It’s twenty-four hours after my daughter was born and our hospital room is filled with balloons, stuffed animals and well wishers coming to see that yes, I had finally managed to reproduce. As Annie basks in her new mother glory a nurse comes in and pulls me aside.
āIām really worried about Natalie,ā she says.
āWhy?ā I say, surprised.
āShe hasnāt eaten for several hours.ā
While itās true Annie isnāt producing much milk and Natalie’s been falling asleep at the breast, the hospitalās lactation consultant told us the baby could go without eating for at least sixteen hours before there was cause for concern. I tell the nurse this.
āIād still like to take her into the nursery and check her out.ā
Natalieās whisked away and twenty minutes later I walk over to the nursery to see whatās happening.
āHer blood sugar is 31,ā the nurse tells me. āIf itās 30 she has to go into the ICU.ā For the first time parental terror grips my heart.
āSee how her lipās trembling?ā she says. āThatās from low blood sugar. Sheās also dehydrated.ā
āSo whatās the plan?ā
āWeāll give her formula,ā the nurse says. āGet her sugar and fluid volume back up.ā
I go back to Annieās room and deliver the news. As you might expect she gets upset. After the visitors suddenly fall into an awkward silence I politely kick everyone out, even the grandparents.
After taking care of AnnieĀ I go back to the nursery. Natalieās polished off a bottle and her sugar is up to 41. It’s supposed to be over 60. āWeāre going to give her another bottle,ā the nurse says. āWeāll keep her here for observation.ā
āCan you tell me why you waited until a crisis point before you intervened?ā I say.
āWe didnāt want to worry you,ā the nurse replies.
I tamp down my fury. āMy wife and I are rational and fairly well-educated adults,ā I say. āWhen it comes to our child we want to know whatās happening. Feel free to worry us. Now, why did you wait until this point before you acted?ā I also want to know why the lactation consultantās advice turned out to be medically unsound.
āIn the old days,ā the nurse says, shrugging āIf a baby didnāt eat for four hours we gave them formula. Now with the family friendly policy it’s different.ā
Ah, the family friendly concept. The hospital’s slick brochures proudly trumpet how they encourage “skin to skin” contact, moms rooming with newborns and breastfeeding from minute one. But Iāve worked in health-care on and off for years and can read between the lines. āSo thereās tension between administration encouraging breastfeeding and what the nurses think should be done?ā I say. The nurse nods.
āSounds like your family friendly policy is marketing,ā I say. āI donāt care about marketing. I care about facts. I trust a blood sugar monitor. I do not trust bullshit. You have my permission to give my baby formula whenever you feel itās warranted.ā
āYes, sir.ā
āGet a supervisor down here. Now.ā
Half an hour later an administrator arrives. At this point Natalieās out of the woods but Iām still pissed. I calmly explain what happened. The administrator listens patiently.
āYou do understand that if something happened to my child Iād sue you for millions?ā I ask in a low even voice.
āYes, sir,ā she says, taken aback.
For the first time in my life I mention all the media contacts Iāve accumulated in my Rolodex and how I got them. āYour family friendly policy sounds like marketing and not medically sound. If something happened to my baby I would not rest until someone lost his or her job. Understand?ā
āYes, sir.ā
āHereās whatās going to happen,ā I say. āMy child will be under observation in the nursery tonight. Then I want a pediatrician to evaluate her prior to any talk of discharge. Someoneās ass is going to be on the line for this kid. Do you understand?ā
āYes, sir.ā
And that folks is how you become the most popular father on the maternity ward.
The evening passes without incident and Natalie is one-hundred percent.Ā Early the next morning another nurse intercepts me in the hallway. Ā āIām glad you spoke up,ā she says. āWe were all talking about your case this morning.ā Then she tells me that the nursing staff has serious problems with the hospitalās family friendly policy and its emphasis on breastfeeding and how children are not getting enough food at times. She tells me they have had conflicts with the lactation consultants. āYouāre not the first parents to run into this problem,ā she says. āWeāre going to have a meeting with administration and voice our concerns.ā
So there you have it. A hospitalās policy put my kid at risk.
Now Iām sure that wasnāt the hospitalās plan. My mother told me horror stories of how nurses used to rule maternity wards like guilt tripping dictators so family friendly policies are probably a good change. But working in mental health showed me how even the most well-meaning plans can be full of unforeseen holes. And when hospital administrators, who often operate like feudal lords, put agendas that look good on paper over real world medical concerns, problems will arise.
