freaking hospital patient recovering from a potentially serious medical event, you are actually considered well enough to take care of at least yourself.”

          Seriously! They didn’t make me get my own water and get out of bed to go to the bathroom myself after my surgeries, with the rationale “Well, you’ll have to take care of yourself once you get home, so obviously you can do it here before you’ve recovered…”

        • Erin
          August 24, 2016 at 1:27 pm #

          Especially when hospitals like the one closest to me (where I had my son), won’t let you leave before they’ve discussed what support you have at home to ensure it’s enough.

          Yet they still use the same argument as to why they can’t help you do things whilst you’re a patient.

          • Charybdis
            August 28, 2016 at 10:30 am #

            I, in my ever-increasing pissitivity level about this sort of thing, would probably ask them why they were so concerned about me having help/support at home.

            Seeing as how they don’t currently give a damn that I’m sleep deprived, have poor pain management/control and my baby is not getting enough to eat because my milk isn’t in yet and they make formula damn near impossible to get, why, all of a sudden are they all concerned/worried about our care and support when we are discharged?

            They don’t care about your well-being and “level of support” while IN THE HOSPITAL, which is their turf, so to speak. Why are they suddenly SO concerned about it when you are discharged?

          • KeeperOfTheBooks
            August 28, 2016 at 10:50 am #

            *sighs sadly because she can only upvote this once*

          • Erin
            August 28, 2016 at 12:23 pm #

            I hope they have the sense not to ask me this time around. Although I’ve got plenty of evidence to back up an insanity defense if they do and I overreact.

            With my “mean” hat on, I’m assuming they don’t care, it’s just checking a list like when they asked me in front of my husband and my Mother in Law if I was a victim of domestic violence.

        • Sarah
          August 24, 2016 at 1:43 pm #

          Fortunately, nobody ever tried that ‘won’t be help when you go home’ line on me. Probably because I gave birth at a hospital in an area with a very traditional working class community where there almost invariably is help when you go home. I got shitloads. My dad even cooked our tea every day for a fortnight. I realise this isn’t the reality for a lot of women but it seems to wilfully ignore that many of us come from backgrounds where it massively is.

          • Roadstergal
            August 24, 2016 at 1:49 pm #

            And shouldn’t the argument be, “You’re not going to have much help when you get home, so you should get all the rest and recovery you can here, where we have it??”

          • Sarah
            August 24, 2016 at 2:12 pm #

            One would think.

      • LeighW
        August 24, 2016 at 9:56 am #

        I can’t think of one other instance where one patient is asked to provide care for another patient in a hospital.

        Do they ask people recovering from abdominal surgery to bring lunch to the other patients?

        No.

        F*ck no.

        That would be unprofessional and completely unacceptable.
        But they force new mothers to do this. WTF?

      • EmbraceYourInnerCrone
        August 24, 2016 at 12:22 pm #

        So sorry this happened to you. Another thing I don’t understand is, how is it safe or secure to have baby’s bassinets parked in the hall next to the nurses station? Nurses stations , to me usually seem like busy places full of people coming and going, random patient visitors coming by and so forth.

      • fiftyfifty1
        August 24, 2016 at 12:24 pm #

        “The midwife at the antenatal classes had already cast scorn on mothers asking for help”

        Yes, because needing help is proof that you have done something wrong. If you had been a sensible, healthy, kale-eating, non-hysterical woman who had Trusted Birth, then you would have popped the baby out and fed it without any help like a good Earth Mother should.

        • Monkey Professor for a Head
          August 24, 2016 at 4:28 pm #

          3 weeks after I had my son, my mum came to visit. I was actually doing pretty well by that stage, but even so she didn’t let me lift a finger the whole time she was here. Every time I would breastfeed, she would bring me a glass of milk and a piece of chocolate, and when minimonkey was done she would take him to burp him whilst I put my feet up. I hardly had to change a nappy for 3 weeks. It was awesome. Funnily enough she’s a midwife (albeit she hasn’t practiced for a few decades), but she’s also a mother of 5 and has a pretty good idea about what new mums actually need.

    • MI Dawn
      August 24, 2016 at 9:20 am #

      Sounds like a story I’d love to read! Do you have a link?

