Booby Traps Series: “Everyone told me something different.”

This is the 18th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

Once when I was working in a hospital breastfeeding clinic I met a sweet couple and their newborn.  They were looking frazzled, and were clearly nearing the end of their rope with breastfeeding.

They said what I’ve heard from so many parents about breastfeeding support: “When we were in the hospital, every nurse told us something different.  One nurse said to latch her this way, the next said to do it a different way.  One nurse said that pacifiers were bad, the next said they were fine.”

But what made me laugh (they did, too), was their follow up:  “So, we just do whatever the last person we talked to tells us to do.”

I’m glad that this couple had a sense of humor about it, but the reality is that inconsistent breastfeeding advice is no laughing manner.  It frustrates parents, creates more problems than it solves, and it saps the credibility away from breastfeeding support people. It can also make parents feel quite isolated.

Those of you who have experienced this confusion first hand may not be surprised to see CDC data show that only half of U.S. hospitals report that “nurses/birth attendants are assessed for competency in basic breastfeeding management and support at least once per year.”  Staff training is one of the Ten Steps to Successful Breastfeeding, which forms the core criteria for Baby Friendly Hospital certification.

Annual training might sound like overkill, but remember that nurses’ preservice training in breastfeeding support can vary a lot, from minimal to extensive, and that there is always staff turnover.  Staff training can also vary in format:  paid or unpaid, mandatory or optional, held for all shifts or just one or two.

I often wonder if another area of medical care were substituted for “breastfeeding support,” how much of this inconsistent care would be tolerated.  Don’t you?  Wouldn’t there be an uproar if every new shift a nurse came into surgery patients’ room said, “Oh, no, that’s not a proper IV.  That last nurse got it all wrong.  Let me fix that for you.”

You deserve consistent, evidence-based breastfeeding support.  We are moving in that direction, but for now many of us must contend with this frustrating Booby Trap.™

Did you get inconsistent advice about breastfeeding in the hospital?  How did it impact your breastfeeding experience?



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16 Responses to Booby Traps Series: “Everyone told me something different.”

  1. Jeni says:

    I went to all the breastfeeding classes at my hospital and felt confident that there would be “lactation specialists or nurses trained in lactation assistance” at my beckon call. After I had little K, I asked the nurse in the room about it. She said, “oh…I don’t think I would be much help… I mean I DID breast feed my own little girl but that was years ago” and she walked out. But, you know what? I figured it out myself. I ended up nursing her 14 months.

  2. Beth says:

    I was lucky enough to have very consistent advice from my midwife, lactation consultant and doula, but they all worked together as a team too, and if one wasnt sure, they said so. I have however heard these horror stories of clashing advice from so many people in hospitals. And, considering my lo and I got off to a very very rough start with bf’ing because of a tongue tie, frustration on my part, and a very lazy eater, Im pretty confident in saying that if I hadnt had the advice and support from my birth team even weeks after my child’s birth, I would be a formula mom, or atleast exclusively pumping

  3. Jennifer says:

    I was at the end of my rope and called a WONDERFUL Lactation Consultant ( I never met her) and I nursed the oldest for one year and the second a little less. That girl would NOT sit still and was all over the place….

    I agree with staff needing an inservice and training but, many (I have had the chance to meet) see it as wasting their time… They don’t support it and never did it themselves…. You have to have someone who cares and is educated in breastfeeding to help you troubleshoot.

    I had plenty of milk, latching while uncomfortable at first got easier…. But, my oldest had the worst gas and would scream and I felt as though I was killing her it seemed everything I had eaten would cause her pain…..
    THe lactaton consultant told me I was hyperlactating and I should feed a FULL feeding on one side… Instead of the 10-15 min per side…..

    A TRUE MIRACLE!!! If I had not gotten that advice I know I would have quit…..

  4. Emma says:

    Yes!! I had this exact same experience, and you’re right — it is no laughing matter.

