Webinar~ WHO CODE ~ “The Code, Companies, and LC’s”
|
|||
|
Oct 6
Oct 6
A Full Moon doesn’t always bring lots of babies
A Full Moon Flight?
We had a Full Moon this past weekend. October 4th– according to my calender. Over the past 35+ years in this business, it has been my experience that the full moon does NOT bring all the babies! We had just one baby born this whole weekend…. and hardly any labor checks. It was eery Quiet. (The “Q” word. Something we only say after our shift!)
The weekend before, however, is another story! We had 13 deliveries during the 2 day wkend and L&D was packed most days during the whole week leading up to this full moon! We had to use a lot of overflow rooms for evals and non-stress tests. Everywhere I turned, it was crazy busy.. and not just in L&D. It seems we get more babies with high bilirubins, more early babies with transitional breathing problems and other little issues whenever we have high census!
In my experience, I have seen the most babies born either on a new moon or the week of waxing or waning of the full moon and not on the actual full moon. Is it like that where you work?? I would really like to know the experiences of other L&D nurses.
So tell me— what happens in your world?
My Breast Pump and I didn’t get Along
Can I Pump my MILK? Should I? …
or Not. Even. Bother.
My Own Struggles with Pumping and Working
and doing what worked for me
Welcome to September’s Carnival of Breastfeeding!!!
I have this post AND an additional post All about Pumping including choosing a pump and how to Practice Pumping before going back. After you read this, check out the other posts on this month’s theme of “Breastfeeding and Work” linked at the bottom of this post. All links will be added as I get them hopefully by the end of the day Monday, so be sure to check back for the full list!
A little history
As far back as I can remember, the only breast pump we had around in nursing school or when I first started working on the maternity unit was this thing that looked like a bicycle horn. This picture above is for an old “Breast Reliever”. It is glass with a rubber bulb to squeeze for suction. This particular antique is from the earlier half of the 20th century. We actually had a similar type glass model in Nursing school and on my 1st OB unit in 1974. Historical use of breast pumps shows the first patent was issued in the 1800’s and a patent for a mechanical version was issued in the 1920’s. Information was scarce then. Not too many nurses knew much about it. Mother’s were instructed to use it if they got engorged. I can’t believe it would have been very helpful.
We got a newer plastic version of this pump in the 70’s but still didn’t have any clear instructions for use. I was never taught by instructors or fellow nurses, so all I could do for the patients in my care was review the instructions on the box with them! I don’t even remember what that said. Those old horn pumps were trouble. They were traumatizing to the breast and the rubber bulb was just a trap for bacteria.
I remember one mother in particular in 1975 had been readmitted with bleeding, gone to the OR for retained placental fragments at 2 weeks postpartum. She was breastfeeding and having trouble. I took care of her postop. She said “I can’t believe how much milk I have, what can I do?” I promptly went for the only pump we had and went over the directions with her. She was saying it hurt but felt better at the same time because it did help to drain some of the milk. I didn’t much know then about how the retained placenta can delay hormonal shifts and your milk coming in. She and I both thought at the time it was because of being separated from her baby!
ANYWAY—
By the time I had my first baby in 1979, (YES- 30 years ago) I had become more familiar with pumps because I had a friend pumping and now I was very personally interested. I wanted to pump just like her! I want to store milk for my baby when I went back to work. Her baby was 3 months old and she had gone back to work. She pumped in front of me once to show me how easy it was. She used a cylinder style hand pump similar to this picture. She got 8 ounces of milk in about 10 min!
It had one chamber inside the other. To pump, you would place the cone over your breast and pull the outer chamber up and down. This was a very popular style pump at the time. Easy right? I promptly went and bought one! I can do this!
My son was born weighing 6 lbs 9 1/2 oz. Breastfeeding got off to a great start, there were no problems at all. I was very confident about that and had great support from my best friend. My son weighed 7lbs 2oz at 2 weeks and nearly 10 lbs by 6 weeks.
I had plenty of milk!
None of which hit the bottom of the chamber when I first tried to pump…. no matter what I did! I knew nothing about the technique of pumping. I worked and worked at it. I could playfully squirt milk across the room. I had squirting contests with my sister. We cracked up laughing! I could not get any milk with the pump.