A quick perusal of the Internet showed me all I ever wanted to know about the lactivists, Nipple Nazis and the breast-feeding war being waged in America. I donāt really give a shit. While Iām all for breastfeeding and recognize itās benefits, itās a function of nature and not an ideology. If a new mom is not making enough milk or the babyās not latching on; giving a baby formula is not the end of the world. It will not wreck their chance of getting into Harvard. Of course every baby is different and every parentās experience and needs will be different ā but Iām talking about my baby here. This nerve wracking episode showed me you have to protect your child from day one. Even from the people who are supposed to know better.
Later that day the nurse who sounded the alarm tearfully apologizes to my wife, saying she would never again let her nursing judgment be influenced by hospital politics. I thank the nurse for speaking up and express our gratitude to her and the entire staff for taking care of Natalie.
āSounds like you started something,ā my wife says after the nurse leaves.
I look at my daughter as she sleeps in my wifeās arms. My outward demeanor is calm but a protective fire is raging within.
āNobody fucks with us,ā I whisper, stroking my daughterās hair. āNobody.ā
When Number One Son was eight-ish, he spent the month of December in the hospital with a lung leaking air post-pneumonia. They finally fixed it surgically December 23rd (half a lung gone…). He’s still in ICU Christmas Eve, when he starts ballooning. We think his chest tube is leaking air again, and he will look like the Michelin Tire Man for Christmas (and, more seriously, his eyes will swell nearly shut; not dangerous, but who wants to not see). The interns who lost the straw draw and got stuck working Christmas Eve are more concerned with getting back to the party than getting No. 1 Son checked out.
So Milady goes and finds his surgeon’s phone number in the book. And calls him at home. He says that he’ll make people jump, and to call him back in 15 minutes if they haven’t, and he’ll be there in 20.
As Milady is coming back to the room, a nurse tries to comfort Milady, and tell her they’ll be up soon. Milady says “Don’t worry, I called Dr. I, and he said that if the interns haven’t got the X-Ray machine up here in 15 minutes, he’ll be in in 20.” The nurse turned so white I thought she’d faint. The X Ray techs were running down the hallway with the machines, and at least one intern was near No. 1 Son the rest of the night.
(As an aside, he just had fluid buildup. One water shot later, he peed about two units of fluid, and all was right in the world.)
There is an absolute power structure in a hospital, and nurses are high on it, but surgeons are God.
We were definitely too passive during our month in. Dr. I said the hospital changed its entire protocol for conditions like No. 1 Son had, to do more aggressive surgery earlier, since waiting just wasn’t helping the patients get over it. It’s good that you took charge of this.
It also helps that children are remarkably non-fragile. No. 1 Son is now 17 and looks like a football lineman. And when the college tuition bill comes due soon, I’m going to wish he was one….
That’s an absolutely incredible story. I’m simultaneously awestruck at your calm and fierce handling of the situation, and horrified that the situation ever existed in the first place.
Wow Congratulations to you. This is an incridble story of your life.
Oh completely! The wonderful nurses at our hospital couldn’t account for where our daughter was for a whole hour when we entrusted her with her in the nursery overnight. And they don’t let family walk around the corridors with the baby for their security and protection!
But I don’t think any less of nurses. I don’t begrudge a whole profession for a mistake that can happen to anyone. A lesson to learn fast in this journey of parenthood, or you are going to find yourself angry all the time! š
If there’s one thing I learnt about parenthood, that it is all about risk management. Whatever you do will have a positive and a negative affect one way or the other. Formula companies do a wonderful job with marketing. What they also don’t legally have to do is to disclose to you are the not-so-wonderful-chemicals (some call them toxins) they add. Just look at European standards vs. USA. Now there’s something to be enraged about (for both adults and children). I am no conspiracy theorist or a boob-nazi or whatever labels you would like to put on me, I am a formula baby too. But before you write-off everything one says, look into things.
Welcome to parenthood. Just a lifetime of such worries ahead!
*slow clap*
Well played sir, well played.
But keep in mind that the nurses will often do what is best for the baby and easiest for them AT THAT POINT IN TIME. So they will probably feed the baby formula with a bottle. Easy for them, easy for the baby. But when your wife tries to nurse the baby, watch out for nipple confusion. The way a baby sucks a bottle is different than mommy. They could give formula using a tiny cup so baby doesn’t suck differently. They could use a tube attached to mommy so baby gets formula while nursing. Talk to lactation consultants to make sure that baby is getting the formula it needs but in the best way to make nursing easier in the long run.
