Avoiding “Booby Traps” After a Hospital Birth

There are many decisions a pregnant woman makes about the birth of her child, yet it is the hospital she chooses that can directly impact her breastfeeding relationship. Why are some hospitals not as supportive of a woman's breastfeeding goals? What steps can you take to ensure you don't get booby-trapped?

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Episode Transcript

The Boob Group
Avoiding ‘Booby Traps’ After a Hospital Birth

Please be advised, this transcription was performed by a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]
Robin Kaplan: There are many decisions a pregnant woman has to make about how she plans to labor and birth her child. Yet, it is the hospital she chooses that can directly affect her breastfeeding relationship. Today, we are speaking with Tanya Lieberman an extremely well accomplished IBCLC in Massachusetts and author of The Booby Traps Series for the Best For Babes Foundation. Our topic today is how to avoid booby traps after a hospital birth”. This is the Boob Group.

[Theme Music/Intro]

Robin Kaplan: Welcome to The Boob Group, broadcasting from the Birth Education Centre of San Diego. I am you host, Robin Kaplan. I am also a Certified Lactation Consultant and owner of The San Diego Breast Feeding Centre. At the Boob Group, we’re your online support group for all things related to breastfeeding. Today, we are so excited to announce The Boob Group Club! Woohooo…. This is an exclusive membership club available to all of our listeners. It gives you access to all of our archived episodes and some written transcripts of the show plus a monthly newsletter with special giveaways, discounts and much more. You can access all of this great information through the web or through our new Boob Group App. For more information visit our website https://www.newmommymedia.com and click on the member’s link at the top of the page. Today, I am joined by three fabulous panelists in this studio. Ladies, will you please introduce yourselves?

Marie Kidder: Hi my name is Marie Kidder. I am a stay-at-home mom. My daughter Aurora is eleven months old.

Erin Esteves: Hi my name is Erin Esteves. I am 42 years old. I am in transition right now as far as my carrier is concerned and my son Cash is eleven months old.

Rachel Rainbolt: My name is Rachel Rainbolt, I am 29. I am a parent educator and author of the Sage Parenting Book and a full-time mom to three wonderful boys.

Robin Kaplan: Fantastic good ladies, welcome to the show!

[Theme Music]
[Featured Segments: News Headlines]

Robin Kaplan: So let’s kick off today’s episode with some unbelievable breastfeeding stories making headlines around the internet. All of these stories are posted on The Boob Group Pinterest board if you wanna check them out. So the topic today is from ABC news online and the title is-Adrienne Pine defends Breastfeed, classroom breastfeeding and so for those of you who don’t know who Adrienne Pineis, she is the American University Professor out of Washington D.C whose one year old was sick and they have a policy at her daycare that sick children are not allowed to go to daycare. On that day and it was the first day of class which is, if any of you remember from college that’s when you decide if you are actually going to stay enrolled in that class or drop it cos is not that interesting and so she teaches the class about Sex Gender and Culture and she figured she had to go to class that day, so she had to bring her baby and at that time her baby wanted to feed and so she decided to breastfeed in front of her class and she’s gotten a lot of interesting feedback both positive and negative and so I was just curious what you all would think if you were sitting there? You know, obviously, your presumption will be different as a college student as compared to now being a breastfeeding mom but, what are your thoughts on this?

Rachel Rainbolt: I have actually had a professor breastfeeding class before and I have had a professor allow me to bring my sick baby to class and I have breastfed in front of the college class when was I giving a guest lecture…. [Laughs]

Robin Kaplan: No kidding [Laughs]!

Rachel Rainbolt: All of my experiences is have been completely positive. I remember when I saw the professor breastfeeding it was a child development class and she was doing a segment on different birth options like home birth and things like breastfeeding as it was relevant to the curriculum and she had her daughter there and she breastfed her and nobody really battered an eye so much. It was just kind of role modeling what she was talking about….

Robin Kaplan: Yeah!

Rachel Rainbolt: And, then I think when my professor let me to bring my sick baby when I saw the article that was the probably the first thing that came to mind like paying it for cos I think I read in one of the comments like a professor would never let student bring a sick baby in class….

Robin Kaplan: Did you write back in?

Rachel Rainbolt: Yeah, I said actually my professor did [Laughs] and then I breastfed when I was a guest lecturer at a class over, that makes the college I was giving a presentation and my baby was really new at that time so he was in his little pouch and sleeping and nursing and making googly eyes at people and it was all positive.

Robin Kaplan: Yeah, that’s really interesting that you bring it up that one of the comments was that they would never allow a student to do that but they are probably way more breastfeeding moms in a class breastfeeding their children than we know off just because I mean we’re kind of out of it, now but it’s really that's a good point I like that, Erin how about you?

