Friday, April 9, 2010
Oompa Loompas Don't Breastfeed
Because Baby F. was born at a birth center, he had to be seen within 24-48 hours by his pediatrician. Luckily, the office was able to squeeze us in the day after he was born. Everything was fine....except Baby F. was taking on a orange hue. The pediatrician was worried that he might have jaundice and sent us over to the hospital for an immediate biliruben lab test. The lab test came back alarmingly high for a baby only a day old--17--which meant Baby F. had to be admitted straightaway to the hospital and be started on phototherapy.
So started 4 draining days and nights at the hospital. Initially, I was told I could continue breastfeeding (which he was doing like a champ), however, when the second test showed that his biliruben levels had increased to a 20 and that he was very dehydrated (my milk hadn’t come in yet, and all Baby F. was getting so far was colostrum) the nurses indicated that I could not continue to breastfeed. Breastfeeding wasn’t giving him enough liquid and it was keeping him away to long from the lights. I instead had to drown him in formula (much quicker) and place him immediately back under the lights so that he would start excreting the broken down biliruben. Every two hours we had to rouse Baby F. from his jaundice and heat induced torpor and force an ounce of formula down his throat.
As we started seeing results (aka wet and soiled diapers) and a decrease in biliruben levels, my thoughts went back to breastfeeding. How was I going to encourage my milk to come in if I wasn’t breastfeeding? How was I going to feed Baby F. if I had no milk? Especially if he was used to such frequent and large feedings? I asked the nurses. “Oh, it will be fine. Don’t worry about it” was the reply. I was also worried about Baby F.’s ability to latch on after bottle feeding for a while. Again I was told “it won’t be an issue.”
I decided that the nurses were idiots.
I realized I had to be very proactive if I wanted to successfully breastfeed after Baby F.’s jaundice was under control. The nurses I had encountered so far were not going to encourage any efforts. I requested to have a breastpump so that I could express milk. Not only would this encourage my milk to come in, I could supplement some of the formula with my own milk. I had to make the request three times before one was actually brought to me. I got the distinct feeling that I was being placated and that my frequent questions regarding my ability to breastfeed my baby were unreasonable and unwanted.
Luckily, nurses change shifts often in a hospital. The next group of nurses were much more pro-breastfeeding. I could, for example, express breastmilk and supplement with formula versus feeding formula and supplementing with breastmilk as I had been doing. I was also told that I could try breastfeeding again. I could wrap him in the biliblanket while I was feeding him so that he was still getting phototherapy. It was a night and day difference. It was also incredibly frustrating. Why wasn’t I told this before?! Why wasn’t I told of my options? (i.e. breastfeeding with the biliblanket. breastfeeding under the lights, etc.)
So, I went back to trying to breastfeed (while still supplementing with formula as needed). However, I was right to be concerned about maintaining breastfeeding. The first time I went to breastfeed Baby F. after a couple of days of strictly bottle feeding, he had trouble latching on. He just didn’t want to work, and I got all panicky. I asked the nurse (one that seemed more amenable to breastfeeding than some of the others) what I could do to encourage a latch. She gave me a few pointers. Thankfully, Baby F. was much more alert during his second feeding and was more inclined to give breastfeeding another go. After that, we had no problems.
The stint in the hospital left me with a sour taste in my mouth. While I realize the danger that Baby F. was in due to his high biliruben levels and the necessity of hydrating him quickly, I was really upset at the lack of foresight shown by a lot of the medical staff (this includes the Doctors to some extent.) Breastfeeding, when done correctly, can really help decrease jaundice as breastmilk is a natural laxative. Also, everyone knows that “breastfeeding is best” and should be encouraged. The medical staff should have been promoting an smooth transition from formula to breastmilk once the biliruben levels were showing a decrease. This, however, was not the case.
Towards the end of my stay I had a conversation with one of the more competent nurses. She told me that I was the mother of the fourth “bilibaby” in a two-week time period that got the impression I couldn’t breastfeed. “Where did this impression come from?” she asked. I told her of all the unspoken cues: the unheard request for a breastpump, the disregard of my breastfeeding questions, the repeated mantra to feed Baby F. with as much formula as he will take, the insistence that breastfeeding took away from his phototherapy, etc. All together it stated a pretty clear message: Do not breastfeed! She then told me that I was the only mother of the four who was able to get her baby to successfully latch on again prior to being discharged from the hospital. I attribute this to my “breastfeed or perish in the attempt” attitude. However, I worry about all the other mothers who leave the hospital thinking that breastfeeding isn’t an option for them.
One of the nurses who attended me and Baby F. was also taking classes in midwifery. She has great plans to establish a birth center in our area (as the other birth centers are hours away). She was worried that this experience (Baby F. having jaundice) might scare me away from birth centers. (I was a bit confused by this. I guess she was thinking that Baby F.’s jaundice might have been picked up on earlier in a hospital setting.) However, I told her that if anything, this experience has just confirmed that I made the right decision. There was nothing in this ordeal which made me wish that I had given birth at a hospital. It instead just reinforced my dislike of the place.