We’re at what I like to call a 70/30 ratio – seventy percent breast milk,thirty percent formula. Natalie gets half her breast milk from the breast and the other half from a bottle. (Milk that has been pumped and stored.) We tend to give the baby formula mostly at night. It fills her up and she sleeps three hours instead of two between feedings. She has not experienced nipple confusion and feeds well from both breast and bottle. Of course, this been our experience and other parents’ mileage may vary – but it works for us.
When we took child classes prior to the birth, the lactation people told us we should feed exclusively from the breast for a month, breast milk exclusively for six months (Bottle or au natural) and to continue using breast milk for a year even when moving to solid foods. I have no problem this as a guideline but it’s not Gospel. But lunatics have latched on to this subject and turned it into an ideological crusade that would make the Taliban blush. There is such pressure on mothers to breast feed that they often are made to feel guilty when the cannot for a variety of reasons. Of course, these zealots claim there is “never a reason not to breastfeed” and online forums are full of mothers (And fathers) who love to get on their high horse and claim they are superior because formula has never entered touched their child’s lips. This rigidness only serves to confuse and upset new parents – making their lives harder than it has to be. Parents should help each other out – not marginalize them.
As far as I’m concerned, many of the contributors to “Mommy blogs” and their related forum posters are neurotic dingbats vying to see who’s got the biggest parental cock. They are living through their children which is a recipe for disaster. It’s not about children, it’s about their egos. Parents disseminating helpful information and telling stories about what works and what doesn’t is laudatory, but I fear those voices are being drowned out by the ideologiocal crazies and their parental “purity tests.” Sort of like the political zealotry which is now poisoning our civic debate.
I will not go on the internet to learn how to raise my child. I’ll talk to someone with a medical degree on their wall or parents that I’ve personally seen raise healthy, happy children. But this draconian focus on breastfeeding is becoming political/fashionable and getting institutionalized into hospital polices – a policy that almost harmed my baby. Fuck that.
Of course, I’m not referring to you SBL. This reply is just an outgrowth of my frustration with the bullshit factory/big business parenting has become. Is breast milk best? Probably. But it isn’t the elixir of the gods either. Every parent has to find what’s best for their child. And since all children are different, all our solutions will be different. Beware of any one pontificating one size fits all solutions.
“who love to get on their high horse and claim they are superior”
Speaking of which, please go look in the mirror.
I don’t see any claims of superiority. I see a father who is pissed that his child’s life was put in danger because of an administrative policy!!! Breast is best, but only if it works for you. I had to give up breastfeeding when my child was 6 months old because when I had to return to work my schedule (in a hospital) made it impossible to pump with any regularity. My kid survived quite well. I have news for you cfr10. Hospital administrators do not always know what they are doing!!!!!!!!!
And it has only just begun….
You’re a natural. Of course you are. WTG Steve.
I’m all for family-friendly, but in the old, old days there were wet-nurses around to step in when the mother couldn’t produce. Unless the hospital’s going to keep a couple of those on duty at all times they need to be more flexible and responsive, and you showed them that. Good work, Warrior Dad.
This: http://gothamist.com/2014/02/28/breastfeeding.php
I’ve been on the other side of this with my wife and son. He was born 5 years ago at a hospital that was really aggressive about pushing formula. They even had an unwritten policy that if the baby was not successfully breastfeeding within 4 hours, they’d threaten the parents with the NICU unless they agreed to supplementation. They’d also fired all of their lactation consultants as a cost-saving measure (or possibly because the maker of Enfamil was a major donor), “replacing” them by having a couple of the nurses take a two-week lactation training course. We requested one of these, but it was almost two days after birth before one had time on her schedule for a visit and that was not particularly helpful. We had no idea what we were doing and no idea that this was anything other than normal, so we went along with it and the entire hospital stay was a nightmare of juggling semi-successful attempts at breastfeeding with supplementation all colored by the fear we were doing something wrong that would result in our baby being taken to the NICU. The mix continued at home for a few more days until, on the advice of a friend, we hired a lactation consultant to come to our house. It took less than an hour of instruction and experimenting for mom and baby to work it out and we never needed to supplement again.