Erin Esteves: Well I think that it, particularly the subject that she was teaching…

Robin Kaplan: Yeah.

Erin Esteves: I would just kind of think it was part of the….

Robin Kaplan: The curriculum?

Erin Esteves: The curriculum, not necessarily- will not necessarily the curriculum but part of her philosophy or part of her, part of the entire ideology of the subject so, I think if I did find it awkward or uncomfortable I would be more introspective on as to why I felt that way as supposed to looking out at her and somehow blaming her and as I understand it, she did warn the class….

Robin Kaplan: Yeah!

Erin Esteves: She didn’t just like whip it out and announced….

Robin Kaplan: Yeah!

Erin Esteves: So they were prepared in some way.

Robin Kaplan: Yeah, how about you Marie?

Marie Kidder: Actually hadn’t heard about that, so it’s really interesting to me. I remember in college, we were out of the restaurant and there was a lady breastfeeding her child with the cover and I remember I was at the kind of prude. I was like,“oh my gosh, it’s so distracting. Why wouldn’t she just get up and go away” and now I have done at a restaurant many times with or without a cover and so it is very interesting how perception do changes now as a breastfeeding mom I would think that’s so great you brought your baby with you, that’s wonderful you know….

Robin Kaplan: How lucky you are?

Marie Kidder: I would really applaud them for doing that and I just think there are so many different people and everyone is gonna react differently, you know…

Robin Kaplan: Absolutely!

Marie Kidder: There is always a little bit of hype with everything, you know, everyone wants a reaction, I guess. [Laughs]

Erin Esteves: Absolutely!

Robin Kaplan: Well, and it's funny cos our most recent episode is actually about sex and breastfeeding and so the stuff that we talked about will be perfect for her class, talking about how sex and culture and how society perceives it and everything so….

Marie Kidder: Especially with college-aged boys there! [Laughs]

Robin Kaplan: Exactly, exactly [Laughs] so I mean, she figured that the topics that she gets into are gonna be very interesting and talking about sexuality and breastfeeding and exactly so….

Rachel Rainbolt: Well in this class being about Booby Traps that really speaks to the double bind that was put in where you’re supposed to breastfeed and you absolutely should breastfeed and you should be there for your sick children but then on the flip side don’t breastfeed and don’t be there and care for your children [Laughs] you kind of can’t have it both ways, if you want the societal norm to be for women to breastfeed then you have to have a culture that supports that!

Robin Kaplan: Absolutely, absolutely! Well ladies, thank you for sharing your opinions. That was very eye-opening.

[Theme Music]

Robin Kaplan: Okay, so today on The Boob Group, we are discussing “How to Avoid Booby Traps after a Hospital Birth”. Our expert Tanya Lieberman is an International Board Certified Lactation Consultant, a mother of two and author of the Booby Traps Series for The best for Babes Foundation. Tanya is also the writer and the producer of the Podcast for Mother Love Herbal Company. So, Tanya, it’s such an honor to have you on our show today, thanks for being here.

Tanya Lieberman: Thank you, it’s a pleasure.

Robin Kaplan: So Tanya I am anavid reader of your Booby Traps series for Best for Babes, but I realize that some of our listeners may not know what the booby traps are. So do you mind defining them, well how do you define a booby trap?

Tanya Lieberman: So the best for Babes Foundation defines Booby Traps as institutional, cultural and legal barriers that prevent moms from meeting their personal breastfeeding goals. So what does that mean? So, institutional things would be things like a hospital policy that are known to undermine breastfeeding. Cultural booby traps would be things like you know maybe the way our culture sometimes abuse nursing in public, or maybe it’s your mother bossing “you’re still doing that?” [Laughs] and legal barriers would be things like, you know, the fact that it is legal from employers to fire a mother just because she’s breastfeeding and the issue here is that, you know, often woman are being told to breastfeeding, told to breastfed and then set-up to fail. Moms, you know, frequently have to fight an uphill battle just to get evidence-based care that we have known works to support breastfeeding for decades. So, you know, I really think that until recently the focus is been on individual moms, you know, fighting the battles on their own. So it’s, you know, up until now it’s been kind of like a currency you need to know and good luck about…..

Robin Kaplan: Yeah!

Tanya Lieberman: And all the responsibilities for the outcome fell on the mom's shoulders no matter what she had to contend with. So Best for Babes is way to send it to tackle the booby traps these barriers head on behalf of all women who want to breastfeed and I can say things are getting better but just not fast enough.

Robin Kaplan: Sure, sure when we have a whole society come back when we are [Laughs] make it big changes then. For a pregnant woman planning a hospital birth Tanya, what steps would recommend that she take to ensure that she won’t be booby-trapped at the hospital?

