Here’s one for the “I Can’t Believe We Needed A Study To Tell Us This” file: an article I read this morning from lactationmatters.org, entitled “Do Interruptions Interfere with Early Breastfeeding?”
I don’t mean that the article was stupid (at all!), and in fact, there’s something validating that someone actually recorded how frikkin’ often new moms and their babies are interrupted while they’re still in the hospital. Want to know how many times?
53. Fifty Three interruptions in a twelve hour period.
This topic came up last week at the new MOMs group — I’d asked a group of new moms who’d just met to talk about what was most surprising since their babies’ births, and although that conversation can go lots of different ways, this group mostly talked about how the births had gone, and the first couple days in the hospital. Several moms talked with annoyance about how frequently people barged into the hospital room, (“it felt like someone was constantly coming in to do something”) and how difficult it was to get any peace, privacy, or even just a little time to think straight.
Well, they’re right: The study found that over the course of a twelve hour period, mothers in the hospital were interrupted an average of 53 times. There were more than twice as many interruptions as periods of alone time. That means that a new mom had to deal with someone coming in to do something to her pretty constantly; and the study also found that the interruptions themselves lasted longer than the stretches of alone time. In fact, half of the “uninterrupted” stretches were less than ten minutes long.
Guess what? Moms didn’t love that.
In my New MOMs group, many of the same moms were also complaining that they didn’t have enough help with getting the hang of nursing, or that they were “left alone” to figure it out by themselves.
These things aren’t at odds, at all: New mothers are not supposed to be left all alone, isolated, without help or company or support. They are supposed to have easy access to supportive, knowledgeable people who can help them, and who can attend to their needs as they learn to get the hang of dealing with the baby. They are not supposed to be isolated and when they are, they languish. And all too often, they not only don’t complain, they feel guilty and weak for not being able to figure everything out themselves.
Isolation is bad for mothers.
But isolation is not the same thing as privacy, and all interruptions are not equal. One mom I spoke to described how frequently people came in to take her blood pressure and temperature, or to check on the baby, or to have her fill out forms. Did anyone come in to just sit with her and keep her company? No. No one in the hospital is paid to provide company. Did anyone come in saying, “Good morning, what can I do for you that might help you feel more comfortable today?” Of course not. The hospital does not provide a concierge. Did anyone give her a list of resources that might help or educate her if she wanted that? No, the hospital is not a school that provides education for its customers.
Did anyone assess her breastfeeding before the baby was discharged and provide her with detailed, evidence-based guidelines about how to proceed? No. Apparently the hospital is also not concerned with infant growth and nutrition. You and your boobs are expected to figure it out for themselves.
What did they do?
Well, lots of people commented that she should be breastfeeding. People talk and talk and talk about how “best” breastfeeding is. People gave varied opinions about how frequently she ought to nurse and how long the baby ought to stay on the breast. Most of them disagreed with each other.
And they got all the data they wanted, about her temperature and blood pressure and wound-healing, and her paperwork was all complete. They did that on their own schedule, in the way that was most streamlined for the hospital, not for the woman who’d just done a day of labor followed by major abdominal surgery and whose nipples were cracked and bleeding and whose baby had lost a lot of weight.
This. Is. Not. Good. Customer. Service.
Newborn babies need lots of skin to skin time with their mothers, but new mothers (understandably) often feel modest about showing skin to strangers. Having the door of your room burst open while your shirt is off can throw even the most unflappable new mom, especially when it happens multiple times per hour.
New babies also need frequent feedings, but new moms getting the hang of nursing often don’t appreciate someone barging into the room just when they’re squeezing the breast and looking at the color of their colostrum. New moms are human beings; they need privacy. When they don’t get it, they cover up.
The study found that moms perceived that interruptions interfered with breastfeeding. This does not mean that doctors and nurses came in and literally said “You need to stop feeding now” or that the moms were told to ignore their babies’ cues to feed if someone else was in the room. What it does mean is that as a practical matter, the moms felt that being on the other side of a revolving door was getting in the way of learning to nurse.
Why aren’t we making it easier on new moms? How about some hospital protocols that group necessary clinical interruptions together in a way that makes it a priority to get new moms longer stretches of privacy?
And how about making sure that, if someone’s going to enter a new mom’s room, that person:
(a) ask the mom “were you about to feed the baby?” and offer to come back later if it’s easier for the mom, so that no mom leaves the hospital feeling like someone was barging in on her every five minutes, and
(b) be prepared, qualified, trained and equipped to ask about nursing, assess the breastfeeding dyad, and provide appropriate, supportive help OR ELSE SUMMON SOMEONE WHO IS, so that no mom is discharged from the hospital without a breastfeeding assessment by an IBCLC.
People like to feel like they know what they’re doing — that’s because we’re human. And when you’ve just had a baby, you often feel the opposite. No one wants strangers barging in on them constantly when they’re feeling like a big messy work in progress — that can make you feel like giving up on whatever you were working on. Instead, what new moms need is enough privacy to get the hang of things, and enough help to be guided in the right direction.
Here’s what you can do:
If you’re pregnant and planning a hospital birth: Make a sign for your door that says, “Please, Only Urgent Interruptions; I Am Feeding The Baby.” Hang it at will. Feel free to ask anyone who comes in whether they can come back in half an hour. Have contact information for an IBCLC who can help you out as you begin breastfeeding.
If you’ve just had a baby: The hospital will contact you with a generic call or letter to ask how your experience was. I know you have a baby and you’re tired. But take the time to answer their questionnaire and answer honestly. If you got lousy customer service and know what would have helped, tell them. You don’t have to figure out how they should conduct all their business, let them sort out the logistics. But you ought to let them know you have a complaint with the way they do it now.
If you are a friend of a new mom, and can see that she had a lousy hospital experience because of this: write to the hospital and complain.
Things don’t change when no one complains.