    I had the impression that the hospital I gave birth in was pro-breastfeeding, but my experience was otherwise… it seemed to be just lip service. It was ridiculous – every nurse had a different take on my situation and none of them treated me with much compassion or empathy. I had a baby who screamed all the time, wasn’t gaining as much as they wanted (I’d had an IV, no wonder he “lost” so much weight!), and was doing a real number on my nipples, which were cracked and raw within a few hours of birth. But every time a nurse came into my room, I had to explain that I was having a rough time with breastfeeding — and they’d just look at me blankly and ask again, “when did he last feed, and for how long?” (Or check the latch and say, “Well, it looks good to me” and basically walk away.)

    It was two full days before I was finally allowed to see the on-staff lactation consultant, who worked with us so patiently and gently, that to remember her almost brings tears to my eyes. Over the next few months I got a lot of conflicting advice about my challenges, which definitely didn’t make things any easier. But I persisted and we are still nursing at 15 months. It is one of my life’s greatest accomplishments.

    I guess in the end, breastfeeding support is as much an art as a science – everyone has their own take on it, and that’s to be expected. But when breastfeeding is clearly going poorly for the mother, it isn’t good enough to say, “everything looks good, just keep at it.” A really good support person will persist until some solution is found.

    Ultimately, I think if nurses aren’t routinely trained in breastfeeding support, they shouldn’t be advising and assisting new mothers in that regard. I realize that’s a little radical, but those first few hours and days are SO critical, and yet so fragile – a breastfeeding relationship can be broken so easily.

  5. mamiehall says:

    My daughter was in the NICU and every single nurse and lactation consultant had a different perspective. It was very frustrating. One told us not to swaddle her because “how would you like to drink with your hands trapped at your sides” and another advised swaddling since she kept using her hands to unlatch herself. One encouraged a nipple shield and another said they were terrible. Our best nursing sessions were in the middle of the night when no one was there to mess with us!

  6. This is such an important topic! As an IBCLC, I hear this from EVERY family I work with, and I see the negative effects of this often. I agree, we would NEVER see such inconsistency in any other field or area of medicine.

    Professionally speaking, I think a big part of the problem is that breastfeeding support has been relegated to nurses and nurses are NOT educated in breastfeeding as a standard part of the education.

    Pair that with hospitals who DO train nurses (once they are hired, that is) or nurses who DO take it upon themselves to get the training, and you are offered breastfeeding care and ‘expertise’ from health care practitioners who often only get training in breastfeeding ONCE. That is, they go to one seminar, workshop, or conference and that is it.

    Then, looking at the information in those training session, and you do not have consistency. Though the information itself is good it may be a few years old, and it is not necessary all the same from provider to provider, or trainer to trainer AND it is only the basic of the basic information. So, those nurses who are not lactation professionals are either not trained in breastfeeding or are trained with outdated information or simply with not enough information.

    Too little, too late.

    Sad for parents. Sad for society.

  7. Natalia says:

    I had my baby boy in March. I had a total of 4 nurses during our stay at the hospital. Each one gave us different advice. The 1st had me smush LO’s face onto my breast and forcefully put him on, the 2nd was a very young nurse that is not a mom so it was not something she had knowledge on, the 3rd wanted me to swaddle LO while I nursed him (even after I told her rather do skin to skin) and the 4th tried to help us with different positions. They were all very nice and really had intentions to help us but they were not really knowledgeable when it came to breastfeeding. I asked to see the IBCLC on board but the couple of times she came, LO had already eaten. I had raw and cracked nipples and was in a lot of pain. I saw stars every time LO latched. Once we got home and I was engorged when my milk came in, I called my WIC office. I was visited by a Peer Counselor twice and saw the IBCLC. She discovered LO’s tongue tie, found out I had thrush. I had been so confused from all of the conflicted advice from the nurses. Long story short, they (WIC) were the most amazing support and thanks to them and my hubby we are nursing at 6.5 months :)

  8. Jeanette says:

    I got terrible advice from the lactation consultant in the hospital about my baby who wasn’t latching. After spending hours and hours with the consultant over two days in the hospital my son still wasn’t nursing. After visiting a La Leche League Leader who gave us a nipple shield he used that to latch for three weeks and then could latch just fine without the shield. When my Dad told the hospital lactation consultant the solution to my problem was a nipple shield she told him “good luck with her sore nipples”. So obviously the lactation consultant NEVER actually listened to me since I NEVER had sore nipples. So, like with doctors, seek a second opinion if you don’t get good results from the first person you see.