Tanya Lieberman: Yeah, it’s a great question! I wanted to just make a couple of notes before I talk about that. The first is that I am going be talking a lot about research about what, you know, what research tells about breastfeeding. But, you know, of course, what research says and what an individual mom experiences might not necessarily be consistent. So, you know, research is the best way we have to understand what’s happening on a large scale. It might not be reflected in your own personal experience and the second thing I want to say is that the barriers that mom face can really depend upon on where you live in the country. I am a proud transplanted Californian listed [Laughs] and I can say that Californian as usual is kind of on a leading edge in eliminating all these barriers. So, you know, when I talk about booby traps I am gonna be speaking nationally and again that may not necessarily represent what you experience where ever you live in a country. Back to your question so, you know, probably the most important thing in planning in a hospital birth to ensure you’re not booby trap is really carefully picking your provider and picking your hospital. You know, you can fight through each of these barriers one by one but, it is just very difficult when, you know, you are in labor or you’re taking care of your baby and recovering.

You know, but if you can find providers that are truly breastfeeding-friendly including a really breastfeeding-friendly hospital, it will all just unfold in a way that supposed to happen. So the other thing that I think is so when you choose carefully you’re kind of voting with your feet and that helps to bring about change for moms in the future. So you know, talk about a bit about you know picking your providers. I have to say it frequently gets people upsets when we talk about the relationship between birth and its impact on breastfeeding but it’s you know, the research clearly says that these two things are very connected. So now picking obstetrician or a mid-wife and I think there’s you know, you can make a good argument that mid-wives are a really good choice, but picking from, you know, care providers for your prenatal period, your pregnancy and your birth you have strong tattered bow intervention birth is important though. If you can find providers who have low rates of induction, low rates of cesarean birth, low rates of epidural user, use of vacuum and forceps-if you are having a baby after having a C-section if you can find a provider who has a good and you know highly VBAC success rate but you know, those are all things that will help you get off to a good start. They also, you know,you are looking for a provider to load you up with formula samples starting with your first appointment [Laughs]…

Robin Kaplan: Sure!

Tanya Lieberman: But they do discuss things with you pre-natally hopefully a couple of times and they know where to refer you for breastfeeding help if you needed. Doctors notoriously get very little and sometimes no education in breastfeeding in their training which is another booby trap. So it can be hard find, next its really helps you have trained labor support at your birth- like a Doula or maybe a family member or a friend who have been trained about to help you, having a trained support person is going to lead to an average or lower intervention birth which will help you get off to a good start and then of course you know, it’s important to find a hospital which practices evidence-based medicine when it comes to breastfeeding. So, you know, that means they follow policies that don’t undermine breastfeeding. They do keep moms and babies together, they don’t supplement babies unless it is medically necessary. They have staff trained in how to help mothers learn how to breastfeed and they don’t load you up with formula way out the door and you know, ideally, this means birthing at a baby-friendly hospital. But, do you know what percentage of birth happens a baby-friendly hospital?

Robin Kaplan: Oh,my gosh! Is it like 3%?

Tanya Lieberman: Yeah, it’s improved a little, it’s 6%.... [Laughs]

Robin Kaplan: 6% okay! I knew it was under 10.

Tanya Lieberman: Its only 143 in our country, you know, compared to thousands in the other countries. So,, you know, it can be really hard. In California, I know not all through research on California, but for those who are in California really,you’re really lucky because I know they are committed to making all of its hospital either baby-friendly or kind of close to it in the coming years, so that’s a big step forward, but for moms living in other parts of the country its basically impossible to give birth in a baby-friendly hospital. Things are changing, there are lots of hospitals in the queue but right now it can be tough. So the next best thing to finding a baby-friendly hospital is to find out the hospital that follows the 10 steps to successful breastfeeding and that’s some, that’s the set up policy on which baby-friendly status is based. So, the problem is that it can be difficulty to figure out what your hospital actually does but I definitely recommend seeing at your hospital can answer some questions about their breastfeeding policies. You often get good information and recommendation from other moms or unless you meet a great leaders or lactation consultant in your community but you know, here’s the booby trap, keep in mind the less than 4% of hospitals according to the CDC follow at least nine under the 10 steps and only 37% follow even five of the ten, so this is a big booby trap.

Robin Kaplan: Absolutely, ladies did you research this information on hospitals and OB/GYN’s and Midwives before you gave birth? Rachel?

Rachel Rainbolt: Yes! Absolutely, I interviewed OB’s before I even became pregnant. When we decided we wanted to have one, we interviewed OB’s and kind of fielded all of those types of questions about honoring kind of our wishes based on the research that we did and found a provider who would support them.

Robin Kaplan: Yeah, how about you Erin?

Erin Esteves: Oh! absolutely, we, not only did I look for an OBG that had personal references for me but also one that was very open to my input. I didn’t want to have that kind of drive-through experience where I didn’t, where I was treated like a child in a sense just put through the emotions, so, absolutely.