I had never practiced. I thought that once I was away from my baby, I would just pump… thought the milk would just come out like my friend. I went to work, let myself get a full feeling and tried. Nothing. I woke him up when I got home and made him eat! The next day… same thing.. Nothing. Luckily I only worked 2 days a week so I nursed him all the rest of the time. I kept trying- week after week– I thought I just had to get used to it. I am sure I was very stressed each time, never using any of the tricks I teach moms today. I still never thought to practice when I was home with the baby. The most I EVER got after 45 min of pumping was one ounce. I gave up and only fed formula while at work. My body adjusted and I was happy doing what I was doing.
I wrote a guest post over at Breastfeeding Moms Unite on pumping including choosing a pump for you and practicing to pump. All moms are so different and many have no trouble at all expressing their milk. Others have trouble releasing their milk to this plastic “thing” on them that doesn’t feel like their baby. It’s just not the same! In that post I say:
I have found it’s important for mothers to understand that pumping is a substitute for the real thing and that it takes practice for lots of moms. I always say to expect hardly anything the first time you try then whatever milk you may get is wonderful! One very important point to realize is that whatever you see come out with a pump or hand expression is NOT a reflection of how much a baby gets in a feeding when he is well latched and effectively feeding. What you see come out with the pump is what your body released at that moment in time. Even women with a great supply and healthy growing babies can have trouble learning to pump. The baby is the master … you are merely trying to imitate him! The type of pump used and when you pump in relation to the age of the baby as well as the time of day, frequency etc. can have a big impact on your results.
My second baby was born in 1985 . Another 6 pounder at birth with rapid weight gain, a great milk supply for me. I had some improved pumping results with him partly because of better pumps and mostly by sheer determination to help him heal through major surgery at 3 months. The Children’s Hospital had a hospital grade electric pump, a pumping room and directions on what to do. Because I was able to provide milk for him in the hospital, I had renewed faith in myself that I could pump once I went back to work.
There were different pumps, better pumps available. I tried my old pump and some piston style pump like above. I don’t remember the name of that either. I tried many…still waiting to pump again till I had eventually gone back to work. There were some battery/ AC adapter electric ones to buy. I had one, but don’t even remember the name. I had to push a button to make the suction go on and off –> otherwise there was constant suction on your breast and no control on the degree or amont of suction. Some people told me to keep the suction on till it started to flow then push that button on/off.
Well it didn’t flow, it hurt. I never released any substantial milk for any of these pumps. I wasn’t able to keep it up. I ended up doing the same as I had with my first son. I made a routine which worked for me of nursing all the time at home and formula when I was at work. We didn’t have any hospital grade mechanical pump until the 1990’s at my hospital, long after my third baby and after I became a Lactation Professional.
I had dealt with so many other issues after my third baby that pumping was never much of a thought in my head. I simply fell back into the routine that had worked for me with the first two babies. She is the baby that nursed the longest even after I went back to work!
Looking back, I think if I had access to the information I know now, and the availability of today’s high quality pumps…I might have, possibly would have had better success pumping. The most important point is that I still felt successful and was happy with my breastfeeding relationship for all my children!
After all, I could squirt my milk the farthest!!
😉
More Carnival Posts:
- Ask an LC: What About Pumping? My Guest Post over at Breastfeeding Moms Unite
- Breastfeeding At My Family Daycare by Melodie at “Breastfeeding Moms Unite”
- A Job where Everyone Breastfeeds by “The Milk Mama”
- Sorry, Facilities Guy by “Momnesia the Book”
- Taking Your Working Boobs to Work by “Marshins”
- Working and Breastfeeding a Toddler by “Strocel.com”
- Working and Pumping by “The Marketing Mama”
- Breastfeeding and working is possible, and you can make it work by “Motherwear Breastfeeding Blog”
- Do you really need a pump? by “Chronicles of a Nursing Mom”
- I Think This Officially Makes Me a Mommy Blogger by “Vanderbilt Wife”
- What about Breastfeeding When I go Back to Work? by “babyREADY”
- Tips for Breastfeeding and Working by “Breastfeeding 1-2-3′
- Breastfeeding and Working in the UK by “Breastfeeding Mums”
- The 5 biggest mistakes working & pumping moms make by “Blacktating”
- This is a Breastfeeding Office by “MumUnplugged”
- Beating the Employment Booby Trap by “Best for Babes”
- Nursing Mothers Need Workplace Support by “My World Edenwild”
Sep 20
No VBAC’s Banned: So Far so Good
My little hospital is not one of those hospitals which has banned VBAC’s.
