“Okay, if he doesn’t have a wet diaper in the next two hours — say, by 11 p.m., you need to take him back to the hospital,” the doctor told me over the phone. These are not the words you want to hear from a pediatrician that you’ve never met, because you haven’t even had a chance to go to the doctor, because your newborn baby is 48 hours old and was discharged from the hospital that very afternoon — a baby-friendly hospital that put my son's life at risk.
“Back to the hospital, back to labor and delivery?” I shrieked.
“No, to the Emergency Room.”
So when 11 p.m. came and went, we were back in the car on our way to the hospital. My son hadn’t had a wet diaper in over 12 hours, meaning he was dehydrated. Born with a bit of jaundice, as some babies are, dehydration is especially worrisome. When I called the pediatrician to note the lack of wet diapers, she suggested I give him some formula. Formula?! But I was breastfeeding. I didn’t have any formula in the house. I had a set of bottles but they were all for a much older baby.
Less than two days ago, I had endured a traumatic delivery with forceps and episiotomy. I could barely walk, much less run.
It didn’t matter; he wouldn’t take the rubber nipple. So we ran into the Emergency Room, carrying him in the car seat. Well, my husband ran. I waddled behind, weeping. Less than two days ago, I had endured a traumatic delivery with forceps and episiotomy. I could barely walk, much less run.
As soon as we entered the ER, the nurses swooped into action. They got us checked in with lightning speed, making room for us in a store room when there was none in triage. A nurse immediately came in to access the situation. When he took my son’s diaper off, he peed. I breathed a sigh of relief. But the doctors still wanted to check his Bilirubin levels and potentially give him fluids. I watched helplessly as the nurses tried to set up in IV in my son’s two-day-old little hand.
The doctor brought us the ready made formula bottles with the small nipples already attached. Why hadn’t anyone explained this to me? Why hadn’t I known to have formula on hand? How had my son become so dehydrated? These questions didn’t even cross my mind that night. The only thing I was concerned about was getting him home, and safe, and getting some fluid into him.
The next day at the pediatrician’s office I was instructed that I needed to supplement with formula. I did so, and continued to struggle with breastfeeding. It was horrific not knowing if he was taking in enough milk. At our second appointment the following week we learned his weight had dropped significantly and that we would need to supplement further with formula or pumped milk.
Thanks to the pediatricians, my son is now thriving. But once the dust had settled, by the time he was about 5 weeks old, the reality of how close we had come to danger hit me — hard.
As any new parent knows, those two nights in the hospital are a blur. You are both exhausted, mom especially so. The hospital where I delivered has a “baby-friendly” status. The "baby-friendly" initiative is a global program sponsored by the WHO and UNICEF that promotes exclusive breastfeeding and rooming-in for the first 48 hours postpartum.
I requested the lactation consultant three or four times during that 48 hour period. She never came.
Nurses at a baby-friendly hospital are trained in breastfeeding practices, and there is a lactation consultant (LC) available for patients. But in this large, overcrowded hospital, I requested the LC three or four times during that 48 hour period. She never came. I had a private LC scheduled to come to my house for a consultation the day after we were discharged. I assumed that would be enough time to get some extra support with breastfeeding.
By the time those first 48 hours had passed, my child was dehydrated — starving for sustenance — and at the hospital no one said a word to me about it. No doctor said: "if he doesn’t have a wet diaper he may not be getting enough liquid. Or, if you’d like, you could give him some formula." No doctor or nurse ever mentioned the word formula.
According to the "baby-friendly" protocol, hospitals are not "to give infants food or drink other than breast milk, unless medically indicated." The very mention of formula is prohibited, because it "discourages mothers from initiating and/or exclusively breastfeeding their infants."
The breastfeeding movement is in full swing. What was once a shunned practice is back in full force thanks to groups like La Leche League. Mothers are pressured to breastfeed at whatever the cost to their physical or mental health. Babies even undergo surgical procedures (like those for tongue-tie) to make breastfeeding possible. But breastfeeding is not always possible. The lengths that some mothers go to to breastfeed their children may outweigh the health benefits.
Why, in those crucial first hours of my son’s life, did I not realize he wasn’t getting enough liquid? Because the hospital’s protocol is to not give a breastfed baby a bottle. Presumably they worry the baby will develop bottle preference and won’t take the breast. But in certain cases, if a baby is dehydrated, isn’t a bottle better than the alternative, if the baby’s health is at stake?
A woman named Jillian Johnson lost her son at 19 days old from accidental starvation. She was so determined to breastfeed and avoid giving him a bottle that she literally starved her child to death. What makes her story even more tragic is how his death could have been prevented simply by giving him a bottle and supplementing with formula or expressed milk.
As my son gained weight and I recuperated from those first few weeks, I was horrified to think that if I hadn’t been keeping track of the wet diapers that afternoon, if I hadn’t called the pediatrician to ask if everything was alright, what could have happened overnight.
I wanted to share my experience so that other first time moms can be more informed about what the term 'baby friendly' really means.
On top of those more serious concerns, our harrowing experience that night made breastfeeding an even more difficult task for me. Afterwards, I was filled with constant anxiety over whether he was getting enough liquid. Parents should always follow the advice of their doctors. But in my experience, attempting to exclusively breastfeed my son and following the hospital’s protocol put him in grave danger.
As Jen Schwartz writes at The Huffington Post, the terminology is also deeply problematic. If a mother chooses to feed her infant formula, or to send her infant to the nursery so that she can get some much needed rest after labor and delivery, is she not "baby friendly"? There are also serious concerns about the rooming-in protocol: is it safe for exhausted mothers to be working to get their infants to latch when they could easily pass out and smother the baby?
I wanted to share my experience so that other first time moms can be more informed about what the term “baby friendly” really means. When it comes to parenting, there is no one-size-fits-all. Every baby is different, every mother’s pregnancy, delivery, and postpartum experience is different.
Exclusive breastfeeding might be easy for some, and difficult for others. But what is undeniably true is that whatever feeding choice you make should be what’s best for the baby’s health, not what's best to meet the standards of a breastfeeding protocol.
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