Booby Traps Series: Was breastfeeding in the hospital harder on the night shift? It probably wasn’t your imagination.

by Tanya Lieberman, IBCLC | August 5, 2013 6:59 am

night shift breastfeedingDid you feel like nursing at night in the hospital was harder than during the day?  If you did, there are probably some good reasons for that, and they’re not all about your biology.

Of course, the mismatch between your baby’s circadian rhythms and yours can make night feedings tough in the early days.  Newborns are more wakeful and often feed a lot at night, and of course that’s when you’re expecting to get some rest after your birth.  So the best time for your baby to work on breastfeeding may feel like your worst time.

But it’s also possible that the way hospitals are organized exacerbates the problem.  It’s not insignificant, as one study found, that during the hospital stay “the highest risk time of day for an infant to receive a supplement is between 7 PM and 9 AM.”

Here are some reasons why hospital routines and staffing may make night feedings harder:

Lactation consultants are generally not available at night.  While learning to breastfeed is a 24/7 job, lactation consultants generally work day shifts.  So if you have a breastfeeding problem at 2:00 am, you may end up waiting for quite a while to see one.

Night nurses may not have had the same training opportunities.  Night nurses are heroes, of course.  They need to be as alert and ready to go as any day time nurse, through the night.  It’s a hard job which can involve physical and psychological sacrifices.

But night nurses may miss out on professional development on breastfeeding, which often occurs during the day.  And they don’t benefit from the collaboration and learning opportunities that occur with a lactation consultant on shift.

Night nurses can feel - and be - marginalized.  Abbott Nutrition, maker of the Similac formula, know this dynamic well, and it’s the basis for their Night Nurse Nation website, which markets formula and supplementation to night nurses in a collegial (“we know you deserve a break”) manner, and provides some questionable breastfeeding information.  For more on this, see Amy West’s blog post: Similac: Fox in the Nurse’s Hen House

“You seem so tired.  Why don’t I take her to the nursery so you can sleep?”
In one study, “maternal fatigue” was cited as a key reason nurses reported for babies being supplemented.  Some of this comes from moms, certainly, but some results from well intentioned statements like the one above.  Suggesting to an exhausted mom that she might be able to get some rest by any means at all isn’t really playing fair.  And unless your hospital has a strict no-supplementation-without-maternal-consent policy, or you know in advance to give strict instructions not to supplement, sending your baby to the nursery may mean that she comes back to you with a new experience under her belt.

Constant interruptions during the day may make nighttime the only time to work on breastfeeding.  As I’ve written before, most hospital rooms are Grand Central Station, with an average of 54 interruptions in the daytime hours.  This means that we have precious little time to really focus on breastfeeding during the day, and by the time we have the chance we’re exhausted.  Add in a cluster feeding and a latch problem, and you have a nighttime train wreck.

So if you feel like night time feedings in the hospital were harder than day time feedings, you probably weren’t imagining it, and it doesn’t have to be this way.

Did you have a tough time with night feedings in the hospital?  Did you get good help from night nurses?  How did it affect your breastfeeding experience?



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