  26. Young CC Prof
    August 23, 2016 at 9:12 pm #

    I really hope this is a sign that the tide is shifting. I’m trying to figure out what types of changes would be most useful:

    Tracking and reporting neonatal readmission rates, along with the number of readmissions related to feeding problems, which are usually preventable. (What you measure, tends to change.)

    NOT tracking exclusive breastfeeding during hospital stay, which isn’t even a good measure of breastfeeding success, much less lactation support, much less quality of care.

    NOT tracking rooming-in rates, which is incentivizes horribly risky behavior.

    Mandating that facilities with a maternity ward include a well-baby nursery or other provision for the care of babies who are not rooming in.

    Still, just getting a voice out there makes a difference.

    • Madtowngirl
      August 23, 2016 at 10:19 pm #

      I hope with all my heart that you are right, and that this is a sign that the tide is shifting. The BFHI is dangerous in practice.

      I’d like to see tracking of the incidence of PPD/PPA. I’d love to see if there is a correlation between the BFHI and maternal mental health.

      • Young CC Prof
        August 23, 2016 at 11:01 pm #

        It would be tough to correlate PPD to post-delivery practices only because diagnosis rates vary over time.

        • Madtowngirl
          August 23, 2016 at 11:03 pm #

          That’s true. I just wonder if the incidence has gone up with this “breastfeed at all costs” mentality. It sure contributed to mine.

          • Young CC Prof
            August 23, 2016 at 11:16 pm #

            There was a study shown here awhile back that showed that women who planned to breastfeed but didn’t were at increased risk of PPD. The statistics were weird, though, so I wasn’t totally sure what to make of it. It also showed that women who did not intend to breastfeed in the second trimester, and then breastfed anyway, were also at increased risk.

            That study would have been 1000% more useful if they’d asked any of the women WHY their plans changed.

          • J.B.
            August 24, 2016 at 10:05 am #

            Me too! Then when we saw a lactation consultant she told me to stop using the pacifier so much. I lasted one day of the kid attached to me every waking moment.

    • swbarnes2
      August 23, 2016 at 11:55 pm #

      Especially since, according to a paper cited on bfmed of all places, 44% of primips have no milk on day 3. So a bunch of those babies they are counting as “exclusively breastfed” are really “just didn’t eat”. At any other point in a kid’s life, I think authorities would be worried if a kid didn’t eat for three days. But if you are in the most fragile 3 days of your life, you can starve with the hospital’s blessing.

      • Young CC Prof
        August 24, 2016 at 12:11 am #

        That’s one reason why exclusive breastfeeding at discharge is a stupid metric: Most hospital stays after delivery of a basically healthy baby are too short to actually establish breastfeeding, sometimes short enough that baby can just not eat the entire time and get home before problems crop up.

        Exclusive breastfeeding during a hospital stay of 24 hours or less is like a driver’s test where you never leave the parking lot.

        • lawyer jane
          August 24, 2016 at 9:49 am #

          Very good point. I’m so glad that I had the good fortune to have scheduled a ped visit and a home lactation consultant visit on the day after we came home from the hospital. That ensured that the baby got some formula since my milk hadn’t come in, and pinpoint when my milk did come in (via pre-and post- weigh ins by the LC at my house). The hospital apparently just didn’t care. Scary!

    • D/
      August 27, 2016 at 10:27 pm #

      (Semi-related) good news:

      It’s annual performance evaluation season with both my employers. And my wondering if my personal refusal to focus directly on breastmilk exclusivity would ultimately get me low marks was answered.

      My full-time employer: “You’re the top of this division. Only four of my 100+ direct reports are ranked this high.”

      My PRN (working toward BFHI-designation) employer: “You always leave mothers and nurses feeling better after you help them.”

      Lower evals wouldn’t have changed what I do, but I must admit I felt pretty good about working this week 🙂

  27. Krista
    August 23, 2016 at 8:40 pm #

    I think we should start referring to the policy as the “Bottom Line-Friendly Hospital Initiative.”

    • Maud Pie
      August 24, 2016 at 9:15 am #

      Even that’s too euphemistic for me. Call it Coercive Breastfeeding Initiative.