Robin Kaplan: How about you Marie?

Marie Kidder: I did a lot research but more my husband’s a family Medicine physician, so he’s trained in OB and he delivers babies in a hospital and so I picked his brain like none other during the pregnancy [Laughs] and he definitely fights with a lot of OBs, where he’s at where they are little bit more C-section friendly, then he has a family medicine physician is and I did not want a C-section and my very good girlfriend is a post-partum nurse at the hospital that I ended up delivering at, and she loved her OB and her birth story was one where her OB let her push for three hours before they did eventually do a C-section cos she had a very large baby and so I mean her OB wasn’t like,“”Hey it’s been 30 minutes lets go, I got to go home for dinner and so that really made an impression on me and so that’s basically how I found my, interviewed a lot personal references as well as doing all my late night on my research trying to figure out what made sense to me, so I got lucky in that regard.

Robin Kaplan: It’s so interesting, you know, my kids are seven now and almost six and we’re the first of our friends who had children and I didn’t know research whatsoever [Laughs] and it ended up kicking me in the ass because, you know, it’s just I ended up having an un-necessary induction and a real interesting labor story and so you know, it definitely I loved being surrounded by women who actually they do, they do their research and I feel its empowered me to do research in other areas now I am not having any more children [Laughs] but you know, with the doctors that we choose we now asks questions a lot where we used to just say,“oh ok well the doctor told me to do this, I am gonna do it” and now we’re kind of that person who are saying well- why, why, why, why; we are like our five year old why, why![Laughs] but it’s amazing because if they can’t answer the why then I am not going to do it and so it’s really cool that a lot of woman are starting to look at these, even before they have had their children, cos I absolutely can be extremely… have different outcome so let’s just put it that way!

Audience: It’s not a small decision.

Robin Kaplan: No they are not…

Audience: Right!

Robin Kaplan: Exactly, exactly! Tanya, what are the most important things that mom can do to support breastfeeding immediately after her baby is born? And I realize all this is all most a loaded question only because they are so many things that she can do but, what would be kind of your top couple ones that really couldn’t, you know, affect breastfeeding if it’s not done appropriately I guess?

Tanya Lieberman: Yeah, so yeah, in that immediately really special time right after the baby is born, I feel like the most important things are to be in close contact with your baby, ideally skin to skin and to initiate breastfeeding, you know, have your first feeding in the first hour, those of these are really closely associated with later breastfeeding success. But, you know, here’s the booby trap, CDC study show that only half of the hospitals say that nearly all their healthy full-term babies born Vaginally are having their first feeding in their first hour, so in some cases moms kind of fight to you know, to really have that first feeding and that first really special skin to skin time. It’s also really helpful to delay the non-essential newborn procedures until after the baby and you’ve had the first feed. So it’s kind of like the first feeding is like priority one and everything else unless there is a medical emergency can really wait, and the American Academic Pediatrics says that you know, to delay the weighing, the measuring, the bathing, the blood test and vaccine, the vitamin K that I group all that stuff until after the first feeding and then when it is time to do that all that stuff can be done with the baby on the moms chest.

So the baby doesn’t need to leave the moms body in that really first special time. You know, as far you know what why don’t hospital do this, yet as in no matter of course, I think it’s you know mostly resistance to change you know they have done it other way where you risk the baby off to nursery or to the warmer or to the somebody else you know maybe it’s an outdated training or maybe its failure of leadership in some cases. I do think that skin to skin is becoming more accepted but there is definitely is still places where it’s not the norm. You know, there was some research about skin to skin in the nick cue or it’s even more important you know, that babies have that close contact with their mom and they can and what they’ve found at the hospital staff out the skin to skin would more work for them which you know I was thought that happy babies and moms may have less work for everyone. [Laughs]

Robin Kaplan: Yeah!

Tanya Lieberman: Maybe not… [Laughs]

Robin Kaplan: Well, and it’s interesting that you said even the AP is behind all of these delayed things until, as long as the baby is okay obviously, the mom’s okay but….

Tanya Lieberman: Yeah!

Robin Kaplan: But delaying all of this stuff until after the first breastfeeding session finishes up but so, if they are saying this already I guess there are not in the labor and delivery room [Laughs] but…..

Tanya Lieberman: And I think another thing that makes this a little complicated is that you know, basically one in three births now is by cesarean. So that, you know, that changes the whole first hour, you know, what happens in the first hour but, you know, Numbrith hospitals have shown that skin to skin is possible in the O.R and that it results actually in better breastfeeding right later on and the A.P- American Academy Pediatrics does say that the first feeding should still happen within the first hour of the cesarean, you know, as long as everybody is healthy and doing okay. So, it’s complicated because work has changed a lot but still it’s possible.