We’ve been doing VBAC’s since 1984. Here is our first VBAC story. You may have read and heard that some places had specific policies against a mother attempting a VBAC. There is really only a small percentage of women who truly are not a good candidate for a vaginal delivery after a cesarean. (Having a previous vertical incision in the uterus for example). There are several places a mother can go to for facts, scientific research, honest information and support if her provider or hospital has denied her an opportunity to VBAC. If this has happened to you, it will be important to do your homework, get the facts and have a really good conversation with your provider. It is important to make an informed choice weighing your benefits and any potential risks.
We do just under a thousand deliveries a year.
From January through July 2009~
We had a 100% successful VBAC rate!!!!
We had 2 mom’s last month that ended up having to go for a cesarean after labor began. I don’t know all the numbers but I had looked over the perinatal data sheets yesterday and I was so very happy to see how we were doing.
Let’s hope we keep it up!
😉
Sep 14
Are YOU an Activist? Healthy People 2020 Public Meeting Announcements
ARE you an activist?
Do you want to have input or learn more??
What do you know about the Healthy People 2010 National Objectives ……. and how the breastfeeding goals haven’t been met?
The PLAN ~ The GOAL:
(From the Healthy People website:)
Healthy People 2010 challenges individuals, communities, and professionals, indeed all of us to take specific steps to ensure that good health, as well as long life, are enjoyed by all.
Healthy People 2010 objectives for breastfeeding in early postpartum period, at 6 months, and 12 months are 75%, 50%, and 25%, respectively. Healthy People 2010 objectives for exclusive breastfeeding through 3 and 6 months of age are 40% and 17%, respectively
So how are we doing???
From the CDC website regarding Breastfeeding Data:
Breastfeeding rates have improved since 1999, but fall short of Healthy People 2010 objectives regarding duration and exclusivity. Among children born in 2006, 74% initiated breastfeeding, whereas 43% were breastfeeding at 6 months and 23% at 12 months of age. Approximately 33% of infants born in 2006 were exclusively breastfed through 3 months of age, and 14% were exclusively breastfed for 6 months.
Check the CDC website above for a complete evaluation of how we measure up. I am so happy for thoses states who actually accomplished these objectives! There are some that exceed these goals and others who are really behind. I think because of this, the national picture as a whole is misleading, reflecting an average of a lot of highs and lows. It doesn’t show a true picture for those areas struggling. I want to learn more to help my area move up towards the goals.
What can we do to improve and work towards accomplishing these goals ????
I got this important email letter today and promptly registered to go the meeting in Philadelphia on November 7th. I want to learn all that I can about what goes into the planning and possibly what more I can do at my local level to help meet the breastfeeding objectives. From the US Lactation Consultant Association:
During October and November the Department of Health and Human Services (DHHS) will conduct public meetings in Kansas City (Kansas), Philadelphia (Pennsylvania), and Seattle (Washington) on draft objectives for Healthy People 2020. The public will have an opportunity to comment on the draft objectives at the public meetings, and on the public comment Web site. The comments received will then be used to revise the objectives appropriately. We hope that you will consider attending if you live near one of these sites. We will coordinate work on this with the US Breastfeeding Committee. This presents a wonderful opportunity to have our voices heard on national policy-making relative to breastfeeding.
I’m not public speaker, I am interested in policy making for the HP2020.
I want to go and learn from my well respected colleagues.
Check it out! Click on the HP 2020 icon at the top of the post!
Sep 7
Yard Sale = Huge Profits
Area Flooding
Summer usually brings many many garage sales and yard sales in my neighborhood. Over the last 3 years, I have accumulated a large quantity of items that I just never got around to selling on eBay. I had been a fairly active seller…. sometimes making a really good profit! The things I had accumulated lately either weren’t suitable for the eBay market or the fees charged would not make it worth my time and effort…. so they sat in boxes collecting dust. We had many antiques, collectibles, items from our old barn, chairs partially refinished, in need of repair etc..etc.. It was going to be the kind of yard sale I would love to peruse!