      • Charybdis
        August 24, 2016 at 10:48 am #

        “Initiative” soft pedals it too much. “Edict”, “Commandment” or “Iron Clad Rule” sums it up much better.

      • Sarah
        August 24, 2016 at 1:46 pm #

        Your Tits Are Belong To Us Rule.

        • Roadstergal
          August 24, 2016 at 1:50 pm #

          You Have No Chance To Rest Make Your Time.

  28. ArmyChick
    August 23, 2016 at 7:37 pm #

    Why should an exhausted mother be forced to care for a newborn? Nobody asks men to do that post-surgery. Nobody hands them a baby and say “see ya!”. I was completely out of it after my c-section. I couldn’t walk without assistance. Laying down hurt. Sitting down hurt. Existing hurt.

    I was so thankful for the nursery just a few steps away from my room. I am glad that when asked “formula or breast” I said formula and nobody ever questioned it. This was back in 2011.

    I didn’t give birth at a “baby friendly” hospital, thank goodness. I do work at one, however and I would never give birth there, unless I knew my choices were respected.

    • CSN0116
      August 23, 2016 at 8:43 pm #

      Because martyr moms are cool moms.

      • Maud Pie
        August 23, 2016 at 10:26 pm #

        And because female suffering is a virtue, irrespective of whether there’s any palpable commensurate benefits.

        • Amy
          August 23, 2016 at 10:36 pm #

          The more you suffer, the more it shows you really care….

          • Mishimoo
            August 24, 2016 at 5:36 am #

            Right? Yeah!

            (Now that damn song is stuck in my head lol)

        • KeeperOfTheBooks
          August 24, 2016 at 9:43 am #

          Exactly. I’d die for my kids, but that doesn’t mean I want to do so unnecessarily! Shove the stroller out of the path of a semi, getting hit in the process? Sure thing. But that’s not, thank goodness, an everyday worry here in the US (I can’t imagine being a mom in Syria right now), and my kids will be much happier long-term with a not-dead-from-PPD-mommy, or, for that matter, a not-horribly-depressed-and-raging-mommy due to unreasonable expectations.

    • guest
      August 23, 2016 at 10:40 pm #

      I’ve said this before, but I was literally strapped to my bed post-c-section. I wasn’t even allowed to be on the post-natal ward, because they couldn’t give me the level of care I needed there. There is no way in hell I could have cared for two newborns that day. Mine went to the NICU, but the hospital did have a nursery for “sick” babies who weren’t NICU-level sick, and I think they would have gone there in that case. But otherwise it was a strict rooming-in hospital, and that is so obviously stupid. The best thing that ever happened to me was the babies being in the NICU for a week (not the best thing for *them*, but for me). I recovered. And you know what? When I took over care at home and the nurses weren’t there to help? We were JUST FINE. It’s not like if you care for a woman’s baby for two days she’ll never be able to do it herself. That’s not how people work.

    • lawyer jane
      August 24, 2016 at 9:50 am #

      For that matter, why don’t they just hand the newborn to the DAD for 24/7 care, instead of to the mom? Hmmm ….

  29. Dr Kitty
    August 23, 2016 at 7:12 pm #

    OT-
    Meanwhile there is a Facebook post doing the rounds about a “warrior mama” who is proud to have survived her CS.

    “Having a shrieking infant pulled out of an incision that is only five inches long, but is cut and shredded and pulled until it rips apart through all of your layers of fat, muscle, and organs (which they lay on the table next to your body, in order to continue to cut until they reach your child) is a completely different experience than I had imagined my son’s birth to be.”

    CS is made to sound horrendous, including very questionable references to having her internal organs pulled from her abdomen onto the operating table beside her (the pregnant uterus lies in front of the bowel, no organs are removed from the abdominal cavity during a CS, because they don’t need to be, because they aren’t in the way).

    If somebody is doing a manual check of your bowel during a CS something has gone badly wrong, and you’d probably be under general anaesthetic while they try to fix it.

    By all means, speak your truth, but could it maybe, actually, be true?