Robin Kaplan: Yeah, we have a, again like you said, we are really fortunate in California and even some of the hospitals in San Diego are really starting to move behind that after a cesarean birth that mom as long as she has a partner in there to make sure that the baby is safe on her chest, you know, while all the….

Tanya Lieberman: Yup.

Robin Kaplan: … other procedures are going on that she can start breastfeeding her baby, you know, even while they are fixing things up. So ladies, did you do anything during your labor and delivery that you felt supported your breastfeeding relationship with your new baby and how supportive was your hospital staff when you ever there, Erin?

Erin Esteves: My, the staff at the hospital was very supportive and that’s one of the reasons I chose that hospital. They are very mother-child friendly. So, they allowed us to do all of those things.They allowed us to not have the umbilical cord cut until it ceased pumping. They didn’t bathe him until he had been dried, you know, all of those things, they waited to weigh him, they left him on my chest, they actually let me pull him out.

Audience: Cool! [Laughs]

Audience: Yeah, that’s not too common…

Erin Esteves: Yeah, they let me pull him out and we did, we breastfed within the first hour. So and, as soon as I came in, the very first thing I requested was a lactation consultant. I knew that if I wanna get that I had to request it immediately and I had done so much research and I was positive that everything would be okay but, I thought it was best to have one there just in case and it turned out to be great that somebody was there. So, yeah! I was definitely empowered and calmed by the amount of research and support that I got from the staff.

Robin Kaplan: Oh that’s fantastic! How about you Rachel?

Rachel Rainbolt: Probably the most important thing I did was just to have it all in a birth plan ahead of time. So that way, it kind of took way a lot of the minute-by-minute battles that you have to make it- it’s just kind of here it is, it was discussed in advance. Everybody has a copy [Laughs] of how the child’s gonna be and basically the biggest thing in there was that baby wasn’t to leave my chest after he was born so he came out with place right on chest and never left and then I left the hospital. So, that helped a lot but also I saw a really marked difference between my children, when I had my son whose now seven when he was born he was placed on my chest and I wouldn’t take him off and about every hour a nurse would come in and fight with me and insist that he needed to be placed in the little plastic bed next me. They said the policy was that he was not allowed to be in the hospital bed with me or on my chest and they wanted to take him out of the room while I sleeping and we didn’t allow that to happen but, we had to I mean battle every single person that came in the room every hour. Whereas, with my third whose just nine months old, it was completely different. We had a care provider that supported all of that, all the nurses were supportive of all that and he was with us the whole time.

Robin Kaplan: How about you Marie?

Marie Kidder: My labor and delivery were a little bit chaotic. We did, my water broke, we did end up having Duratocin because nothing was happening. I was completely stalled out and eventually 30 hours later, they did wait a long time before they wanted a C-section because despite the temperature and my daughter did actually get pneumonia from it. So, the things that I wanted to happen like her going on my chest even with the C-section didn’t, during the birthing class when they talked about C-sections I totally tuned to that time out [Laughs-Audience] because that’s not gonna happen to me and I was completely unaware of how groggy you are and I think that’s cos I was very nervous and I think they shot me with some happy juice at the end of it cos he squired at something in the bag and I got really loopy. So I wasn’t a 100% with it, probably the first 12 hours after she was born and then at that time they were concerned about her breathing which is why she didn’t go on my chest right way and they took her to take a look at her and I don’t think it, I don’t even think we breastfed in the first hour and I think it might have been a couple of hours, I was just asking my husband before we came in and then they did end up actually taking her to a different hospital. So we had a lot of challenges in the beginning. The post-partum nurses, unfortunately,I didn’t get a lot of support with pumping right away until I asked for it. I remember the doctor actually came in and said, “she should have been pumping hours ago” and then in my groggy state I got coaching on how to pump and then later when I was a little bit more lucid I was able to talk to 2 lactation consultants and get the help. But, once we actually I was discharged and I got to go to children’s where she was at, the Lactation consultant there was fabulous and was total and the nursing staff as well were like here and let me show you how to latch her on. The hospital did let me leave before I was discharged for a 4 hours trip to visit her to help establish breastfeeding which was great.

Robin Kaplan: Oh that’s nice.

Marie Kidder: Which we did make a seven-hour trip but [Laughs]….

Robin Kaplan: Wow!

Marie Kidder: We got in trouble for that [Audience Laughs] but so they were good and bad with our experiences as far as the lactation support where it goes.

Robin Kaplan: Yeah, when we come back, we are going to discuss how to avoid common “Booby Traps” on the postpartum floor. So we will be right back.

[Theme Music]

Robin Kaplan: Okay, so we are back and Tanya, I know I cut you off before you wanted to answer Marie before you wanted to take a break. I know you had a comment. What did you want to say?

