How Mommy-Friendly Is The Baby-Friendly Hospital Initiative?

A mom delivers her second child at a local hospital and decides to try formula after her baby girl struggles to latch. She informs the lactation consultant about her decision to feed her baby half a bottle of formula and asks for a remedy for her sore nipples. When the lactation consultant suggests coconut oil, the mom expresses concern over her baby ingesting it while she breastfeeds. The lactation consultants responds, “You already destroyed her gut by feeding her formula. What’s it matter if she has some coconut oil?”

The same mom, who has now been up for over 24 hours, later begs the nurses to take her newborn to the nursery so she can get a few hours of rest. They tell her no, hardly check in on her, and as a result, she falls asleep while breastfeeding her baby. Thankfully, no harm comes to the child. I’m not saying the two are linked, but this mom is diagnosed with postpartum depression shortly after going home from the hospital.

Another mom delivers her first son at the same hospital. During her pregnancy, she makes the decision to both pump and formula feed because she will return to work (her own business) soon after delivery. While getting ready to feed her new baby, the nurse drops off a breast pump and tells her she probably won’t be successful with it, gives her a log and some diapers, and tells her to write down when she changes and feeds him. The mom repeatedly asks for formula and is met with an eye roll from the nurse who tells her she will bring it when she can get to it.

Mom is in tears when her sister arrives at the hospital two hours later. She is so overwhelmed from the lack of care and the harsh treatment she experiences after requesting formula that she requests early release because she would rather fend for herself at home than stay at the hospital any longer. She tells me: “As soon as I told them I wasn’t breastfeeding they pretty much wrote me off. The nurse told me that since I was supplementing, I should feed him every 4-5 hours. The first night home, he screamed the entire night because he was starving. When our baby nurse came, she told me he was supposed to eat every 2-3 hours. I felt like I was set up to fail before I even left the hospital.”

Not all nurses at this hospital greet their patients with eye rolls and judgement. Another mom delivers her third son at this same hospital via C-section. After delivery, her baby refuses to latch so mom, with the help of her nurse, decides to pump and supplement with formula. Her nurse is compassionate, supportive, and helps the baby latch better than anyone else. She tries to be helpful and find what works for this mom of three no matter what method of feeding that might be. At night, mom asks the nurse to take her son to the nursery so she can rest, the nurse agrees and even feeds him some formula.

But the following morning, after a shift change, a new nurse comes in looking annoyed to see mom pumping. The nurse tells her that no lactation consultant would have suggested giving as much formula as she did because it would make the baby extremely fussy. Mom speaks up and tells the nurse her son is the happiest he’s been since his arrival because he isn’t starving anymore. That she is doing what she needs to do because she has no interest in fighting with a screaming baby to latch when she has two other boys at home to take care of as well. The same nurse proceeds to take away his pacifier because if the baby wants to suck on something, it should be on mom’s breast. Mom assertively asks the nurse to leave.

What do these three moms all have in common? They delivered their most recent children at a hospital that has adopted the Baby-Friendly Hospital Initiative. The Baby-Friendly Hospital Initiative (BFHI) was launched by UNICEF and the World Health Organization in 1991 to promote breastfeeding as the normal way for infants to be nourished and encourage mother-baby bonding. While the initiative has been around for almost 20 years, it has gained momentum in the last several years with more hospitals adopting its 10 Steps to Successful Breastfeeding that include: on demand breastfeeding, no pacifiers or artificial nipples, and rooming in where mothers are no longer allowed to send their newborns to the nursery so they can get some much needed rest and recovery.

I delivered my son at this same hospital almost four years ago, before they fully adopted the initiative. I breastfed my son right after he was born following an extremely long labor that ultimately resulted in a C-section. He latched so easily and ate for almost 45 minutes. I thought in that moment, “Wow, this breastfeeding thing is going to be so easy.” It wasn’t. I tried pumping in the hospital but supplemented with formula often. I used a pacifier when he got fussy. I sent my baby to the nursery for a few hours during each day and every night where the nurses fed him formula so I could sleep. They did so willingly, without judgment and checked in on me often.

Clearly, I do not fit the “Baby-Friendly” criteria, so does this make me and all moms who choose to formula feed, use pacifiers, and send their babies to the nursery horrible mothers? Does this mean we are not “Baby-Friendly” mommies? 403 hospitals across the United States might argue yes. I also quit breastfeeding and went the exclusively formula route after five days when I was hit with a severe case of postpartum depression. What would the lactation consultants say about that? I chose to take care of my health as the best way to take care of my baby. And he never starved.