    • Fleur
      August 23, 2016 at 7:32 pm #

      Funny how all these warrior mama types, who pride themselves on not needing pain relief during labour, go completely to pieces at the idea of an op which I (a certified wimp if there ever was one) took in my stride.

      Oh, and even if she’s got the medical details right, anything sounds disgusting if you describe it in that kind of detail. There’s a reason why little girls, the first time someone explains to them how most babies are born, tend to respond by saying that they’re never having children.

      • Fleur
        August 23, 2016 at 7:39 pm #

        Something rubs me up the wrong way about that “screaming infant” reference, too. Fair enough, maybe that’s how she felt, but it’s so dehumanising. And it’s not as though healthy babies don’t make a fair bit of noise when they’re born vaginally too, but apparently they’re bundles of joy who can’t be cuddled soon enough, gunk and all, whereas a CS baby is obviously just a screeching brat.

        • Monkey Professor for a Head
          August 23, 2016 at 7:52 pm #

          I thought that a baby’s first cry was a good thing. If they’re crying then they’re breathing. I know I was immensely relieved to hear my son cry.

          • Clorinda
            August 23, 2016 at 8:12 pm #

            We lost one of my babies due to kidney issues and therefore lack of lung development when the amniotic fluid never was created. The most shocking part about his birth was the fact that he DID let out two little squawks right at birth. All my babies were c-sections and I definitely heard them all before I saw them. But this was one time we were expecting silence and didn’t get it.

          • Monkey Professor for a Head
            August 23, 2016 at 8:32 pm #

            I’m very sorry for your loss.

          • Clorinda
            August 24, 2016 at 1:22 pm #

            Thank you everyone. For a child to NOT be crying at birth is usually a sign of something seriously wrong. I think I was clumsily trying to make that point by showing what can happen when you know it is going wrong and the kid defies expectations.

          • Fleur
            August 24, 2016 at 4:48 am #

            I’m so sorry.

          • MI Dawn
            August 24, 2016 at 8:04 am #

            Hugs. That’s very tough.

          • Stephanie Rotherham
            August 24, 2016 at 11:56 am #

            I’m so sorry for your loss.

          • Fleur
            August 24, 2016 at 4:48 am #

            Same here. I sobbed with gratitude when I first heard my daughter (born by c-section) cry. But apparently she should have been sitting in the corner in silence until she was ready to apologise to ruining mama’s birth experience!

          • Glia
            August 24, 2016 at 12:55 pm #

            Me too! After all the worry (anxiety plus previous loss makes for a super fun pregnancy), the sound of him screaming mad about being out was the best sound I’d ever heard.

          • Amy M
            August 24, 2016 at 5:36 pm #

            Yes, I remember straining to hear crying–which I probably couldn’t because they had taken the babies into the next room. There are pics of them screaming on the scale, and I heard them when they brought them back by me. I do remember feeling relieved however, when I did finally hear them.

        • guest
          August 23, 2016 at 10:48 pm #

          My c-section twins came out crying. No sound in the world was more thrilling than hearing them cry while being born, particularly because the section was due to one of them being in distress. Crying told me they were breathing, and it was active, deep crying. I was also pleased to note that I could immediately tell the difference between their cries.

          • August 24, 2016 at 10:01 am #

            Yep. I did St John’s Cadets once and one of the first thing they told us about triage was: “Noisy people can breathe. Worry more about the quiet ones.”

        • demodocus
          August 24, 2016 at 9:41 am #

          i thought the goal was a screaming baby?

          • KeeperOfTheBooks
            August 24, 2016 at 9:51 am #

            At the same ER I mentioned above, one of the older docs said not infrequently that he loved it when babies came in red-faced and screaming their heads off, because if they’re in that condition, you’ve got airway, breathing, and circulation sorted out. Slight oversimplification, of course, but he did have a point.

          • demodocus
            August 24, 2016 at 9:58 am #

            Yeah, my little girl was silent, then stopped breathing for a bit. not good. Fortunately, she was sorted out quickly but it could have been so much worse.