Tanya Lieberman: Actually, just for all your, you know, moms there, I am really impressed with how carefully they, you know, they researched and well brook, you know, the breastfeeding-friendly plans and, you know, just how self-off what they were about all this and I wholeheartedly supportive even doing that’s what I did was my birth too and I also think that the best for babes would say, you know, mom shouldn’t need a Ph.D. and Boobology. [Laughs] These things, you know,care that mom shouldn’t need to do all the researching and planning and be on the defensive and be on the offensive, you know, to they should be able to walk in to a hospital and be confident that the hospital is going to have procedures and routines and standards that are evidence-based, that doesn’t undermine breastfeeding, that will help them get off, you know, get off to a good start with breastfeeding.

Robin Kaplan: Absolutely I know, we, like you said in the beginning, we have come far but we have really long way to go off. If we have to do this much research to make sure that we have a successful birth and breastfeeding situation, we still have ways to go. Tanya, to talk about kind of the post-partum floor after the baby is been born, I have read a lot of articles lately that promote laying of baby’s first bath and not even just after the first breastfeeding session but actually even, you know, a couple of days. Why would this help nurture the breastfeeding relationship?

Tanya Lieberman: Well, there are several reasons, well first, you guys think about how you feel when you step of the shower- cold right [Audience Laughs] we all feel cold but you know we can regulate the temperatures pretty well but babies really hard time doing that and so, if you bathe the baby, they are at higher risk of hypothermia and Hypo Thermia often leads to babies spending time in nursery under warmer, away from you and if you have noticed, you know, stretched down hallways and corridors and under doors [Laughs] you know it just makes breastfeeding harder if you are separated from your baby and that it is more likely to happen if they get, if the temperature is not well controlled and the second thing is, it’s kind of you know, the babies are born with instincts to seek out the breast and to have that really important first feeding and some of those, some of the cues are based on smell, the way the baby’s smells and the way you smell. So if you take the baby away and you bring them and they smell like Johnson baby shampoo,it really [Laughs] you know, it changes that system and it kind of interrupt, it can interrupt this whole really in kind of miraculous sequence, the behaviors that enfolds in that first hour and so that’s another reason and, you know, those are some of the reasons why that the American Academy Pediatrics and your own Californian dept. Public Health says that you know look the newborn bathe should be delayed in order to focus on the important things like skin to skin contact, learning how to breastfeed, you know, so wiping down the baby is fine but in early bathe can really undermine breastfeeding.

Robin Kaplan: Okay, in addition to that what are your biggest tips for avoiding Booby Traps once a mom is in her hospital room with her baby?

Tanya Lieberman: So first, you know, keep your baby with you as much as you can. You know, It’s just harder to get breastfeeding going, you know, if your baby is down the hall and its easier for babies on your chest. So, we know I know you're tired, I was tired [Laughs] but keeping your baby in your room really gonna help. Unfortunately, here’s the booby trap again, see the CDC says that only 33% of the hospital says that all of their healthy full-term babies stay in their rooms with their moms and that’s really just a shame. So, keep your baby with you, do as much skin-to-skin contact as you can, its wonderful for a whole range of outcomes with your baby. Third, you know, take time to focus on learning how to feed your baby and you might have to fight for uninterrupted time to do this. There was one study that showed that moms are interrupted by the combination of hospital staff and visitors and phone calls, 54 times in the first day on average and the most common duration of time a mom had to learn with her baby was one minute [Laughs] so you don’t want your room to be grand central station. If you can, you know, put a file on the door or station your sister or your partner, two people by so you get the time to focus on learning how to breastfeed. Get help from a lactation consultant if you can, if your hospital offers the services of one and if they don’t, ask, you know, which nurse on the shift is really good at breastfeeding and they will know and they hopefully get someone in to help you, if you feel like you needed. You know, don’t use the pacifier, don’t ask for supplements unless it is medically necessary and that you know, that’s something you discuss with your provider. Once you go home, you know, before you go home make sure you have the referrals for support once you go home whether that means, you know, how do I come back to the hospital for help or where do I go in the community for help and if you are offered of formula gift bag on your way out, you must say, “No thanks”. Those are some of the things that I think can help.

Robin Kaplan: Okay, thank you! Ladies, how was your hospital stay after your baby was born? Was breastfeeding encouraged? I would assume being in California but that’s not always the case as well as were there any anything’s that made breastfeeding more difficult and I know Marie somewhat different just cos you’re a little one wasn’t in the room with you so but Erin, how about you?

Erin Esteves: Everything was very pro-breastfeeding for me. But I find it really interesting going back to what time is that earlier because just a few months ago my niece had a child in the same hospital and her birth experience was very different than mine. I mean, it was like night and day, and it was solely because I was demanding. I was asking of these things and she didn’t get any of those things because she didn’t ask; but yes, they were very supportive in breastfeeding, they knew I wanted to breastfeed. They very shortly afterward when they moved me to the other room, they brought in a pump, they said okay, you know, this is, if your milk could- this will help your milk come in. They showed me how to use it, all of that stuff, it was really, really fabulous and I did see 2 lactation consultants in my three days at the hospital and they made sure that I had support and formula when I left, so..

