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The Best Baby-Friendly Policy

I loathe the term cluster feed. Ever heard of it? My second night postpartum, I asked my nurse to take my son to the nursery so that I could sleep. She shook her head and said that Baby-Friendly hospitals encourage rooming in so that babies can cluster feed. Come again?

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By this time, I’d been awake for nearly 48 hours. My son? Nursing all day long. My right nipple? Cracked. Also, I was recovering from the natural birth of a nearly nine pound baby. He’d torn my lady parts to pieces. Sometimes I think the world forgets that childbirth is hard. I decided that what was best for both of us was some uninterrupted sleep.

It was difficult to ask for the help to begin with. After all, I’d waited nine months to meet my son and expected that I’d want to snuggle him 24/7. To receive such a negative response from the nurse took me by surprise. I sort of understood where she was coming from. This was a Baby-Friendly hospital, and Baby-Friendly hospitals champion the breastfeeding relationship. In fact, I’d decided to deliver at this hospital because it promotes Baby-Friendly policies. I wanted to exclusively nurse my son, and I was excited for the help the hospital would provide in order to enrich this relationship. (You can read more about Baby-Friendly breastfeeding policies here.)

Step seven of the Baby-Friendly guidelines encourages moms to room in 24/7 so that babies can nurse on demand. Nursing on demand can certainly mean cluster feeding from time to time. Cluster feeding can be defined as follows: 

Cluster feeding, also called bunch feeding, is when babies space feeding closer together at certain times of the day and go longer between feedings at other times. This is very common and often occurs in the evenings. It’s often—but not always—followed by a longer sleep period than usual: baby may be “tanking up” before a long sleep.

This definition makes sense. What does not make sense? The nurse’s advice. My son shouldn’t have been cluster feeding all night. He’d been cluster feeding all day and into the early evening. It was time for a break. Not only was the nurse trying to impose a rule that I’d never heard of before, she was policing the room-in policy without regard to my well-being and wishes. 

Speaking of wishes, I wished for a pacifier and was told that pacifiers are against the Baby-Friendly initiative (see step nine). Why the strict no-pacifier rule? Do babies really have widespread nipple confusion? My son, at six months, prefers the boob to a bottle. And this is a kid who will put anything in his mouth. The nurse could’ve offered one in the middle of the night to help soothe my baby for a bit—particularly after I’d expressed that I was tired and in pain. Since there seemed to be zero flexibility, I took matters into my own hands. With the blessing of my pediatrician, I sent a friend home for a pacifier, and she smuggled in the contraband. My son used it on and off for about a week. (It did no harm to our breastfeeding relationship.) It did provide relief to me in the early stages of postpartum recovery.

To me, the best Baby-Friendly policy is a Mom-Friendly policy. Should a baby nurse on demand if possible? Absolutely. Is it a good idea to avoid pacifiers if nursing is going well for mom and baby? Of course. However, every new mom has a unique experience, and it’s unrealistic to expect them all to adhere to a one-size-fits-all postpartum plan. Without lactation consultants helping throughout the night, I did damage to my nipple. This damage eventually led to my first of three rounds of mastitis. It could have been prevented if the nurse had shown the same concern for my recovery as she showed for the Baby-Friendly policies. Had I gotten the support I’d needed in the hospital, I would have been better able to care for my son once I got home. 

My hope in writing this is to encourage new moms to advocate for their own needs as well as the needs of their newborn. It’s commendable to seek what’s best for your child. Often, what’s best for your child is a healthy mom. If that means sneaking in a pacifier and sending your baby to the nursery? Own your decision and get some rest. It’s much easier to take care of someone else when you’ve also taken care of yourself.

To the moms who are struggling with breastfeeding—
consider reaching out to the Tennessee Breastfeeding Hotline.

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31 Responses to The Best Baby-Friendly Policy

  1. Cassie March 30, 2017 at 5:58 am #

    I couldn’t agree more.

  2. Sarah
    Sarah March 30, 2017 at 8:11 am #

    YES. I had a similar experience after my son was born too. I wish I knew to stand up for myself… but it’s hard, especially for first-time moms.

    • lindsaysledge April 2, 2017 at 9:34 pm #

      Agreed! It is so hard to stand up for yourself as a first time mom!

  3. Karen Adams March 30, 2017 at 8:46 am #

    This could not be said better. I understand their encouragement though if Mom request the nursery don’t make her feel like a horrible mom. There is enough mom shaming in the world, we don’t need it the first 2 days we should only be focused on the wonderful miracle in our arms.