We went back to the same hospital last summer for the birth of our daughter. This time we were fully prepared to battle with them over formula, but it turned out that policies had changed completely in the interim. No formula in the room and encouragement of breastfeeding. They had even re-hired lactation consultants. The result, according to our local paper, was “71 percent of babies born at the hospital in August [2013] were breast-fed without formula supplementation, up from 34 percent in September 2012.” Note that the 34% includes all births, it was closer to 0% of first children when we were there in 2008.
Talking to the nurses about the change it turns out that much of the cause of our original experience was pure defensive medicine. Formula is great for keeping the baby’s numbers out of the malpractice zone for the first couple of days which trumped trifles like mother and baby’s comfort and the long term positive effects of breastfeeding. What turned it around was the internet. We live in a big city where there’s a lot of competition among hospitals and people discussing experiences like ours was causing a lot of pushback from parents and either an actual loss of business or the fear of it amongst the administrators.
Good for you- both for good parenting and for keeping your head! Your little one is lucky to have a fierce Daddy.
“But lunatics have latched on to this subject and turned it into an ideological crusade that would make the Taliban blush.”
Thank you. This is SO true. And good for you and Annie for doing what is best for Natalie.
I had a similar experience when my son was born 8 years ago. I couldn’t produce milk and hadn’t slept in three days. My son was losing weight quickly and one night, I begged the nurse to get him some formula. She made things so much more difficult by saying I should try to breast feed (wasn’t working even though the old boobs had gone from normal to porn star in size) then when I begged for formula for my son she gave me three or four choices. I broke down in tears telling her to choose one but she refused. In my sleep deprived state, I managed to remember what my cousin had fed her daughters and asked for it. She finally brought the bottle which my son drained. Then my husband asked if our son could go into the nursery because I was beyond exhausted. She refused saying that our son was ‘too old’ (he was 72 hours old) to go in. A few hours later, shift change and another nurse came in. She saw that our son was still hungry, I was a huge mess and asked what was going on. My husband told her while I wept. Thoroughly pissed off, she swept off to move a baby out of the nursery (“the parents need to learn to take care of the kid now”) and bring our son into the nursery. Then she put a do not disturb sign on my door and refused entrance to the room to anyone for four hours so I could sleep. The kicker? When my OB walked in after I had six hours of sleep, he said that the nurse that had given me so much trouble had written in my chart that I had post partum depression and needed to be put on medication immediately. I told the OB what had happened and his face got grim. Guess who got her ass chewed out and was sucking up to me like a vacuum on dirt the following night? Some times we have to be our own advocates. I talked to the lactation specialist later and told them that the women in my family were unable to breast feed and she said, “Oh well that would mean you couldn’t so I don’t know why you bothered trying.” Really? Really?? I dropped friends because of the breast vs formula debate since they felt I was committing child abuse by not breast feeding – not getting that I could not. This is a very loaded debate. But, Steve, GOOD ON YOU for calling people on the carpet to get what was best for your family. Go mad dog on them.
The commenter before me, Kim, was on the money! Good on you for speaking up and best of, good for the baby, good for your wife and good for you! Ain’t nothing wrong with going mad dog when the situation arises! xoxo
Good for you! When my daughter was born, she wouldn’t latch on and there was no milk but the lactation expert said she’d be fine and that she was getting plenty of nutrition and to keep trying. We were released (against my OBs wishes) and I kept trying to breast feed for the next 24 hours. The baby kept crying, I hadn’t slept since we got home and my husband felt helpless. I finally called a friend who’d had 3 kids and she brought over some formula. The kid sucked it down and immediately fell asleep. When the lactation expert did a follow up call the next day and I told her my daughter was drinking formula, she berated me by saying I didn’t try hard enough and the baby would have been fine for a couple of days. I hung up on her. Somehow, my kid has made it to age 19 just fine.
Welcome to parenthood! I work in a hospital, so totally understand this scenario – and others the readers have shared. As with so many situations in life (and Parenthood) trusting your gut, paying attention and speaking your truth is required. Sounds like you have set some good motion rolling.
So looking forward to more dispatches from Fatherdom!
Hi Waiter. Checking in after several years. Wow, big life changes. First, warm welcome to your baby girl. Second, I was a wreck after my baby girl was born jaundiced, a few weeks early, and begging for a bottle of any formula in the house. Had forgotten all about that nightmare till your post. But you know what? Now she’s my upstairs neighbor as of a few weeks ago and my best girlfriend. It goes by so fast, my friend. Savor every moment–the good, the great, and the ongoing challenges!