Robin Kaplan: Okay, [Laughs] how about you Rachel?

Rachel Rainbolt: Well kind of like I said, there was a big variation between having three kids, between the three births. My most recent one was great. I think a lot of that was because I mean, I was super prepared and this is my third time around. We hired a doula and a huge part of her job was just to run interference between us and the hospital staff like space between forced our wishes and to have an OB who already has a standing policy not to give formulas to his patients, not when we are in the hospital, all those kinds of things were really, really helpful. So we had a really wonderful experience, we had the lights off, we got to sign on the door to say this to stay out unless we’ve been requested to come in, you know, all that kind of stuff. Whereas with my first it was totally different. They were trying to give him formula constantly. They were trying to give us a formula. They were trying to keep us separated and it was exhausting. It was like a war [Laughs] to try to get him to stay with me and I remember this moment, at one point it was in the middle of the night and I was breastfeeding him and my eyes were closed and I was relaxed and nurse came in and try to really put her foot down and say he cannot be with you in this bed during the night and I looked right in the eye and I said,“you will pry this baby out of my cold dead hand”. [Laughs] That was like a kind of moment where was I like-this is ridiculous, the baby is happy, I am happy we are both healthy, why is everybody fighting this so hard. So I am glad that it has come so far at least an our neck of the woods but I just, we love for, to see things change more so that every mom doesn’t have to battle so hard, cos not every mom is able to battle as so hard and knows all of that stuff going intoit.

Robin Kaplan: Yeah, how about you Marie?

Marie Kidder: I think a lot of it for me it depended on, so, we are in the hospital for nine days, I was at my hospital for three and then I joined my daughter at Children’s and she was in there for a totally nine days. Basically, she was fine, she just needed antibiotics to get over pneumonia but it really, really varied from nurse to nurse. So once I was able to get to Children’s which was fabulous and I told them that all I was really excited about nursing, I really wanted to make this happen. They had already started to give her formula because she was ique-baby and the idea I think that she needed those extra calories which at the time I was like,“hey she’s sick, give her what she needs but I am gonna pump and once I have enough breast milk that’s what she’s gonna take” and they were completely for that and it wasn’t very long before I was providing enough breastmilk pumped to give her in the bottle if I wasn’t there. After I was discharged for 2 days, I think the biggest thing that helped was the lactation consultant they had got me permission to room in because at children’s especially in the nick cue parents don’t sleep in the same room as their baby’s you have to go home and that was the most heartbreaking thing for me to be separated from her for three days to her, all the other babies in the hospital were with their mommies and my baby wasn’t with me and then once I got there to be told okay you need to go home and rest and I understand logistically there is no room for an adult bed the way that the nick cues were set up but, once she was in a less intensive level of the nick cue, there was an opening available in the corner room and the lactation consultant said if you want this I can make it happen. It’s a new thing I am trying to push for breastfeeding moms and she got basically one of the daddy’s pull out beds from labor and delivery and that was my bed for the next four days and I think I didn’t have to pump thank god [Laughs] cos I hate doing that but I got to be with her 24 hours a day in those crucial times and I got to really work on a latch and making breastfeeding successful so it was a, I think she was only on formula for the first maybe four days. So after I was with her, we were able to go 100% breast milk. But as far as like, you know, I really think a lot of it is the nurse that you get because especially the overnight nurses, a lot of them were floating in from different departments and because my baby was one of the healthier babies in the nick cue, and she was trying to be really nice, she was trying to let me sleep so instead and I guess, I didn’t wake up that time that my baby woke up and she gave her formula which I had breast milk in the fridge, so the lactation consultant was actually another again advocated and basically made sure to let her know that one breast milk is available that’s what you give the baby over formula but really just wake up mom when moms there and…..

Audience: This was she was sleeping

Marie Kidder: Yeah, I changed the diaper, I fed her and I did those things because that’s what I would be doing at home. So we had a rocky time but I think a lot of it had to do with the support I got from the lactation consultant who was advocating on my behalf, cos I wasn’t sure what was allowed in the nick cue, so to speak.

Robin Kaplan: Sure, and Tanya you know, all three of these ladies mentioned formula supplementation, so and a lot of moms actually don’t know what is considered medically necessary and so how would a mom know if its medically necessary to supplement her baby with formula while in the hospital?

