labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Sunday, December 16, 2007

Rebirth of Slick

Speaking of breastfeeding, I thought I'd share a postpartum nursing secret with you all.

You know when you were exhausted after giving birth, and it's now 3AM and your baby is still fussy after 4 hours of cluster feeding (or lack of breastfeeding, or difficulty with latch.... insert breastfeeding problem here)? And then the nurse offers to take your baby to nursery so that you can get a couples hours of uninterrupted sleep?

Well, she's likely giving your baby some formula to settle him down and get him to sleep. Did you really think that when you woke 4 hours later and are told that your baby settled right down in the nursery that it was just sheer miracle? No. It wasn't. It was because he was given formula.

When I first saw this happen as a new obstetrics nurse, I was shocked. How could a nurse do this? I thought this was awfully ballsy, to say the least, and something that I would imagine could get the nurse in a lot of trouble if found out. It is never something I've done, although as I gained more experience I could understand why it was done. You've got a mom who is about to lose her mind, a baby that won't settle down and has worked himself into a fury, and a nurse who doesn't want to spend hours trying to get a crying baby onto a crying mother's breast. For those who give this secret formula feeding, it's a win-win situation. Baby's happy, mom's happy, and nurse is happy.

And for those who have allowed the nurse to take the baby to the nursery only to have him return within 20 or 30 minutes, you can rest assured that likely she didn't give him the secret formula. She probably tried rocking him, swaddling him tight, burping him, or pushing him around in the crib (for the vibration) with no success.


Anonymous said...

No Mam, not at my hospital. We try everything but... even our vibrating swings, which usually do the trick, or a stint naked in the radiant warmer... et this is ONLY if mama is at her witts end, and we are asked to keep babe in the nsy. We only resort to sugar water if mom gives permission! How can a nurse sneak formula... a baby will eventually spit it up or burp the evidence... that is grounds for a write up at my hospital!

Michele in Michigan said...

I have to disagree with this. I work nights and often encourage a mom to let me care for the baby between feedings if she has "hit the wall." (You know the ones--crying, eyes propped open with toothpicks, all the lights in the room are on...) None of us would ever give a baby formula withour being told to do so by the parents.

I think that in our facility, we have a very cohesive nightshift team. When we are not busy with our mommas/babies, we all go into the nursery to care for the babies. We are fortunate to have rocking chairs, which we utilize heavily. We also use & teach Harvey Karp's "Happiest Baby on the Block" techniques to new parents. The video is on our pt ed channels.

Personally, I find that the babies sleep well with all the noise & activity in the nursery. It was an extremely noisy place in utero, the babies are delivered & everything is much more quiet than s/he is used to.

But sometimes the babies DON'T sleep; but if they are content they stay with us. We never let a baby cry for very long--we get to them asap. But if I can settle a little one down, s/he stays. If baby is unsettled, s/he goes out to nurse

Also, a major difference is in perception of "slept well." WE don't react to every whimper or sound from the babies, but the moms DO. We pass by a crib, see a wiggler or hear a whimperer (of course we eval to see if it's something that needs attention) & can "triage" it. Moms see or hear the same things & immediately think that the baby needs to be picked up or fed etc.

I have had moms tell me to formula feed, but I tell them honestly if I think Peanut needs it or not. I explain "brown fat" to them. I also tell them that baby may only need a tsp or 2 ONCE to "top his tank off" after nursing. This is done by cupfeeding here. Rarely does a baby need more than 10-15ml. I want that baby to nurse again in 2-3hrs, which usually won't happen if they get more.

We are respectful of parents' wishes. It isn't always easy, but we DO want to stay out of trouble ;)

BTW, I enjoy your insight!

Labor Nurse said...

I'm glad to hear other's experiences are different. I have worked at several hospitals and have seen this at each place. It wasn't every nurse. It was certain nurses, and from my observations they were older nurses who started their career when bottle feeding was the norm.

Anonymous said...

