NICU nurse Louise is now hosting a weekly Twitter chat for the #MatExp campaign called #MatExpHour. It takes place every Friday, alternating between a midday-1pm and a 8pm-9pm timeslot. Yesterday I had the privilege of co-hosting with Louise as the topic was breastfeeding support on paediatric wards – the focus of my #hospitalbreastfeeding campaign.
In previous discussions on this topic I have looked at the needs of cardiac babies, the knowledge of healthcare professionals when it comes to specific breastfeeding problems, and the role of International Board Certified Lactation Consultants (IBCLCs) in supporting breastfeeding in difficult circumstances. For last night’s chat I wanted to go a bit more “back to basics”. So I asked the following four questions:
- Is everyone aware of the new Baby Friendly training for paediatric nurses? Who has signed up?
- Are all children’s wards equipped to keep breastfeeding mums and children together?
- Do all children’s wards provide food and drink to breastfeeding mums?
- Can breastfeeding peer support work on children’s wards? What are the barriers?
The new BFI training looks fab (if pricey at £450):
We discussed the fact that finding funding for individuals to complete the two day course might be difficult.
But there was no doubt that it is much needed. Even in Baby Friendly accredited hospitals the paediatric nurses (and doctors) are often under-informed with regards to infant feeding. The fact that Baby Friendly are now offering this course is a step in the right direction, as paediatrics have been left out of the BFI system for too long. It came as a surprise to some that there is currently no BFI pathway for children’s wards or children’s hospitals. I suggested that the BFI team might well be a bit sick of hearing me bang on about that gap!
So when a breastfed child is admitted to paediatrics, are the basics covered? Are mum and child kept together, and is mum provided with food and drink free of charge?
Firstly I should explain the rationale behind the food and drink issue. In an ideal world all parents of sick children would be provided with food and drink so that they can stay by their children without having to worry about finding meals or paying for them. However, that is not a realistic possibility in our healthcare system. However, a breastfeeding mother is producing food for her child, the patient. Her ability to produce that milk relies on her being well fed and hydrated. As a result, providing her with food is a part of providing nutrition to the patient, which is absolutely a part of a hospital’s remit.
The World Health Organisation’s Global Strategy for Infant and Young Child Feeding makes it clear that “Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.” (page 10)
So what are the practices around the country?
And the provision of food and drink?
This was interesting, as discussions earlier in the week on the #MatExp Facebook group had suggested that the provision of food and drink to breastfeeding mothers is not universal practice. One member commented that “At our local hospital they are obligated to treat a breastfeeding Mum as another patient, including food.” Yet others reported that this is not the policy in their hospitals, and one doula mentioned that a particular hospital used to provide food and drink to breastfeeding mothers but no longer does so. A worrying step backwards.
One mum reported:
“Well for 3 days I was living off microwave meals my husband brought in while I was staying in NICU. As a vegetarian the options are limited for microwave meals. I was so exhausted I barely had the energy to make toast or use the microwave. I had been told you had to be self catering in the NICU parents’ accommodation. Turned out that was b******s and eventually a NICU nurse explained that if I went down to the postnatal ward at set times I could collect meals. Which I then did for 7 days when I could. Although due to the rigid feeding/expressing schedule I wasn’t always able to leave NICU at the right time to fetch my dinner. It seemed so unfair that the ladies in postnatal who had their babies with them got food brought to them, but us NICU mums had to leave our sick babies, go down a floor and get buzzed in to the postnatal ward to practically beg for food.
I was not the only mum who wasn’t told she could get fed.”
Any breastfeeding mother will tell you just how much food and drink you need, especially in the early days, to maintain your supply and provide for your baby. That this is overlooked in some hospitals is a big concern.
Understanding as we do that doctors and nurses have limited time available to them, even if they were all to be trained in breastfeeding support is there still a place for peer support on paediatric wards? NHS breastfeeding support worker Emma (pictured above) has written about the in hospital service she works for and how they support breastfeeding families. The team covers paediatrics as well as NICU, postnatal and community. A model for other trusts to consider?
I know of instances where breastfeeding peer supporters have clashed with clinical teams so expressed a concern that if peer support is to work it needs to have buy in from the doctors, and respect needs to be shown for the expertise of both sides. Perhaps in an ideal world, when BFI training is made available for paediatricians, the nurses, doctors and peer supporters from a hospital will all train together?
I would like to once again thank everyone who took part in the discussion, and to ask anyone with an interest in breastfeeding support on children’s wards to take a look at my website and to follow the #hospitalbreastfeeding hashtag on Twitter. There is also now a page for you to follow on Facebook: https://www.facebook.com/hospitalbreastfeeding/ Hope these platforms can bring together all those who are interested in helping sick children to breastfeed.