Welcome to baby gooroo!
This is the inaugural post announcing the launch of our new community and blog. Like a proud mother, we know this site will have a lot to offer new families, moms, and dads alike. Our “gooroos” are a Who’s Who of the baby health industry and we will continually be adding new contributors who will provide unique and up-to-the-minute content that will keep people coming back. We look forward to hearing back from the community of new moms, because it is your struggles and successes that will drive our growth, and provide the real value for new families everywhere.
Stay tuned!
Wow Amy…this is exciting!!!
[...] Amy recently “gave birth” to a new addition of her own. She launched a new online community called babygooroo.com. The “gooroos” are a Who's Who of Experts who provide unique and up-to-the-minute content about all things breastfeeding and parenting. [...]
I recently attended an excellent conference by Amy and enjoyed sharing info with my co-workers. I am still struggling with babies at night who are hungry, moms milk not in yet, and moms who desperately want a break so infants are sent to the nursery. I have learned no pacifier, no sweet teas, no water supplements, but these moms are sometimes sick and they do not have a helpful partner. We don’t want them to become so sick and tired that they ask for a formula supplement the 2nd day. I sure wish I had something to calm baby and mom. So far we consistently have those babies come to the nursery, especially those whose mothers have had C-sections. Any new ideas besides swaddling, rocking etc? Thanks!
I think one of the most frustrating parts of caring for the new mother and baby in the early days in the hospital is when the mother is very tired (labor is aptly named – it is work) and the baby is new to the world of eating. We identify with the mother and want to give her rest and yet we worry about the baby. But I never want to “rescue” a mother from her child – especially if she is pretty much alone, she needs to feel competent as well as cared for.
One thing that helps me in this situation is to remind myself that the system (breastfeeding) works. Although the mother’s milk “is not in yet,” her colostrum is in, and her baby will get very concentrated calories if s/he is latched on correctly and feeding effectively. Babies do not need a large feeding the first few days and the colostrum is well-suited to the small volume because it is pure calories with very little water.
First I acknowledge the mother’s frustration and fatigue and tell her that even though she knows what to do to feed her baby, her baby does not have any practice at eating. Then I ask if she would like to go to the bathroom or have a drink before we get the baby latched on (yes, this takes about 5 minutes and feels like forever!). Once she is ready, I get Mom comfortable and postioned in bed in a semi-reclining postion (head of the bed up about 40 degrees), put stacked blankets (pillows are too squishy) under her arm, up against her side, and then I unwrap the baby to tee shirt and daiper and place the baby in a football hold. The baby’s mouth is in line with the outer edge of the areola – so his/her bottom is way back under Mom’s arm – and Mom is supporting the baby’s shoulders with her hand and has her thumb and forefinger going up the sides of the baby’s neck for support. Then with the opposite hand she is supporting her breast from the inside and I am supporting it from the outside and have my spare hand over hers on the baby’s shoulders.
When the baby roots, I help her bring the baby quickly on to the breast so she feels how to do it. Once the baby is sucking rythmically, I try to slide my hand away from the breast and then put a rolled up baby blanket, towel or whatever is handy, under the mother’s hand to support it. I know things are going well if the mother tells me she is feeling a tug but the pain is gone after the first few sucks. If the baby keeps sucking, I cover them together and leave for about 15 minutes. If the baby keeps “falling asleep” (i.e. shutting down because he doesn’t know there is more to come), I stay and stimulate him to suck while Mom dozes. This may take about 15 minutes on one side, after which many babies will doze off and not even want the second side.
The sleep induced by the release of prolactin when the baby is sucking correctly is very restful and restorative for the mother; the confidence you have given her that she can care for her baby is invaluable; and her milk production will transition quickly because the breasts are drained and the hormone release is occuring regularly.
The scenario you mention is a challenge for many nurses. On one hand, you want to support the mother who is tired and recovering from birth. On the other hand, you are caring for a baby who needs her mother as well as her milk. It may help to remember that baby humans are baby mammals. What other mammal would be happy if removed from its mother, especially during the first days of life?
The dilemma is how to meet the needs of both mother and baby and still preserve breastfeeding. I find that care must be individualized for each mother/baby pair. For example, a mother who has had a cesarean birth, has no friends or family to rely on for help, and is taking pain medicine will need lots of help the first night. While many babies sleep much of the first night, if you feel a mother cannot respond to the needs of her baby, then the baby may need to be watched carefully in the nursery and brought to mom at the first sign of hunger. If a baby’s blood sugar is stable there is no reason to panic over the need for frequent feedings during this time.
Sometimes the problem comes when the baby is allowed to cry. Most babies, if picked up and lovingly cared for within 30 seconds of starting to cry, can be soothed back to sleep fairly easily. If this doesn’t work and the baby is showing signs of hunger, bring the baby to his mother and assist her with positioning and latch. It is best to stay with the mother and baby until you are certain the baby is latched on well and transferring milk effectively. This will give you an opportunity to provide much needed encouragement and support.
Some mothers prefer to keep their baby with them at all times. Policies vary regarding placing the baby in the bed with the mother. It's important to keep the baby safe. Some mothers like to keep their babies on their chest at night, tucked snugly into their gown and secured by a couple of blankets. You can check on them frequently to be sure all is well. If this is not possible due to hospital regulations, the baby can be kept within arm’s reach in a bassinette.
The importance of a mother and baby staying together cannot be overemphasized. A positive attitude on your part can serve to motivate parents and staff. Your support during this critical time period is essential to breastfeeding success. Committing to spending extra time with a mother and baby the first and second night after birth can make such a difference.
One final suggestion would be to examine your daytime visiting policy. If a mother is entertaining guests all day long, she may find it difficult to care for her baby at night. You might suggest that she nap at least once during the day when the baby naps in order to stay energized. Rest is so essential to recovery.
It's wonderful to hear a caring nurse share their concerns. Please know that you make a difference in the lives of mothers and babies!