The day before the sale, as we tried to prepare and set-up, was the day when “Daniel” came up the east coast causing huge torrential downpours in my area… We had already advertised, I had to be ready for the dealers that come at 5 am! Waves of heavy rain hampered our efforts, collapsed tents and blown away drapes caused my husband to make a few trips out for more tarps and plastic drapes.
I knew we would not be ready for the incredibly annoying dealers… so I parked my van sideways at the end of our driveway effectively blocking entry. I did not sleep before the sale and subsequently got a migraine to add to our muddy fun. All in all it turned out to be a profitable sale. The weather eventually cleared and we had waves of buyers instead of rain.
I have tried to tally our profits.. ….. keep in mind I don’t know how much I originally paid for some of these collectibles over the years…
Amount in my pocket at end of sale : $342.00
Total money paid by buyers over 2 days : $302.00
Start-up pocket cash for change : $40.00
Ad in the paper : $24.00
Markers, stickers, flourescent paper for signs : $11.50
Trips to Home Depot and Lowes for more tarps/plastic : $43.00
$342.00 in pocket minus costs and start-up cash = $223.50 POTENTIAL PROFIT
Handing over the ENTIRE $342.00 to my mom to help with her taxes—>
The look on her face and her tears–>
PRICELESS
😉
Sep 2
Babies EVERYWHERE! Wordless Wednesday
Babies Everywhere!!
I got this greeting card a while back and I adore it.
1950’s to 1960’s style maternity outing…
cloth diapers and outfits
Partial of the inscription inside reads:
“Whatever you’ve got, bet your glad it’s not this!”
(Credit—> Shoebox division Hallmark)
Aug 31
A Wonderful Day in the BirthingHood
What a great fun day in the world of birthing.
The first words I heard at work today were words that I just love to hear when used in this sequence….
“Section’s Canceled”
Hooray!
Her Cesarean had been scheduled because her baby had been in a transverse lie position…. for weeks. However–> this smart little genius baby had positioned his little self into a beautiful head down position before arriving at the hospital this morning! Mom was also contracting regularly and was 3 cm dilated. This was her second baby, first exam of the day, so she hung out for a while until it was clear she was continuing to make cervical changes and labor was underway.
A few others decided it was their time to make an appearance today. One baby boy was a couple weeks early and another a few days over 41 weeks.
Ever hear that things sometimes happen in 3’s ??
As luck would have it, 3 young men decided to be born within 15 minutes of each other! All 3 were spontaneous vaginal deliveries. All 3 boys were breastfeeding within that first hour and 1/2 … not bad!
All the moms were so happy with their birth experiences. All the babies were healthy. The staff worked really well together. Our midwife was awesome! The doctors were fun, funny, thoughtful and kind and made really good patient centered decisions.
It was just an all around wonderful day in the birthinghood!
Wordless Wednesday ~The Mom Song
This is funny ~
Have you seen it??
You may be able to appreciate more at my age…….
Aug 24
Frustrations in Obstetrical Care …Culturally Sensitive? Oppressive Male Partners?
The drama that went on here this weekend would be fodder for 10 or more Jerry Springer shows!
~Unreal~
I kept thinking…
“Please help me”
I am not and never have been prejudiced or bigoted in thought process, personality or behavior towards others. I am actually on a campaign to help educate our staff on being culturally sensitive and delivering culturally competent care in relation to obstetrical, breastfeeding and newborn care…. I’m currently organizing a quick reference handbook so certain beliefs & cultural values are better understood by our staff.
This type of sensitivity is very important to me.
It may not matter how I say this. Despite me trying to convince you that I am not intending to offend any type of people…..someone will most likely get annoyed or upset. I don’t usually enter into this type of discussion. I am quite adept at diffusing anger. I am not singling out a problem with any specific culture, ethnicity, or country of origin. I am not attributing any certain behavior to any certain culture.
This weekend, we had mother’s giving birth who have recently arrived in the United States from the following areas: Argentina, Poland, Liberia, Egypt, Iraq, India, Dominican Republic and Nigeria. Sometimes their husband, boyfriend or significant other was from yet another different country. These are not unusual immigrants for our patient population. It is however, unusual to have such diversity in a single 2-3 day period!
My concern is this— As a health care provider– how do you even begin to try to understand another’s strong belief’s or values when you are treated with tremendous disrespect and confronted with attitudes which are unusually demanding of the caregivers to “provide” for any and all needs. Now this is of course what we do…. provide for the needs of those in our care. That includes our responsibility for understanding different certain religious beliefs, cultures and their various norms and values. But this should be done within an environment or culture of MUTUAL RESPECT.
