1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
Mongoosine: I never saw or heard of it, but as I'm not staff, I can't say.
Snapdragon: Again, I never heard a specific policy, but am not part of the health care staff.
2. Train all health care staff in skills necessary to implement this policy.
Mongoosine: I don't know but have my suspicions about training and skills...
Snapdragon: I DO know that the general hospital staff was not trained in a manner which encouraged breastfeeding, much to the chagrin of the LC.
3. Inform all pregnant women about the benefits and management of breastfeeding.
Mongoosine: When I was pregnant, they asked me if I was intending to breastfeed, and I said yes. They asked me why and in my head I was thinking "because it's the right answer, and it's free," but my mouth said "because it's best for the baby." They left it at that and the conversation rolled on to other things.
Snapdragon: They asked me if I was planning to breastfeed and I said I was planning to try but that I wasn't married to the concept. That I believed firmly in the benefits of colostrum for aiding the development of the newborn's immune system, but that I wasn't going to kill myself trying. The Nurse Practitioner with whom I was having this informational meeting smiled, said it was good I planned to try, and the conversation rolled on to whether or not I'd want to have baby's bits snipped if baby was a boy. (He was, and I didn't.)
4. Help mothers initiate breastfeeding within half an hour of birth.
Mongoosine: Yes. They did this. A nurse handed baby to me and asked me if I wanted to nurse her. I said I didn't really understand how, and a nurse helped me take down the top of my hospital gown and said that you just get them to open up and put them on.
Snapdragon: Yes. Still all vernixy and gooey, but wrapped in a blanket, a nurse handed him back to me to try to latch on. I had his head in a ridiculous position and she helped me position him better within five minutes of birth, though we had some immediate skin to skin contact even before his cord was cut. In retrospect I wish I'd asked to nurse him immediately.
5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
Mongoosine: No, no, no, no, no, no, no.
Snapdragon: I had a WONDERFUL Lactation Consultant. She was an RN who was a passionate breastfeeding advocate with answers to questions I never even dreamed I needed to know the answers to until I did. I really feel SHE made all the difference.
6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
Mongoosine: I don't *think* they did, but i I don't know, because...
Snapdragon: I want to believe that they didn't, but I don't know for a fact because...
7. Practise rooming-in – that is, allow mothers and infants to remain together – 24 hours a day.
Mongoosine: No. Mongoosine spent a goodly amount of time in a nursery I never saw, because I couldn't walk until they discharged me. It took me about 18 hours to get most of the sensation back in my left leg following my lovely epidural, (11 years later and I still haven't gotten it ALL back) and so I never managed to see just where they were keeping her, but rooming in was never offered as an option.
Snapdragon: I wanted Snapdragon to room in with me, and it was an option available at the hospital he was born in, so this was not their fail. Spouse insisted that he be taken out for a few hours in the night because he was convinced I was going to fall asleep holding him and *gasp* accidentally co-sleep with him. You know, accidentally co-sleep with the kid who has spent the last nearly 15 months co-sleeping. Yeah. That said, other than those few hours at night or during an examination, Snapdragon stayed in my room, so we were together about 19 hours a day for the two days we spent in the hospital following his birth.
8. Encourage breastfeeding on demand.
Mongoosine: I am going to say no on this one. They brought her to me every few hours to nurse and diaper, but words like "on demand" were completely new to me still 10 years later when Snapdragon was born.
Snapdragon: Yes. The Lactation Consultant was all about nursing on demand and reminded me time and again that it was important to establishing a good and regulated milk supply.
9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
Mongoosine: Total fail on this one. It was a soft green pacifier, I remember it well. I know they gave it to her and I know she used it, but she never got all that attached to a pacifier, thank goodness.
Snapdragon: There were those hours while I was unconscious, and I know there was a pacifier in his crib, but he didn't seem to care much about it and I suspect that it wasn't used, or was only unsuccessfully offered.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Mongoosine: No. There was absolutely no referral to a support group, no mention of the LaLeche League, nothing. I only heard of the LaLeche League weeks later as a "why didn't you contact" sort of Monday morning quarterbacking after she had already transitioned to formula and my supply was well and dried up.
Snapdragon: Kind of. In his case the Lactation Consultant suggested contacting my nearest LaLeche League group for ongoing support, and when he was three months old, I finally did, and it was a very good choice.
So what do I take away from this? Snapdragon's hospital of birth was a lot more baby friendly, and the LC with whom I met there gave me good advice which genuinely helped me develop and maintain a healthy nursing relationship with my son, whereas the lack of support and information with Mongoosine likely contributed to the failure there.
Verdict: The Ten Steps are important. I would definitely call and ask questions about a hospitals breastfeeding support policies before choosing where to birth in the future. It does matter.
So, how did they stack up where you birthed?