I also am somewhat offended that you suggest this is a common practice. At my facility, this would never be done and don't believe I have even heard it suggested. This would so undermind the trust the pt. has in the hosp. staff.

BrooklynGirl said...

No offense, but new mothers have just given birth--they have not been lobotomized.

I don't know anyone who would send a baby off to the nursery without inquiring as to what would be done with the baby there.

With #2, I sent the baby to the nursery for one feeding per night so I could get some sleep, and I had very detailed conversations with the nurse about how much she'd eaten, what brand of formula, etc.

Labor Nurse said...

I certainly not condoning this; I do understand why it would be done. I would not feel right doing it, however. Anonymous, I agree that it undermines the trust. I'm glad to hear that it doesn't occur where you work. This issue has been brought up in staff meetings and nothing was done about it other than management saying we are not to give formula without mother's consent.

Brooklyngirl, you'd be surprised the number of mothers who do allow someone to take their baby from their room with little explanation. I once was recently in with a mother having a lengthy conversation; the nurse's assistant came in to do a hearing test on the baby. She briefly said she was taking the baby for a hearing test and several minutes after she left the mother asked me what it was they needed her baby for. Not everyone is on top of their game after giving birth, rightfully so.

Sarahthedoula said...

I doula-ed at a birth where not only was the baby given formula against the mother's explicit wishes, but the nursing staff lied about it. This was at a 'breast-feeding friendly' hospital! Since this was the only birth I've attended at that hospital I can only hope (In a sad sort of way) that this is not their standard, but that the prejudices which they had toward my client were the cause (Ie they thought they were doing Mom & baby a favour).

I have also worked with many Mom's who had their baby whisked away with little or no explanation. The whole hospital system is designed around patients complying; not asking questions but doing as they are told. While some have the fortitude to stand against this, many other women really believe that the hospital knows best and they should just allow them to do whatever they want. This happens during the labour and delivery, and it continues through the postpartum hospital time as well.

Oh the stories I could tell.... but I'll step off my soapbox now.

OBRNinNE said...

I have seen this, so I won't pretend it doesn't happen. However, I still encourage parents to take the rest if it's offered, but to make it clear that they don't want formula or pacifiers by prominently displaying it on the crib. Also, I encourage them to make it clear that they want to be woken up for feedings. If I see it happening...I always say something. It's not made me popular in the nursery (I'm primarily a labor RN), but as a former nursing mom who tried not to send my baby to the nursery at all out of fear of this, I get really fired up. I've seen them use sucrose water, too...and not only is it's against policy. If I'm in charge and it happens, I won't hesitate to write them up. I cannot figure out why so many nurses sabotage breastfeeding. A coworker and I were talking about a study of this.

I am a Monkey's Momma said...

This post makes me glad that the only time my newborn spent in the nursery was fully supervised by my staunch pro-breastfeeding husband. I swear...makes me so glad that, barring a life threatening emergency, I will never give birth in a hospital again.

CrazyRN said...

I'm always mortified when I hear of these kinds of stories happening. Do those nurses who are giving formula think the baby will never spit it up? Wow..I'd sure like to see them explain to the new parents why the baby is spitting up white stuff! LOL!

I've cup fed sugar water before if the mom requests, but most times I'll sit in the rocker in the nursery with the radio on. They usually settle down pretty quickly, sometimes for 3-4 hours, and I haven't given them a drop of formula.

Plus, I agree, I remember when I was a new parent. I was hypersensitive to the noises my babies made. I don't think I rested well until they were a year old! LOL!

Jill said...

I was so tired so I told the nurse she could take my newborn son to the nursery. I told her more than once make sure to bring him back to eat, and do not give him a bottle or paci. 8 hours of gorgeous sleep later I awake in a panic, where is my baby! I call the nurses station and they bring him down wide eyed and perfectly content.

"Did you give him a bottle?" I ask


"Did you give him a paci?"


A million dollars says they gave him formula. I can't stay too made though I ended up nursing him for 16 months, and that 8 hours of sleep was incredibly blissful!