As much as it is our responsibility to provide for those individuals in our care….. to be culturally sensitive. I feel there should at least be some responsibility on the part of the patient — and or their family- to learn what may be expected of them …. to communicate their history, needs and or wishes to the doctors and nurses~~ or at least to try to understand when it is explained to them at the time of birth and not lash out with anger or disrespect to their caregivers. Is it too much to ask for a little bit of responsibility to understand at least a little something about what is involved in childbirth, postpartum, newborn care and the legal recording of birth in the facility, state and country in which they have come to and chosen to give birth! {Many times I have been told they came here so their baby would be an American citizen.} Am I allowed to ask that those from other countries try to be somewhat sensitive to and try to understand our culture? I am not trying to victim blame here. Really. Many of the patients exhibited rude entitled behaviors and were very disrespectful to staff. We are all “others” to each other –> but one big blending of society. Lets ALL understand and respect each other.
Some of the behaviors we dealt with include:
- A mother is married, the father of her baby is NOT her husband. The FOB becomes physically violent that his name can not be on the birth certificate–yet– until there is an affidavit submitted that the husband is not the father…. This turned into an all out fist fight between the the 2 men. “SECURITY!!”
- A husband refused to allow his wife to be examined in labor during his absence, yet left for hours at a time demanding the hospital provide for his transportation to and from his business 15 – 20 miles away.
- This same father would not allow his wife to speak for herself…. then called our unit many times after the birth when he was not there to say he was sure his wife was suffering from post-partum depression and we needed to treat her!
- An unmarried young girl had a PFO against the father of her baby — She did NOT want to see his family yet that FOB’s family demanded to be allowed to visit, displaying hostility, speaking loudly and threatening staff in a non-English language outside the entrance to our unit!
- Another mother delivered and the father of her baby was currently in jail on drug charges. She met the criteria (for other reasons) where she and her baby were screened for drugs…. Both were positive for cocaine and heroin… sadly.. 😦 This infant needed to be placed in protective custody of Children’s Services and treated for withdrawal. This is always difficult and heart wrenching. This mother spoke very little english, was ANGRY the tests were done and we were not able to help her understand a situation of this magnitude easily with the language line….
- Frenzied inpatient banging on the window and yelling for the only nurses’s attention to simply ask a question or get more supplies for their infant even though she was involved in an exam with a doctor on a new very sick infant and had signaled she’d be there “in a moment’…
- The family and multiple extended family members demanding minute by minute updates on a sick newborn, interrupting our care by knocking on the doors and windows to the nursery… after we have explained all minute by minute updates to the parents of that baby who were at the bedside. I have a feeling that culture may have placed a value on the elders decisions over the actual parents, but this mother did not want the father’s family to be in the nursery with her. They don’t understand HIPAA or even know what it is! My job is to support the mother and keep her informed and with her baby.
- A family not wanting to answer most of the questions for the birth certificate because… it was simply an invasion of their privacy. Alright then.. it will remain blank and the Bureau of Vital Statistics can deal with it, right?
- A father of a baby requesting then ultimately demanding to speak to the doctor ONLY for each and every one of his questions.. (I am just a nurse).. did I mention it was the weekend?? We don’t have doctors present 24/7 !
There are times when these situations unfortunately occur. Many times the individuals involved are Americans who are 2nd or 3rd generation of mixed ethnic background or are of no discernable ethnic or cultural background, have lived in this country all of their lives and still exhibit the same type difficult personality traits. Since they are more “Americanized” shall I say-or however is politically correct to discuss it— it isn’t so difficult to diffuse hostility’s, discuss options, assist with birth, newborn care, breastfeeding, do birth certificates…etc. It is my opinion that sometimes they understand things better simply from living here. We will ALWAYS encounter individuals with difficult personalities regardless of background who may be demanding in nature. They may not initially understand what’s happening but usually respond well to a gentle receptive approach.
That was NOT the case this weekend!
I only wish for strength and future guidance to help and support those who don’t quite understand.
Don’t yell at me or treat me with disrespect.
I ask those individuals new to our country to help themselves a little and learn some of our language and the framework for which we deliver our obstetrical care.
Please.