  9. Jorie says:

    This was absolutely the case in the hospital I had my first baby in, and it was a Baby Friendly hospital!! Fortunately I was educated enough about breastfeeding that I disregarded the worst of the advice (one nurse confided to me, “I’m not supposed to tell you this but you know, a bottle isn’t going to hurt! If you want to pump a bottle or give a bottle of formula at night so you can rest, it will be fine. I did with my kids and I never had any problems!”) It was well intentioned, but what is “fine” for one mom can cause major problems for another, so personal experience does not medical advice make. The same nurse gave me some breast shells (which I never opened) “just in case! I give these to every breast feeding mom.”

  10. Jess says:

    What bothers me even more than this is when lactation consultants provide innaccurate or inconsistent information! I’ve heard some TERRIBLE advice that came directly from hospital lactation consultants. Now that’s just unacceptable. Facilitating breastfeeding may not be at the top of a nurse’s list of priorities, but when a new mother calls in the lactation consultant on staff, and is STILL provided with completely false information that sabotages her efforts, it just infuriates me. I have more than one friend who’s efforts to breastfeed FAILED specifically because of what MORE THAN ONE hopsital LC told them. It’s outrageous.

  11. Tarah says:

    I was like quadruple lucky. My mom breastfed 4 kids, so I had her there to offer advice and check things out. I had my midwife to sort of prep me for it I guess. My hospital ran a free breastfeeding center as well with trained lactation consultants. And on top of that they sent them to your room to help you with breastfeeding. They were very committed to helping moms breastfeed. Just not committed to letting moms sleep so I left after 24 hours, lol. And I guess I was quintuple lucky???? Because my son and I really had no problems on top of all of that, lol.

  12. Jennifer P says:

    This was seriously annoying at the hospital where I gave birth, St. David’s in Austin. It’s interesting to have confirmation that this means they probably don’t offer their staff training in breastfeeding mgmt. So essential to getting off on the right foot! We didn’t have any major issues and figured it out on our own after 2 days, but I wish it had been smoother b/c no matter how much you’ve read the reality of a little one on your breast is confusing!

  13. Beth says:

    I live in the UK and my start to breastfeeding was exactly the same!

  14. JJ says:

    This, exactly! We got something different from every single nurse, I’m not sure how my baby didn’t starve. Each person told me something different, and the lactation consultant came for about 30 seconds on day THREE of us struggling, saw that she had latched, and left. There was 1 nurse who was like our guardian angel – she came to us in the middle of the night, stayed until I was able to feed the baby, for an hour. If my mother’s best friend had not been a lactation consultant who worked with the women who literally wrote the book, I would have never succeeded – she came over every time I breastfed. It took us about 4-5 weeks to get it right.

  15. Erin says:

    Before I had my daughter I read a lot about nursing and was absolutely determined to make it work. My daughter had no problems latching on correctly, but the first piece of advice the nurses told me was to not let her use me as a pacifier or I would get cracked nipples. All she wanted to do was suckle so I was stressed out about that, and when she wasn’t suckling, she was screaming. Consequently the nurses told me I was starving my daughter (even though she was a healthy 8 lbs and was nursing for at least 20 minutes out of every hour). They insisted on formula and pacifiers, and luckily I knew to say no. The nurses stressed me out and I couldn’t sleep at all in the hospital. Even though they said they allowed rooming in, they wouldn’t let the baby stay in your room if you were asleep, and I didn’t want her to go to the nursery with them.

    Even though I braced myself for pain during the first few weeks, I was in no pain at all, so she got the boob any time she wanted it and that was fine with me. Within a week she had already started gaining weight (and then I felt comfortable giving her a binki) and was a great nurser until she decided she was finished at 16 months.

    This time I’m planning a home birth. Partially for a better birth experience, and partially so I can just enjoy my baby in peace!

  16. Chinta says:

    we need more support and breastfeeding training should be on top of the list for the staff assisting mothers who have just given birth and have decided to breastfeed. Its just not pushed enough

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