Being Supportive of Breastfeeding: What NOT to Say

Last week, a woman who was having her second baby (by repeat cesarean surgery) asked if I would come to the hospital with her. I did. She was hoping I could help her to optimize that first hour or so when breastfeeding is so important as she had been only mildly successful breastfeeding her first baby. Just prior to the surgery, I was in her room when the “baby nurse” came in to introduce herself, and to take a brief history. I perceived the nurse as experienced, warm, and caring. But in the few minutes she was there, she gave multiple messages that were unsupportive of breastfeeding.

Not asking about feeding plans

The nurse didn’t have a sheet of “prompts,” but she did have a battery of questions about the mother’s health, any problems that had been noted with the fetus, and plans for anesthesia. She never asked about feeding plans.

You could argue, “Marie, it’s on the medical record!” Yah, right. It should be. Maybe it was. But not giving the mother an opportunity to talk about a feeding plan makes it seem unimportant. I mentioned the mother’s desire to breastfeed to the nurse.

“He won’t start right away.”

This comment was unsupportive of breastfeeding and made me wonder if I should hold my tongue or be an advocate. She added, “Well, most of them just lie there like a fish on a dock.” That did it! I about went through the roof! I heard myself snap, “Oh, I disagree!”

Unfortunately, the mother cannot “un-hear” that comment. Months before, the mother had verbalized to me her fear that her baby might not latch on. Now, this comment seemed to confirm that latch-on, at least in the immediate period, is unlikely.

“Moms get claustrophobic with a 7-pound baby on their chest.”

I sat there with my jaw hanging open. Claustrophobia is an anxiety disorder. I’ve never seen a mother become claustrophobic with her baby on her chest.

“We have plenty of pumps.”

The mother seemed to understand the importance of colostrum. She wondered what to do to get the colostrum if the baby didn’t latch. Why is a pump the first answer? How about trying again? How about skin-to-skin contact? (Listen to my podcast with Dr. Nils Bergman.) How about hand expression?

These days, it feels to me like the pump is the default solution for just about everything; the baby is optional.

Later, Gator

More than an hour after the baby was born, I still hadn’t heard a peep out of the “baby nurse,” or any other nurse. When I inquired, the staff told me, “Oh, we’re getting her settled.” I honestly wasn’t sure what to do next. Pushing might only inflame the situation.

So, of course, by the time I was “invited” into the postpartum room, the baby was about 90 minutes old. By then, of course, babies go into a deep sleep, as shown in that grand, 1966 landmark study by Desmond, Rudolph, and Phitaksphraiwan.

“We’ll make sure he’s happy.”

And there sat the pacifier on the over-the-bed table. Here’s this just-born baby, settled into a deep, quiet, motionless sleep, and someone has already issued a pacifier to keep him happy. Sigh…

Warm, but misinformed

Let me repeat that I perceived the nurse as warm, caring, and experienced. She could not possibly have realized that she sounded unsupportive of breastfeeding with the potentially detrimental comments.

I walked away feeling like the mother and baby had been cheated out of a great opportunity. Unquestionably, research shows that continuation of breastfeeding goes well for babies who suckle within that first hour or so of life.

Yes, the hospital had the Ten Steps posted on their wall. Although the nurse was friendly, her messages were unsupportive of breastfeeding, and were very inconsistent with the Baby-Friendly™ program.

No mother should hear such unsupportive messages. She, and others, might learn some helpful comments in my podcast with guest Tipper Gallagher, as she talks about  “Breastfeeding Advice Moms Need” that go beyond the “same old, same old” topics.

Do you work with people who say these things? Do they hear themselves?