Sunday, July 8, 2012

Everyday Advocacy

How I'm meeting one of those first resolutions, the one about doing more in my community for mothers and new babies--a recent letter sent to a local hospital:
I recently learned that the lactation program at Singing River Hospital in Ocean Springs was eliminated.  I am extremely concerned about the ways in which this will reduce the quality of care for new mothers at your hospital.  This is a worthwhile program.  Every hospital that provides services for birthing women needs a highly-trained and experienced lactation staff.  Almost all new mothers plan to breastfeed, but very few make it to their own goals.  A recent study published cites unnecessary supplementation in the hospital as the number one undermining factor. 

I do understand that our current economy necessitates tight budgeting and review of all programs for improvement and efficiency.  There are several easy, mostly free ways to decrease costs in the LDRP programs.  As you will see on this mPINC survey, the CDC agrees with my suggestions.

Healthy newborns should be placed skin-to-skin with their mothers immediately.  All routine newborn procedures may be performed this way easily.  All babies, even those born by cesarean should be nursing within the first hour of life.  The neonate’s instinct to root and suckle are strongest in that first hour to two, so delaying skin-to-skin contact results in a missed window of ideal breastfeeding initiation. A baby who is given formula, or artificial breastmilk substitutes according to UNICEF and WHO, or glucose water is likely to have a harder time latching appropriately to the breast to express its own mother’s milk.

In Memphis, TN and Jacksonville, FL where I have lived previously, mothers who give birth by cesarean are offered lactation support in recovery and never separated from their babies.  I have not seen or heard of this anywhere in the state of Mississippi.  Immediate skin-to-skin and unlimited access to nursing on demand are the standard of care in states whose overall healthcare outcomes far exceed our own.
Well-baby nurseries are unnecessary, undermine breastfeeding, and require costly additional staffing.  Healthy mothers and babies should room-in.  As the mPINC survey shows, 0% of MS hospitals report healthy newborns being with their mothers for 23+ hours a day.  This is shocking and upsetting to me.  I was not ever separated from either of my two children, both of whom are extraordinarily healthy and breastfeed well over their first year of life.  The hospital at which my first child was born did not even have a well-baby nursery.  Their staff truly supported breastfeeding.

The “transition” period should be an in-room service.  Science consistently confirms that neonates, even preterm babies, regulate both breathing and temperature best when placed skin-to-skin with their mothers.  In addition, they are first colonized by bacteria from their mother’s skin rather than what happens to be floating about the newborn nursery.  Namely, they thrive while infants routinely separated from their mothers experience greatly increased stress.  There is no reason for healthy babies to be separated from their mothers for up to 4 hours.  In fact, research supports eliminating routine separation of healthy mothers and babies as the ideal way in which to support the mother-baby dyad.

Staff should be truly trained in lactation support.  Nursing school does not provide adequate training, nor does any program sponsored by a formula company.  We are so close to New Orleans, where the annual Gold Standard conference convenes and literally world-renown breastfeeding experts share their knowledge and experience in teaching workshops.  Key staff should attend that conference.  Several groups offer breastfeeding specialty workshops designed for nurses.  There is no excuse for hospital staff not to be better trained to support the needs of their mothers and babies.

These changes and strides towards evidence-based care would drastically impact the number of mother and babies who enjoyed the often hoped for exclusive breastfeeding relationship.  It would, thereby, positively impact the patients of your hospital and families in our community both in terms of physical and emotional health. 

I am very concerned at the lack of breastfeeding knowledge and support within the hospitals of the Mississippi Gulf Coast and our great state at large.  I am committed to serving the women around me through support and education, but I cannot do it alone.  Eliminating lactation at your hospital is a step backwards.  I would be so proud if any of the Singing River hospitals began to implement the UNICEF/WHO Baby Friendly Hospital Initiative.  Mothers in our area would absolutely change care providers willingly to receive care at an officially designated baby-friendly hospital. 

Thank you for your time, and I look forward to hearing back from you and working together to enact positive change.  I am happy to schedule a meeting to brainstorm ideas on this subject or provide you with additional resources and research.  Also, if it would be best to contact another individual in regards to this problem, please let me know.
Sincerely,
Kate Fillingim, LCCE
Additional resources for your perusal:

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