          • KeeperOfTheBooks
            August 24, 2016 at 10:02 am #

            Glad everything turned out well! DD tried to smother herself on the boob at a day old–like, latched on face-down. I figured she was okay because she’d stop eating if she couldn’t breathe. I overestimated the intelligence of the average newborn. :p Looking down and seeing that your child is literally blue is NOT a good moment.

          • Erin
            August 24, 2016 at 2:16 pm #

            I had one of those moments, was rather frightening. Although we spent today at a play park and my son apparently still has all the judgement of an exceedingly drunk teenager. When he wasn’t trying to catch a wasp, he was trying to climb the biggest, scariest climbing frame in ways the makers had not envisaged when they made it.

          • KeeperOfTheBooks
            August 24, 2016 at 2:49 pm #

            Ha! DD started climbing *up* slides pretty much as soon as she could crawl. I swear the kid keeps hair color manufacturers in business, as I need so much in order to cover up the grey hairs she’s given me…

          • shay simmons
            August 24, 2016 at 5:25 pm #

            One of my sisters (who, ironically, is an RN), jokes that there’s a gurney in the local emergency department with her oldest son’s name on it.

          • Monkey Professor for a Head
            August 24, 2016 at 6:06 pm #

            My son does this. And he learnt how to climb up on the couch two days ago, and just gave me a minor heart attack by falling off. Another situation where I was very happy to hear crying straight away.

          • demodocus
            August 24, 2016 at 4:03 pm #

            i’m still a bit afraid of playground equipment…

          • MI Dawn
            August 25, 2016 at 9:59 am #

            My mom still tells the story of the time she looked out the back door and saw 18 month-old *me* on TOP of the swingset (the old kind, all metal pipes). She has no clue how I climbed up there. She says she called my name, told me it was lunch time, and turned her back. 2 minutes later, I walked in the door. She doesn’t know how I got down, either, because she was scared to watch! (I’m still a climber, but not quite as fearless as I was).

          • demodocus
            August 24, 2016 at 4:02 pm #

            She’s quite the chatterbox now, coos and gurgles far more than her brother did.

          • Sarah
            August 24, 2016 at 1:49 pm #

            Of course. The sound of a silent baby straight after birth is not a happy one. Believe me I know.

          • demodocus
            August 24, 2016 at 4:02 pm #

            I’m sorry

          • Sarah
            August 25, 2016 at 3:57 am #

            Thank you. I’ve just realised I might have made that sound like a loss, if so I apologise for my poor choice of words because two days in special care plus a brief readmssion and she was fine. Right as rain. I’m so very, very grateful for modern medicine.

          • demodocus
            August 25, 2016 at 10:34 am #

            oh good!

          • August 24, 2016 at 4:20 pm #

            Urgh…disqus so needs reactions. I want to upvote this but I can’t.

          • Sarah
            August 25, 2016 at 3:54 am #

            Really? I can upvote you!

          • August 25, 2016 at 4:08 am #

            No, I can upvote you. I just … it’s like liking a post where someone’s grandmother died. Ugh.

          • Sarah
            August 25, 2016 at 3:54 am #

            The silent at birth baby I had is fine now btw, currently flinging herself around my living room and shrieking.

          • August 25, 2016 at 4:09 am #

            Oh, I’m so glad to hear that….not the silent at birth part but…..

          • Sarah
            August 25, 2016 at 11:39 am #

            Of course, I get what you mean!

        • LeighW
          August 24, 2016 at 10:03 am #

          And you know she’s likely going to feel that way about the kid for the rest of her life, unless she has a “healing birth” soon after.

        • MI Dawn
          August 24, 2016 at 10:42 am #

          You know….it just occurred to me. You read all these peaceful births, and the baby comes out (apparently) all quiet, cooing, and smiling. No cries, no screaming. The only babies I ever saw that didn’t cry like a banshee were blue and limp, needing resusitation. (And yes, I attended many a “peaceful” hospital or birth center birth, with water births, lights low, etc. Those babies cried, also.) Do you think that maybe their expectations of baby’s first breathing are off?

