BOOOOO for Bad Breastfeeding Advice!

So, you give birth in a hospital that is very “pro-breastfeeding,” assures you that they will help you overcome breastfeeding challenges and won’t interfere by giving a bottle or pacifier, and even has lactation consulatants frequently available to come to your room and help you. You assume that they will start you on the right foot and you’ll have the general idea by the time you get home, right?

Well, apparently, not always. Two recent stories I heard have left me fuming, and I feel that it’s important to share them so we can try to stop this from happening to more women.

Jocelyn* spent a few days in the hospital after giving birth to a beautiful baby girl. She was determined to breastfeed, so she told the nurses not to give her daughter a pacifier or bottle. She said that her daughter latched well, but was experiencing a lot of pain and her nipples were even bleeding by the third day. When she asked both of the two lactation consultants if it was supposed to hurt, they said, “Yep, that’s the way it is! You just have toughen up, honey!”

But that’s NOT the way it is. It turns out her daughter was latching only onto the nipple, not the whole areola. Some tenderness when beginning breastfeeding is normal. But pain and bleeding is not. I’m not a lactation consultant, so please correct me if I’m wrong, but it seems that perhaps these particular consultants should have spotted this latch and helped to correct it so Jocelyn could have nursed more comfortably.

To top it off, the hospital nurses took Jocelyn’s daughter to the nursery and did not bring her back for two feedings. Afterwards, the baby girl did not latch on to the breast well at all. Jocelyn strongly suspected that the nurses probably gave her bottles during this time, therefore sabotaging some of her earliest efforts to breastfeed. Jocelyn is still determined to make nursing happen despite these setbacks, which is very admirable.

Lily* was working on nursing her son in a hospital that boasted some of the best breastfeeding support available. However, when her milk didn’t come in by the third day, she had nurses telling her that she would have to supplement because her son wasn’t getting enough. (Now, I’m not sure how it works for every woman, but my milk didn’t come in until the end of the fourth day/beginning of the fifth day, and my son is in the 90th percentile for weight.) This was, of course, very upsetting to her. When she started to tear up about the possibility, one lactation consultant remarked, “I’m really glad to see you crying about this. It shows me that you actually care about your son.” Needless to say, this remark was an abysmal thing to say to a brand new mother learning to breastfeed.

Lily was required to drive back to the hospital a couple of times after she came home to do weight checks. They threatened hospitalization and switching to formula if he didn’t gain weight. She supplemented with formula through a tube attached to her breast at home in hopes that it would bring up his weight. Finally, one kind hearted lactation consultant told her that he looked healthy, was eating, pooping, and peeing well- if his ounces were slightly lower than average, it was okay. He wasn’t in a danger zone yet. She told Lily not to worry and to keep up the good work.

Lily kept at it, and her son’s weight finally satisfied the hospital enough that that they didn’t ask to keep him. She is no longer supplementing, and her son is thriving on her milk and filling out beautifully.

Now, I definitely know there are many wonderful lactation consultants out there, some of which I have been blessed to meet. I am so grateful these women are there to help mothers learn to breastfeed successfully. But what about the others? These two stories I shared are, unfortunately, not the only incidents when lactation consultants and nurses have failed to provide the support and advice needed to help mothers successfully nurse. There have been too many mothers who genuinely wanted to breastfeed, and were falsely made to believe they were not making enough or that it just had to hurt badly until they “toughened up.”

What can we do to help stop this from happening and ensure that every mother who wishes to nurse gets the help she needs? Please share your ideas.

*Names have been changed to protect the mothers’ privacy.

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14 responses to this post.

  1. Posted by StorkStories on February 2, 2011 at 9:04 pm

    You have touched on a problem that is a constant thorn in my side! Both moms’ did not receive proper lactation evaluation or guidance promptly or consistently! These LC’s sound ridiculous and cause me to wonder if they are truly IBCLC’s or some other lactation professional. Unfortunately many mom’s get bad advice from all levels of health care providers and even from well meaning family and friends. Then the advice they do get is filled with inconsistencies. I am sorry this happen to these women and YAY for them pushing forward!
    Mom do need to know some current evidenced-based recommendations/ guidelines going in so they can filter out the bad suggestions. I don’t think moms need to “study” bfing but keeping it simple– a little knowledge is a good thing!

    Reply

  2. Thank you for posting on this topic. I am a lactation consultant in private practice and am frequently appalled at the misinformation, poor guidance, and ineffective help some mothers receive from some health care providers (and yes, even lactation consultants)in regards to breastfeeding. Being in private practice families have often already seen lactation in the hospital or elsewhere before coming to me and I am often saddened by the advice these moms have been given and how dis-empowered other providers made them feel. My comments are meant to bash my hospital based colleagues or fellow health care providers, most mean well but have limited time and varying levels of lactation experience. Sadly, it is the mom and baby that pay the price when hospital/clinic polices, budget cuts, time constraints get in the way of quality care. All too often, a nipple shield and a wave good bye are all these moms and babies get. That is plain negligent in my opinion. The blog post ends by asking “what can we do to stop this from happening?”. In short I don’t think the answer is so simple. The “in and out” highly medicalized birth experience and hospital system that is the norm is not set up to be breastfeeding friendly not what what title they give themselves.The hospital industry is a business and sadly having a top notch LC spend a good 2-3 hours with a family isn’t very cost effective in their opinion. To really save breastfeeding, births needs to be normalized as much as possible and insurance needs to cover out of hospital lactation options so families aren’t limited to one type of care.