    • lindsaysledge April 2, 2017 at 9:38 pm #

      Yes, the mom shaming is intense and so unnecessary. Those first few weeks are rough. New moms need all the help, and sleep, they can get.

  4. Katie April 1, 2017 at 11:12 pm #

    Thank you for writing this!

  5. Kristen April 2, 2017 at 9:35 am #

    Agree! I had the exact response told to me after 60+ hours of labor and emergency c-section. As a first time mom I felt like a failure and my nurse’s response really wounded my soul. For this reason alone, I stopped at one child. My choice and I’m fine knowing I will NEVER have to be treated that way again.

    • lindsaysledge April 2, 2017 at 9:42 pm #

      I am so sorry to hear that you had such a difficult experience, and I understand your decision. You will never be treated like that again, and it shouldn’t have happened in the first place.

    • Courtney April 5, 2017 at 2:31 am #

      Same thing happened with me. 23 hour labor followed by c section and they refused to take him for even a couple of hours. Yet I’m paid out the 8&& for medical bills!!
      Thank you for writing this.

      • lindsaysledge April 5, 2017 at 4:13 pm #

        Thank you for commenting! So sorry to read that you had a similar experience. I agree about the medical bills. Seems ridiculous.

  6. Emma Litton April 3, 2017 at 2:57 pm #

    Yes, I couldn’t agree more about owning what you need as a Mama. I wish all the Mama shaming could just stoooop. I had the opposite shaming issues. I was told I should keep my baby in the nursery (odd for the hospital I was in) and when I said I didn’t want to was told I had no idea what I was in for and I’d be asking to get him out of the room soon enough. Multiple instances like that took place. I wish medical staff would be respectful enough to understand that crazily enough sometimes Mothers do know what they want/need whether that be having a break and putting baby in the nursery or keeping baby with them. Great post.

    • lindsaysledge April 4, 2017 at 1:05 pm #

      Thank you for reading! It’s interesting that you had the opposite experience. You are right — mothers do know what they want/need, even if they are completely new moms. Hospitals need to respect a mother’s intuition and go with the flow. It would help us all adjust to the early days without so much stress and shame.

  7. Anne Kerr April 3, 2017 at 7:51 pm #

    You really should do more research. Nurses are forced to implement these policies that are mandated by administration. I am sure your nurse would have loved to give your baby a pacifier but she may have been written up for doing so, lactation consultants do not work at night, giving a baby a bottle is totally against baby friendly the nurse would have to have a medical order from a physician who they would need to call and document in 36 places with an inquiry the next day. The nurse can not take baby to the nursery because there is no nursery anymore and no nurse to watch the baby and if there is a transition nursery administration rounds in the morning to count babies and make sure there are no boarders or heads will roll. You see those wonderful ideals you bought into about baby friendly its really about money and cutting cost and making your nurse take care of two patients for the price of one.

    • lindsaysledge April 4, 2017 at 1:09 pm #

      Thank you for your feedback. I’ve done plenty of research on BF hospitals, and I’ve spoken with many other moms who delivered at my hospital. There is a nursery, and on the first night nurses are often happy to watch after babies. The second night was the issue, and the hospital has a policy of pushing “cluster feeding” on moms this second night. That’s the focus of this post.

    • Amy May 12, 2017 at 3:55 pm #

      That’s a true story!

  8. Toni April 4, 2017 at 3:58 pm #

    I hate this new policy! For my first 3 babies they kept them in the nursery at night and brought them in to feed as needed. The 4th had to stay with me per the policy and it was the worst few days of my life! Talk about encouraging postpartum depression! I felt that it completely disregards the well being of a mother that just went through labor. With my 5th and 6th I insisted on the nursery at night despite the negative feedback from the nurses. I NEEDED the rest in order to be a good mom. I can honestly say the policy changed me and the baby from being patients to being just bodies in a room. It’s amazing they can still charge for care as you are essentially on your own now.

    • lindsaysledge April 5, 2017 at 7:21 am #

      Wow! Six kids! Congrats, mama. You rock! I absolutely agree that the policy seems to change baby and mom from being patients to bodies in a room. Rest is so critical during the first few days, and next time I will also insist that the nurse take my baby to the nursery at night.

  9. Tamsen April 4, 2017 at 5:46 pm #

    Just to add a little more perspective, keeping baby close in those first few days also speeds mothers recovery and cluster feeding is how milk supply is calibrated for the duration of the nursing relationship. Moms should always be given the chance to make informed decisions about the health of themselves and their babies. Having a better knowledge of how the baby/mother dyad is beneficial to the health of mother and baby may help mothers understand the baby friendly policies better.