        • indigo_sky
          August 24, 2016 at 1:54 pm #

          “Shrieking” is the word from the quote. I think probably chosen to add to the imagery of chaos and trauma she’s painting. Screaming baby could be either normal or a word used to indicate being annoyed with the sound, but shrieking, clearly that kid is being messed up by the experience! Goes with the idea that c-sections and being yanked from the womb by gloved hands are very rough and traumatic for a baby, while being tightly squeezed through a vag and pressed against pelvic bones is a “gentle birth.”

      • Amy
        August 23, 2016 at 10:38 pm #

        Forget needing an operation, they flip out at having an IV line in. Or, in Paala’s case, at not being handed a menu the moment they walk into the ER.

        • Sean Jungian
          August 23, 2016 at 10:49 pm #

          “What? No catch of the day? What kind of dump are you running here??”

    • Glia
      August 23, 2016 at 8:12 pm #

      I feel proud of “surviving” my CS. I was devastated I was having one (what can I say, NCB got under my skin a little), and utterly terrified of the surgery, but I read everything I could, determined that it was, in fact, the safest thing for my baby, took a deep breath, and did what I had to. I think the inclination to make it sound horrible makes sense, since one half of the CS-are-bad rhetoric pushed by NCB is how it is the easy way out (that the other half is that they are terrible things that steal away your beautiful birth experience is inconsistent with that claim is irrelevant, obvs), but is seriously misguided. It ends up playing into the narrative, and rather than making the mother look strong, just reinforces the idea that NCB is infinitely superior. I prefer telling the truth, since for me, it is that I didn’t need to be so afraid, because my kid’s birth by cesarean turned out to be absolutely an amazing and beautiful experience of its own…and that it would have also been ok if it wasn’t so great, because healthy baby.

    • Azuran
      August 23, 2016 at 10:16 pm #

      What the hell is she even talking about? They don’t rip through your organs nor put them on the table next to you while they get the baby out. FFS a term baby is taking basically all your abdomen, and it’s in front of your organs… it’s not hard to find.

    • guest
      August 23, 2016 at 10:43 pm #

      Well, I don’t doubt that it was different than how she “imagined” it would be.

    • mabelcruet
      August 24, 2016 at 3:34 am #

      I wonder if she could feel the weight of a retractor or other surgical instrument resting on her abdomen, and if there was a screen up she might not have realised that it was surgical equipment and instead decided it was her liver or something. I had a heated discussion years ago with a family member who was getting eye surgery and they claimed that their eyeball had been removed completely and they could feel it resting on their cheek-they refused to accept it was surgical equipment despite me showing them anatomical pictures of the eye and explaining how the optic nerve isn’t like an elasticated bungee cord.

      • Dr Kitty
        August 24, 2016 at 6:40 am #

        I was wondering if it was blood soaked gauze pads she saw, or the placenta. Anatomically it just doesn’t make sense. Nobody gets unpacked like a suitcase to get to their uterus.

        They exteriorised my ovaries both times during my CS because of my history of cysts and endometriosis. Not my favourite part, but not in any way actually unpleasant. They asked my permission, the anesthetist was ready to give me extra meds if it hurt or I felt woozy. Still didn’t have my intetnal organs on a table beside me.

        They’re doing more orthopaedic surgeries under epidural and “light” sedation for the frail elderly. The recollections of an octogenarian of their surgery, when on a combination of benzodiazepines and opioids for the first time in their life, is very interesting, “trippy” even.

        • KeeperOfTheBooks
          August 24, 2016 at 9:49 am #

          When I was in high school, I volunteered in the ER of the local hospital. At one point, one of our elderly volunteers came in with a suspected heart attack or stroke, something along those lines. Of course, we rallied around, offered his wife coffee/a phone/a private room in which to make calls/a page to the chaplain etc. He was the sweetest old guy, so we all wanted to do everything we could to take good care of him and his wife. At one point, I stuck my head in to ask if there was anything I could do? “Oh,” quoth he, “it’s not really a big deal…I don’t want to bother you…”
          “No worries,” said I, “I’m pretty slow at the moment anyhow. What can I do?”
          “Well…if you’re sure you aren’t too busy…I was wondering if you could scrape just a few of the frogs off the walls?” (To state the obvious, the walls were, in fact, free of amphibians.)
          I told him that that was above my competency level, but I’d find a nurse who could help. 😀

          • Charybdis
            August 24, 2016 at 11:02 am #

            Last summer my aunt fell and broke her hip. When Mom and I drove up to see her in the hospital, she was smiling and giggling a little bit. We asked her what was so funny and she said that she had just seen a couple of mice run across the ceiling. She told us not to worry, because they were cartoon mice and that they had been running across her ceiling for a couple of days now.

