The Tyranny of the Ignorant…
A young family member recently had a baby girl in a Florida hospital. My relative was interested in nursing and I had sent her information, gave her the number of the local Le Leche League leader and had been sending her daily ‘nursing tips’ via text to encourage her efforts.
Still, things weren’t going as well as I’d have liked. My young cousin was unable to grasp that nursing every two hours until the baby is satisfied and self-detaches on the first breast, then a burp, then ‘dessert’ offered on the second breast means just that- every two hours. Baby was getting fed every three hours (the minimum amount necessary to establish a sufficient long-term supply) and was being given bottles of formula whenever mom didn’t feel like nursing. But my young cousin still insists that she wants to nurse, so I’m committed to offering whatever help I can.
I was shocked when I received a message at 9 am last Thursday that my cousin was in the hospital for an infection. Apparently, she had retained some parts of the placenta and now had a severe infection. The physician had put her on an IV medication that precluded the possibility of nursing, so the baby was being given formula. My cousin had entered the hospital at 9:30 the evening prior and had not yet been given the opportunity to pump.
I was incensed. Was this hospital staff INSANE? Of course there are alternative medications that can be given to mothers who are nursing! And even if, for some reason, my cousin absolutely needed to have the medication that then made nursing impossible for a time, she should have been given a breast pump so she could maintain her supply while discarding the tainted milk.
I asked to speak to the nurse. I asked when a breast pump would be available for my cousin who had been unable to relieve her breasts for almost 12 hours, the nurse said they were working on getting a collection kit (Um, where’s your maternity floor? Unless it’s in another state, take the 5 minutes to go get the thing!); I asked if the doctor would consider another medication that would be nursing compatible and was told that if a nursing compatible antibiotic could have been prescribed, it would have been (uh, what lactation training has this nurse or physician been given? Likely NONE); I asked if the hospital had an IBCLC (International Board Certified Lactation Consultant) on staff who could come visit my cousin and teach her manual milk expression methods until a collection kit was found- I was told she would have to check to see if the IBCLC was in since she wasn’t in every day (I’m so glad to know the babies in their hospital don’t have to eat every day and that their mothers never experience any lactation specific needs). The nurse went on to say, ‘Honey, honey, we have this covered. Don’t worry. We’re taking good care of her.’
Doctors and nurses are so used to receiving unquestioning obedience from those they care for. There seems to be this implicit understanding that the ‘experts’ give orders, the ‘ignorant’ follow them and, mostly, people recover. If you rock the boat by questioning their ‘expert’ opinion, it’s implied that life will soon become very unpleasant for you. The problem is, most physicians and nurses don’t have a CLUE about lactation. They pretend wisdom to make their patients compliant and to streamline their patient’s care. Maybe some of them think they know what they’re doing, but if they haven’t received training, they know as much as your maiden Aunt Tilly- rumor, myth and guesses. They are medical tyrants who know little to nothing about the topic of human lactation. Doctors- even OBs and pediarticians- receive NO formal training about breastfeeding in medical school. Neither do nurses- even OB nurses. Unless they have specifically sought out additional lactation training, they know NOTHING when they enter your room to give you advice about how to feed your newborn. But they pretend that they do and if you question them, you are treated like a trouble maker, ignorant and bothersome.
My cousin is so young- just 18- and I know she is unable to advocate for herself. I was 32 when I had my youngest and I had a heck of a time resisting the poor instructions my military-trained nurse gave me. I knew that my cousin stood almost no chance of coming out of that hospital with her nursing relationship intact if I didn’t intervene. I wound up making a call to a friend who had to leave work, go to WalMart, purchase a small hand pump and deliver it to my cousin. That hand pump and my phone calls were the ONLY help my cousin received while admitted for her infection. She was NEVER brought a hospital grade pump, she NEVER had the requested consultation with the IBCLC, a nursing-compatible antibiotic was never researched and offered.
We need better care for lactating women in this country. There need to be consequences when doctors and nurses are ignorant of how to best care for nursing women. If it would be unacceptable for a patient with diabetes to enter a hospital and not have that medical condition considered when planning treatment, why is it permissible for a woman to risk plugged ducts, mastitis and the premature cessation of a nursing relationship that contributes to her recovery from childbirth? We need full-time IBCLCs in every hospital that desires to offer maternity care. We need more birth & postpartum doulas to assist women during their labors and in the weeks after delivery. And we need hospitals with vision who are willing to truly care for their nursing patients needs. This was a disgrace.
–A
PS: As of the publishing of this blog post, my cousin has ceased pumping and has weaned her daughter from the breast. She was required to continue pumping even after leaving the hospital becaused she was prescribed an oral antibiotic that was incompatible with nursing although there are many medications that ARE compatible with breastfeeding that could have been prescribed. The doctor, in my opinion, is solely responsible for ruining an already shaky nursing relationship.
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