    • lindsaysledge April 5, 2017 at 7:27 am #

      Thanks for your comment! I do believe that the intent of the BF policies is for the benefit of mom and baby. For moms with difficult deliveries, and rather alert babies, it may be more beneficial to allow for a bit of space during the first few nights so that mom can rest. I believe this uninterrupted time for sleep is as important to recovery as keeping baby close may be.

  10. Christi Tom April 5, 2017 at 1:12 pm #

    Theee years ago with my first baby they kept asking to take her to the nursery and warned me against keeping her. I was high on hormones and excitement and basically stayed up all night holding her and nursing. I didn’t want to let her out of my sight. My second baby three months ago, I sent to the nursery the second night so I could catch up on sleep. They brought her to me to nurse every 2-3 hours and were great at communicating and making me feel safe. They said they were they only local hospital with a nursery anymore. I can’t imagine not having a nursery for moms with long labors or cesareans or for single moms without a spouse to help.

    • lindsaysledge April 5, 2017 at 4:15 pm #

      Oh wow, this hospital sounds amazing! So glad to hear that their communication was spot on. Here’s to hoping that nurseries don’t continue to disappear. Moms really need all the support that they can get!

  11. Ashley F April 5, 2017 at 10:43 pm #

    Amen! I had a traumatic birth and had to be put under anesthesia after being induced and getting no sleep the night before. I was in desperate need of rest and a nurse feigned hearing wheezing from our newborn to give us 3 hours of sleep. I was recovering from major surgery and she had to break protocol.

    You know, we are lucky, we mom’s with partners and support systems. Can you IMAGINE what these policies do to mom’s without anyone there with them? Can you even wrap your head around having a mom give birth and not giving her a couple of hours to sleep and recover before sending her home alone with her baby? To drive them both is dangerous. And we wonder why PPD and similar disorders are so prevalent.

    • lindsaysledge April 9, 2017 at 6:13 pm #

      You are so right! We are lucky to have had great partners to help during the transition to life with a newborn. I cannot imagine doing it alone!

  12. Elizabeth Gillum April 6, 2017 at 3:15 pm #

    I could not agree more. We sent both babies to the nursery on night one … and they too would wheel them in every few hours to nurse. It was magical. We bonded perfectly, they nursed well, and I was able to rest a little before heading home – where I was up all night for weeks on end! The nurses did say that they encouraged babies to sleep in the room with mom, but I didn’t think twice about it. Thank you for sharing this.

    • lindsaysledge April 9, 2017 at 6:14 pm #

      Thanks for your comment! So glad that you didn’t think twice about sending your babies to the nursery. It’s encouraging to hear that from another mom! I hope to be as confident with my decisions the next time around.

  13. Laura April 16, 2017 at 3:48 am #

    At my hospital, I labored for over 2 days, ending with emergency c section, and ended up in ICU after that. I woke up the next day with a breathing tube and my husband crying on my shoulder.
    They took me back up to Labor so they could monitor me, and came in that night to help me nurse, and where all over me to do this or do that, I got so mad and nearly cried. I had to tell them to feed him themselves, I still had a heavy amount of medication in my system and couldn’t handle staying awake to do anything. Then the next day, they expressed concern that my husband and I couldn’t stay awake the night before. Really?! Do you know the weekend we just had!! All in all my experience was pretty good. I had some amazing nurses. That one set caused me some major stress after waking up with a breathing tube and not knowing if my baby was ok or what was going on.

    • lindsaysledge April 17, 2017 at 3:44 pm #

      Wow, Laura. Thanks so much for reading and responding! You story sounds traumatizing. So sorry to read that you had such a negative experience after such a difficult delivery. I cannot imagine the stress the situation must have caused you!

  14. Hayley May 12, 2017 at 1:40 pm #

    With my first (9 yrs ago) I had planned to bf exclusively. The hospital (in Nashville) staff were great. They brought him to me to try nursing, but I also requested he sleep in the nursery so I could sleep. He ended up jaundice because of hunger and our pediatrician recommended formula to supplement (apparently I don’t produce milk) anyway we went formula only after about 2 weeks. My 2nd 5 yrs later was similar. Same hospital, this time I requested formula to supplement just in case and for same reason ended up formula only. Third baby almost 2 yrs ago same hospital I filled out forms stating I was NOT breastfeeding and the hospital provided formula and everything! Best hospital in Nashville to have a baby (in my opinion)!

    • lindsaysledge May 19, 2017 at 9:18 am #

      Wow, Hayley, that hospital does sound excellent. I’m so glad that they were flexible and willing to work with you to provide formula! Thanks for sharing your story!

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