          • EmbraceYourInnerCrone
            August 24, 2016 at 12:32 pm #

            When my daughter broke her arm they put her on a morphine drip while waiting for the on call orthopedic surgeon to arrive. After her fracture was reduced she turned to me and said ” why do you have a lizard head?” followed by ” omg i can’t feel my legs, my legs don’t work anymore” Needless to say, years later the Lizard head one is still something we tease her about.

          • Rach
            August 24, 2016 at 8:22 pm #

            When my son broke his arm, he got given the ‘green whistle’ by the ambos, and then two doses of morphine in hospital. He was singing Bob Sinclair’s ‘Rock this Party’ while shaking his head from side to side, completely out of it. Being the #shitparents we are, it was recorded.

          • Mrs.Katt the Cat
            August 24, 2016 at 8:56 pm #

            When Mr Katt was in the hospital, he got 2 shots of dilauded. When he asked me how many clocks were on the wall, because he saw 5, I told him one but they gave you the good stuff. We then had a very coherent discussion about his hallucinations – first time he could speak coherently and knew where he was in a week.

          • BeatriceC
            August 24, 2016 at 9:33 pm #

            As many people know, two of my kid have a genetic bone condition and undergo quite a bit of surgery. When my oldest was 14, he had a pretty major operation, and was kept overnight on a morphine pump. In the middle of the night, he bolted upright in bed and shouted at the top of his lungs “WE FORGOT TO BATHE THE TURTLES!” It should be noted that we do not have, and have never had, pet turtles.

            Also, we tell this story frequently to his friends because we are also #shitparents.

          • Charybdis
            August 24, 2016 at 9:47 pm #

            There was one night I fell asleep well before my husband did. When he came to bed, I apparently asked him “Did you unplug the cow?”. Twice. Then I rolled over and went back to sleep and no recollection of doing this the next morning. I still get razzed about it.

            I must mention that this happened without the benefit of medication of any type.

          • BeatriceC
            August 24, 2016 at 9:50 pm #

            I’ve been known to say weird things in my sleep. MrC still teases me about the time I was frantic that we needed to call the San Diego Zoo because the tiger was taking a bath in the pool and the penguins were upset because they wanted to swim. Yeah, no drugs there either.

          • Empliau
            August 24, 2016 at 6:37 pm #

            Doonesbury – Duke on a bad trip: “Get rid of the killer lizards! …. Oh, I see they’re sheep. Sheep I can deal with.”

      • MI Dawn
        August 24, 2016 at 8:07 am #

        OK….I have to admit I LOL’d at “the optic nerve isn’t like an elasticated bungee cord.”

    • MI Dawn
      August 24, 2016 at 8:03 am #

      Da FOOK???? I’ve seen many a C/Section in my life, but I’ve never seen organs laid on the table next to the body!!! Did this person give birth on another planet?

      • PrimaryCareDoc
        August 24, 2016 at 1:02 pm #

        Her only reference point is the game Operation, clearly.

        • Roadstergal
          August 24, 2016 at 1:06 pm #

          Oooh! I want a version of Operation where you have to withdraw a baby from either a C-section or the vagina.

    • Mrs.Katt the Cat
      August 24, 2016 at 10:58 am #

      I found that and read it. Seems she was defending herself from accusations that a c section was the easy way out, so perhaps she took some creative liberty in making her point that an emergency c section is by no means ‘easy’

      • Poogles
        August 24, 2016 at 1:05 pm #

        Yes, it was in response to someone telling her she didn’t really “give birth” since she had a CS, taking the “easy way out”.

