I was excited to see this issue addressed at Best for Babes, because it is something I have seen over and over in pretty much every hospital birth I’ve attended as a doula.
When a woman hears one thing from her L&D nurse, another from the baby nurse, and still another from the lactation consultant, it is no surprise to see her and her baby battling uphill to do something that they were both designed to do. The amount and quality of training for the many professionals women encounter during the birth and postpartum period in the hospital varies widely. Then, there are the individual experiences of the women in the profession that – like it or not – color the advice they give.
It can make a woman’s head spin!
As a labor doula, I see so many women go from a sense of satisfaction in their labor and birth, to frustration and discouragement in the immediate postpartum period. One thing I hear all the time from these mothers is this very complaint: inconsistent advice. I’m there to help with initial latch, but I am always upfront that my training only extends that far, and for any issues they come across, they need to speak with a lactation professional.
I have begun sharing some basic tips with my clients before I tuck them into their bed in the Mom & Baby unit, in the hopes of mitigating this factor somewhat. I have seen some good results, but until some truly fundamental changes are made in most hospital lactation departments, these results are sadly limited. I find my role gravitating more and more to peer support and referrals to independent professionals.
In the interest of making even a small difference, I would like to share a little bit of advice I give to many mothers who are planning to breastfeed their babies. The most fundamental piece of advice I can share is this:
At the very least, request to see the same consultant throughout your hospital stay. This will help streamline the advice you’re given, as the consultant will have helped you from the first, and will be familiar with the options you and your baby have already tried.
Also, decline advice from anyone who is not from the lactation department, as you can have no guarantee of what they are basing their advice on. Smile, nod, and let them go about their business as you do what you think is best. And for heaven’s sake, don’t let them grab your boob and shove the baby’s head in! Babies don’t need that much “help.”
Take an independent (i.e. non-hospital), evidence-based breastfeeding class, if at all possible, especially if you have never breastfed before. Watch a lot of good breastfeeding videos (check out Dr. Jack Newman’s website).
You can also take a good breastfeeding book to the hospital with you, and consult it as needed while you’re there. Here are three great ones: The Womanly Art of Breastfeeding, The Breastfeeding Book, or The Ultimate Breastfeeding Book of Answers.
You also may consider scheduling an appointment to meet with the head of the lactation department before you give birth, and ask about the qualifications, training, and philosophy of the consultants who work in your hospital. If possible, find one you seem to line up with in philosophy, and request to wait for her shift before getting any lactation advice in the hospital.
Consider your place of birth. Revisit the idea of an out-of-hospital birth place, especially if your hospital is not certified Baby-Friendly. I have yet to see homebirth moms struggle quite as much as their hospital counterparts, no matter how great the birth was. When moms and babies are comfortable, uninterrupted, and given support, they tend to have far fewer issues – and this does not really happen in the hospital, despite the kindness and good intentions of the hospital staff.
Side note: Most midwives have decent training and experience in breastfeeding basics, but if there is an issue beyond that, please turn to peer support you can find in La Leche League, or an IBCLC, stat!
Last, but not least – if you still feel the hospital is the best option for you: Did you know that you can opt to sign an AMA (Against Medical Advice) form, and get home early!? As long as both you and baby are healthy, you should be free to leave the hospital within several hours of giving birth, and try this breastfeeding thing at home in your own bed! I highly recommend this option if your hospital is known for anything that is not baby-friendly, especially if they make a habit of separating moms and babies in the early postpartum hours.
One last note.
When you try a new piece of advice, give it more than one feeding before you decide it’s not working. Trust your instinct – when you know, you know, but give each trick a solid try. This can be different for different circumstances, so make sure you always ask the advice-giver how soon you should see a difference.
I truly hope this has equipped you a little more thoroughly to navigate the first breastfeeding days, and to minimize the inconsistent advice you will receive. Hey – you can’t avoid it all!
Have you experienced this problem of inconsistent advice? How did you handle it? What was the impact on you and your baby, if any? Do you have any tips to offer?
Grace & Peace,
Tiffany Miller, CLD, CCCE