Why are we judging and shaming moms before they even step foot outside the hospital? Shouldn’t the care and support of the mother, her health, and that of her baby combined be the first priority rather than the immediate and obsessive promotion of breastfeeding? The best way to take care of a new baby is to take care of his or her mother too. It seems that the more “Baby-Friendly” hospitals become, the less “Mommy-Friendly” they tend to be.

The mom above who fell asleep while breastfeeding her infant daughter could have rolled over and suffocated her. The baby could have fallen out of the bed. This new mom was beyond exhausted and the simple solution of taking the baby to the nursery for a few hours could have prevented an almost-tragedy and the guilt she suffered from ever occurring. How many other moms have experienced the same or even fell while holding their babies because they were given no opportunity to rest and recover after the depleting, mind and body-shattering experience of labor?

New moms are tired, have been awake for hours upon hours, are taking strong pain medication, and many have undergone major surgery. Then they’re, “Hey, I hope you’re ready to stay up even longer because your baby will be in this room with you 24-7 and if you’re not kept awake from the crying, you will be from obsessing over every noise, breath, and movement your new little one makes.”

While you do all this, try to ignore the excruciating pain you might be feeling from those stitches holding your stomach together. And by the way, we are doing this so you have the best possible chance to bond with, breastfeed and learn the cues of your new little one because that is what our hospital believes makes you a good mother. Good mothers would never send their babies to the nursery. If you send them to the nursery, you will have trouble bonding. You won’t pick up on their cues that let you know when they’re hungry.

Say goodbye to your confidence if you can’t seem to make this work and hello to the guilt you will now feel from believing you are a shitty mother, a view that you will probably follow you home from the hospital and shape your early experiences as a mother.

The mom who asked for her third son to go to the nursery overnight and talked back to the nurse who judged her for pumping and pacifier use knew how to advocate for herself. This was her third go around. What about first time moms who don’t and take what they are told by their nurses and lactations consultants to be the right and only acceptable way to feed and care for their babies? Hospitals and their staff should be cultivating an environment of support and choice, rather than one that makes women feel ashamed or like failures when they struggle to meet the unfair expectation that “good mothers are the ones who exclusively breastfeed and want their babies by their sides at all times.” They need to empower new moms to make their health and recovery a priority.

Having a little bit of rest and knowing your baby is safe and well-cared for in the nursery can make a world of difference for a new mom. Moms who feel well-rested and cared for have more energy to make the effort to breastfeed even when it’s a struggle. They are more awake and alert and can fully engage in bonding with their babies when they aren’t fighting off the overwhelming exhaustion from not being able to recover after giving birth.

Is the “Baby-Friendly Initiative” successful in its endeavor to increase the number of moms who wish to exclusively breastfeed or is it only acting to increase the pressure on the ones who can’t or don’t want to? Why are lactation consultants and nurses, who should be there to educate and help new moms in a loving, supportive manor judging and shaming them instead? Do pacifiers actually get in the way of successful breastfeeding? Does rooming in really increase the likelihood of new moms to exclusively breastfeed? Or does the initiative simply shame moms for choosing alternative methods of feeding as well as decrease the level of safe care for infants by not having a nursery to send them to?

What is the opposite of baby-friendly? Does using the term “Baby-Friendly” imply that any mother who doesn’t follow the initiative’s guidelines is not? How do we think that will make a new mom feel? No mom deserves to be accused of not being “baby-friendly” because of how she chooses to feed and bond with her new baby.

There is no one size fits all when it comes to motherhood. I wasn’t breastfed. My husband wasn’t breastfed. Together we made a pretty incredible baby boy, who was breastfed for only five days before he lived exclusively on formula. Did I mention how intelligent, funny, and compassionate he is? He also has no food allergies, doesn’t get sick very often, and has had one ear infection in his four-year life.

My good friend, Jennifer Bronsnick, a social worker on a mission to redefine what it means to be a “good mom” by inspiring mothers to make make mindful living, self-care and pleasure a daily habit, sums it up perfectly. “The purpose of Baby-Friendly Hospitals is to encourage bonding and breastfeeding, which as long as it allows mothers to rest before going home is a fantastic thing. However, breastfeeding can be wonderful OR it can be torture and lead to moms feeling inadequate and exhausted. As a mom of three and a licensed professional, I can say with certainty that it should be the mother’s choice whether she wants to breastfeed, bottle feed, co-sleep, send the baby to the nursery, have visitors, use a swaddle, use a pacifier and any other non-medical decision regarding infant care. In the hospital, mothers need to be empowered with accurate information about postpartum mood and anxiety, the benefits of breastfeeding and given adequate support so she has all she needs to heal her mind, body, and spirit after giving birth. All you have to do to be a ‘good mom’ is to feed your baby.”

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