  30. demodocus
    August 23, 2016 at 6:46 pm #

    Sleeping is *so* overrated; why no one ever gets into car accidents and such from being exhausted. That’s why long-haul truckers and pilots are discouraged from napping

  31. August 23, 2016 at 6:02 pm #

    My husband had a gastric sleeve operation by laparoscopic methods about 13 months ago. Near as I can tell, his surgery was less complicated than my sister’s C-section after a few days of failed labor inductions.

    Oddly enough, no one decided that it would be a good idea for him to care for a newborn immediately post-surgery. The nurses seemed to think that he had his hands full working on walking again and getting his gastric system online again.

    Thankfully, no one thought it would be a good idea for my sis to care solely for my nephew, either. She was encouraged to BF and walk around, but there was a healthy newborn nursery available 24-7 for her to use to let her (and her husband) get several hours of uninterrupted sleep in a row.

    But then sis didn’t give birth at a BFHI hospital either…..

    • Kelly
      August 23, 2016 at 9:34 pm #

      The only time a baby absolutely needs their mother to take care of them is if they are breastfeeding and even there are other options if the mother is struggling. So, I just don’t get why they have to take care of the baby when they are the ones who have gone through a delivery. I have had three very easy deliveries but I still did not feel 100%. I had nurses take each of babies each time and I had lots of help from my mother and husband when we got home. I just don’t get it why hospitals think it is ok to expect a mother to go from giving birth to taking care of their baby full time. Babies thrive without all these special rules as well. I am just thankful that the two hospitals I have delivered at were not baby friendly because I was able to recover so that I could go home and do what I needed to do.

      • CSN0116
        August 23, 2016 at 9:55 pm #

        It’s honestly one of the most prevalent current threats to women’s rights in the health care setting, and nobody’s even paying attention! And those who are endorse it because of martyrdom and superiority complexes. It’s sick! It is treating women as second-rate citizens and patients, violating their bodily autonomy, literally harming them physically and mentally, all the while making money for hospitals. The fact that breast and bottle, crunch and squish, women cannot collectively see how fucked up this is scares the shit out of me.

      • Amy M
        August 24, 2016 at 5:39 pm #

        Yes, I realize that not everyone is lucky enough to have a partner and/or family nearby to help, but from a cultural standpoint, I don’t think there is one where new mothers are routinely deliberately abandoned wo/any help at all. Some cultures even seem to have very elaborate systems, for new moms to the point where the mom may not have to do much of anything but feed the baby.

    • demodocus
      August 23, 2016 at 6:43 pm #

      Fortunately not at the moment, and in the interests of not self-harming I think I shall avoid this.

    • BeatriceC
      August 23, 2016 at 8:51 pm #

      I think I will pass on this one. I’m already in a rage elsewhere on that topic.

    • mabelcruet
      August 24, 2016 at 3:47 am #

      Sensible article. Some total and utter nutjobs in the comments.

    • MI Dawn
      August 24, 2016 at 8:01 am #

      Nah, I read enough of those nutjobs. Anyone who doesn’t vaccinate their children, excepting those too young or with VALID medical exemptions, is just stupid.

  32. Gretta
    August 23, 2016 at 5:36 pm #

    I’m already in a bad mood and this just put me in a worse one.

    OF COURSE a lot of that is a bad idea when done so rigidly! Are you kidding me??? A sedated, exhausted mother may be inadvertently placing her infant in danger when denied help??? NO SHIT SHERLOCK.

    How and why were these practices put into place so rigidly by hospitals in the first place???

    I have a guess. And it starts with MO- and ends with -NEY….and conveniently uses this “baby friendly” mumbo jumbo as an excuse.

    • Young CC Prof
      August 24, 2016 at 1:41 am #

      Some of it’s money, but there just isn’t enough money involved to explain the overwhelming passion some of these things draw. It’s breastfeeding politics, with a logic chain that goes approximately: Breast milk is good for babies, here are some things that support breastfeeding mixed with some things that are claimed to support breastfeeding, so they all must be good for babies, so they should all be done AS MUCH AS POSSIBLE WITH NO EXCEPTIONS.

      • Gretta
        August 24, 2016 at 3:16 pm #

        So even those in the medical profession…those who are supposed to be smart, analytical, thoughtful….can be swayed to make crazy policy decisions by zealotry. Great.

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