When dealing with medical professionals, I always remind myself of this joke: “What do you call someone who got all C’s in med school? Doctor.” They are just people, they have good days and bad days, some are amazing, and some are barely scraping by. Just like in any profession.
You learned first off what all parents should know, no one will watch our for your children like you will. I’ve “fired” nurses and doctors when it became clear the health of my kids or my wife was not their #1 priority, or if I felt they weren’t competent to the task. One notable incident was when my son was in the hospital, and the nurse came in to put in the IV (which they do whether you need it or not). She walked into the door jamb, tripped over a cart, and clearly was not focused on the task at hand. I told her to go find someone else to put the IV in, as I had zero confidence in her ability to do it. She got all pissed, himmed and hawed, and finally gave up when I called the head nurse in and explained my reasons. The head nurse did it first try, and my little guy barely reacted.
Keep being that advocate, whether it’s at the doctor, in school, or just simply with all the ignorant people in the world. Good luck and congrats!
I had my first about two months ago – it’s a responsibility I take with the most extreme of seriousness because the price of failure is so high. It is good that you voiced your concerns with utmost seriousness; it is obvious to me that many in the medical profession feel the need to pander to the rising popularity of “mothers know best,” “breast is best,” natural organic hippies and this, as you saw first hand, inevitably leads to some dangerous consequences. As soon as my kid was born it was straight on formula; my partner is not a cow, and I wasn’t letting my child starve to death just so we could be one with the Universe and avoid a few frowns from the NetMums crowd.
I’m surprised – they say the same thing all over the place. Babies don’t need much the first few days. In fact in our hospital they don’t even measure blood sugar (or at least I was never told if they did). After two days of suckling, my milk hadn’t come in and I was told my baby was producing pink pee (a sign of dehydration) and they asked if they could give her 20ml of water just as a precaution. I said yes and asked for cup feeding, since I didn’t want her to get nipple confusion.
I brought her home three days after (had a c-sect) and my milk had only just come in. Baby’s weight had dropped from 3.235kg to 2.9kg but as always, assured that this is normal (and well-documented). Until then I don’t think baby got any more than a couple of drops of milk.
While I’m very glad your baby had the formula she needed (because formula is NOT evil, and babies should get whatever they need to thrive!), I don’t think that on the lactation consultants’ part it was necessarily a marketing ploy. It’s well documented that babies really don’t eat much (and mine ate nothing but 20ml of water for two days) and that they do live off reserve fats (which is why so many abandoned newborns miraculously survive). I now completely understand parental terror (my own baby was born just a month ago!) but do have a heart for the hospital staff. Perhaps what happened to your little one was an anomaly. I am very very glad they caught her blood sugar early enough to give her formula!
Good on you. I had a similar issue when my first child was born in the UK. I was home within 24 hrs of the birth and the following day the midwife came to visit. I thought that I was breastfeeding correctly but when I asked her why my son had crystals in his nappy and she said that he was dehydrated and sent my husband out immediately to buy formula. While my husband was out I got a phone call from the District Nurse who rang to introduce herself and ask how baby was doing. I told her that my husband had gone out to buy formula on the advice of the midwife. She didn’t like that one bit and told me that I should keep up the breastfeeding and not feed him formula. Just what a new mother needs – conflicting advice from so-called experts. Needless to say I ignored her and gave him the formula which he guzzled. Over the following months I alternated between formula and breastfeeding whilst feeling incredibly guilty that I wasn’t exclusively breastfeeding.
Funnily enough I had no problems breastfeeding my second child.
On a side note, I later heard from the midwife who suggested formula that there was a big blow up back at headquarters over the conflicting advice given to me.
Love the blog
In 1990 when my 1st baby was born, it was the same story. The La Leche League was big in my area and breastfeeding was ‘the’ BEST method and EVERYTHING the baby needed, except mine had horrible colic. Talk about maddening. Finally, after several doctor visits and no real change, our pediatrician recommended Good Start (Whey based). The first sip, and we saw her really smile for the first time. What A relief! And I totally agree with you Waiter… the breastfeeding frenzy goes too far…new mothers only want to do want is best for their child, but you’ve got to be realistic!!!