    Reply

    • Great point. Sadly, it seems that there are a lot of problems in hospital maternity care that arise from a lack of desire to pay for the best services. Do you think it would help if more women began to ask for out of hospital options from their insurance companies and demanding better lactaion care from the hospital itself?

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      • Yes, families need to demand access to out of hospital birth and postpartum options, including lactation services from their insurance. And yes, demanding better lactation care from their local hospitals is key too. However, even though I’d like to be optimistic about those changes being made in the future the bottom line is still that hospitals and insurance companies care most about their bottom line. So even when hospitals hire IBCLCs many times they double duty them as RNs or those dedicated IBCLCs are limited to small chunks of time and hospital policies. Some hospitals have excellent LC care and I applaud their initiative. However that level of care is not across the board. When the primary tenet of medicine is “first do no harm”, the quality of maternal/child health issues is often the exception to the rule.
        So families making demands on insurance and hospitals is a first step towards more adequate care. However the harder step is changing the actual culture of the hospital system and that is a much tougher thing to do.
        In the mean time if families receive sub optimal lactation help from their providers I urge them to keep searching for help. Breastfeeding is too important not to.

      • Very true! One of the really good LCs I have met does double as an RN, so I’m sure she doesn’t have a ton of time to spend with her clients. I have seen her in action, though, and the time that she does spend is very high quality, with mom and baby’s needs and concerns always foremost in her mind.
        “In the mean time if families receive sub optimal lactation help from their providers I urge them to keep searching for help. Breastfeeding is too important not to.”- This I wholeheartedly agree with. I looked around your site, and it looks like you are making awesome contributions. 🙂

      • Posted by StorkStories on February 4, 2011 at 5:58 pm

        I agree. It is very difficult to provide comprehensive evidence-based lactation evaluation/ assessment/ assistance and feeding plan options allowing the mom to make sound informed decisions when your primary role is patient care as an RN. It is frustrating and hodgepodge. Sometimes I had about 5 min to spend with a mom who’s baby wasn’t latching… best I could do would be put her Skin to Skin and come back in 20 min… I had to work like that as an IBCLC for 10 years after trying to get the hospital to implement a comprehensive lactation program including F/U weight checks within 48hrs of discharge.
        I keep trying to find an answer and I haven’t. I think the consumer “demanding” this service will have greater impact than those of us lactation professionals who attempt to persuade administration that this is a necessary service!
        @Melissa this statement is SO TRUE:
        “However that level of care is not across the board. When the primary tenet of medicine is “first do no harm”, the quality of maternal/child health issues is often the exception to the rule.”
        Touche

  3. Oops my above post should read: “my comments are NOT meant to bash my hospital based colleagues”. My apologies for the error!

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  4. This is unbelievable, and I too wonder if these LCs were IBCLCs. I second the need for evidence based, accurate, reliable, information being available for mums everywhere.

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  5. Ahh, thanks birthbug, I do love what I do! Also, blogs like yours are incredibly important. Building awareness is a critical part of change. Keep up the good work!

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  6. Have EVERY nurse who works in Post Partum do Lactation Educator Training. I learned SO much at my weekend training and I probably now know more then many nurses.

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    • Great suggestion! I think parents assume the L&D nurses, their OB, midwife, pediatrician, etc has had decent lactation education and that simply isn’t always the case.

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  7. Posted by amandasworldofmotherhood on April 21, 2011 at 6:36 pm

    My experience with my first was horrible. I had a nurse come into the room and tell me flat out that I wasn’t going to be able to breastfeed! I had lots of issues and horrible support from a pedi. I ended up exclussively pumping for him.
    This time around has been so much better. I have a 16 lb 15 week old. 🙂
    I tell all women to join their local La Leche League before giving birth. I wish I had with my first.

    Reply

    • Wow, I’m sorry you had such a bad first experience! Sadly, it seems like situations like your first are far too common.
      Joining La Leche League a great idea, Amanda. Having the right support and available information makes a BIG difference.

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  8. Posted by Monica on April 20, 2012 at 12:55 am

    I have had a horrible experiences recently with Lactation Consultants! In the hospital (after my c-section) I had the following experiences: 1 LC pinched my nipple and told me I wasn’t producing colostrum. Several just placed my daughter in the football hold and left. I had to take her to the ER because she was not making diapers and was extremely listless from an elevated billirubin level (at the hospital she was a 9.8, and she discharged with me two days later. The next day she was at a 16.1). At the ER she was also diagnosed as being dehydrated, so the LC (one of those I saw at the hospital) grabbed her, and fed her a bottle, even though I told her not to at least use my bottle that is breastfeeding friendly. Today, I had an LC appointment at the women’s clinic I go to. Ended up being the same lady from the ER! My child is gaining weight slowly and making all her diapers. Her response to the fact that at 17 days she still isn’t up to BW (mind you that my milk came in around day 7, she was jaundiced, we have had latch problems, AND she is just getting over a cold) AND because her latch is “causing her to use up calories” was that I needed to supplement. This LC didn’t even try to help me get to the bottom of the issue, and only spend a few moments manipulating my daughter’s mouth. If it weren’t for the research I had done during pregnancy and since I would be using formula!

    Reply

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