Tanya Lieberman: Yup, yup so just the right [Laughs] you know, I think you guys you kind of described this. I mean, there’s a big booby trap here that CDC says that nearly 80% of hospitals say that they supplement breastfed babies with formula when it’s not medically necessary except for no medical reason. But yeah, so how do you know? Well, there’s an organization called Academy of Breastfeeding Medicine that has protocols for when to supplement, when you know,a whole range of issues about breastfeeding but in an organization and suggestion towards having expertise in breastfeeding and they, what they say it’s really rare for the babies to need supplementation in the first 24- 48 hours of life which is of course the time in the hospital, but you know, indication are medically necessary supplementation are mostly weight loss and excess of 10% of birth weight accompanied by signs of dehydration, things like lethargy, you know, poor feeding and when it can’t be improved by skilled breastfeeding help so what a mother might see that the baby will not feeding well, you know, a lot of times are babies born little early just tire out of that the breast after few sucks and they have lost more than 10% and things seem to be improving even after they get help from the lactation consultant, that might be the time. Another time might be you know the 10% weight loss above that in-conjunction with the signs and also milk coming in late so not you know, not arriving until, milk not coming until they are 4 day 5. So you know, the 10% less figure than the quarterly that means to be viewed in the contacts to help the baby doing otherwise and also let her some skilled help show you things that are moving in right direction hopefully gonna say that ringmaster is a little tricky right now because of some recent research is really interesting and has been showing that when moms gonna a lot of IV fluids during labor and you guys I don’t know if you any of you had cankles, I did [Laughs] you know like your feet in your ankle swell up like crazy but when that happens you have a lot of IV fluids on board babies are often born with excess water on board too which they, you know, naturally inappropriately shed in the first 24 hours just to bring ’em back in the normal state but if you record the birth weight of that waterlogged birth weight than 10% loss of weight can happen when actually things are totally fine. So, I think,you know,it’s confusing things it’s…. for a long time it’s confusing but the research is coming out now that there’s really highlighting that’s when I think here about more about that in coming years.

Robin Kaplan: Well fantastic! Well, thank you so much Tanya for your advice and expertise on avoiding Booby Traps after a hospital birth and don’t forget to follow Tanya at https://www.thebestforbabesfoundation.com and https://www.motherloveherbal.com Thanks so much Tanya.

Tanya Lieberman: Thanks Robin.

[Theme Music]
[Featured Segment: The Best Online Breastfeeding Resources]

Robin Kaplan: Here’s Amber McCain with another tip for agreed online breastfeeding resources.

Amber McCain: Hello Boob Group listeners, I am Amber McCain, an International Board Certified Lactation Consultant and the owner of Nourish Breastfeeding Support just outside of Washington DC. I am here to answer some of your most common questions when it comes to finding quality breastfeeding resources online such as Google is a cutting edge, where can I find some face-to-face support. Even though I distinctly remember Quote,” the day internet came to town and my college, I would consider myself a digital native. I tend to check my e-mail before even get out of bed and my online life sometimes gets in the way of our life. Even before my first child was born, I went straight to the internet for information and support but as wonderful as its help was, it simply couldn’t replace sitting face to face with another breastfeeding mother who’d tell me. You can do this, but finding that kind of support can be confusing. I needed quick and easy access to schedule and locations for such meetings.”Ensure Breastfeeding USA, they are a new and growing mother-to-mother support organization that recognizes that you the breastfeeding mother are online and also need in-person support, to help you long and engage you on Facebook and Twitter. Check them out https://www.breastfeedingUSA.org and click on the find the breastfeeding counselor button. Thank you for listening, I am Amber McCain and I would love for you to check out my website https://www.nourishbreastfeeding.com for more information about my business and the little bit about where you are connected with great online breastfeeding support or you can join me on my Facebook page https://www.facebook.com/noursihbreastfeeding and if you have great online breastfeeding resources you like us to know about, please send me an email to amber@nourishbreastfeeding.com or share it on Boob Group Facebook page. Be sure to listen to the Boob Group each week for more fantastic conversations about breastfeeding and how to find great breastfeeding support.
Robin Kaplan: Thank you to all of our Listeners. I hope you’ll visit our website https://www.newmommymedia.com to add your advice in the comment section of this episode about your experiences with breastfeeding after your hospital birth. If you have any questions about today’s show or the topics that we discussed, call our Boob Group Hotline @ 619-866-4775 and we’ll answer your question in an upcoming episode. Coming up next week we’ll be talking about when breastfeeding doesn’t go as planned. Thanks for listening to the Boob Group, “Because mother’s knows breast”!

[Theme Music]
This has been a New Mommy Media Production. The information and materials contained in this episode are presented for educational purpose only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. For such information in which areas are believed to be accurate, it is not intended to replace or substitute for professional, medical and advise or care, and should not be used for diagnosing or treating healthcare problem or disease or prescribing any medications. If you’ve questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.

[00:44:05] End Of Audio.

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