As if I wasn’t already worried enough about the future of maternal child health, my paranoia’s been cranked to an all time high having made it through Chapter 4 of Michel Odent’s Childbirth and the Future of Homo Sapiens. So far, in his fascinating book, Odent has only begun to introduce the repercussions of a declining oxytocin system in humans and what that means for our future.
What’s wrong with the world, mama
People livin’ like they ain’t got no mamas,
Even the Black Eyed Peas notice the effects of Odent’s hypothesis.
The idea of a world void of love is to say the very least, horrifying.
Equally worrisome is the notion of the very people working to improve maternal child health– the lactation consultants, the breastfeeding counselors, the midwives, the lactation counselors, the obstetricians, the social workers, the doulas, the nurses, the childbirth educators, etcetera–pitted against one another denouncing one credential, extolling another.
Where is the love, the love, the love?
Sabrina Ganaway, RN, IBCLC of North Mississippi Medical Center (pegged the largest rural hospital in the country according to Ganaway) questions this hostility within the field and shares with us her inspiring story.
Throughout her career, Ganaway has heard first hand accounts of nurses feeling pitted against doctors, hospitals against WIC programs, nurses against lactation consultants and lactation consultants against lactation counselors. Ganaway admits falling prey to this mentality.
“So I tried to start my dialog with We,” she explains. “After all, we are all on the same side. We pretty much all want the same thing where breastfeeding is concerned, so I started actively trying to present a message that it’s we, all of us together working together that could do more collectively than leaving branches of us isolated or left out.”
Our energy is much too precious to be wasted on cutting down individuals with pure intentions. Instead, our angry energy could be changing a faulty system.
Part of that faulty system is the 25 year old information circulating hospitals, Ganaway explains.
“I had been and was one of those nurses who had not known what to do for breastfeeding or was the suction queen in the delivery room unnecessarily,” she says of old practice. “And my intentions were always what I thought was noble.”
Ganaway goes on to shed light on the reality for nurses dealing with poor protocols. She says most nurses would love for breastfeeding to go well without intervention like “shields, pumping and supplementing at the breast or other means just to keep a baby hydrated and out of the NICU.”
“But often [a nurse’s] reality is a mom has been induced, had a minimum of four hours antibiotics and more during the labor, with 12 to 24 hours or more of IV fluid, then c-section late at night for failure to progress,” she continues. “Then we wonder why a baby can’t latch onto a…breast…[where the] areola[s] are pitted with fluid, thick, no elasticity, causing the nipple to almost disappear…A well-intentioned person will certainly use a shield or other means to help get a baby nursing…”
Breastfeeding initiation rates at NMMC hover around 50 percent. Exclusive breastfeeding rates at discharge plummet to about 30 percent. In Miss., the rate of babies ever breastfed was just over 50 percent in 2013.
“We have work to do!” Ganaway exclaims.
Despite harmful birth practices and low breastfeeding rates, a lot of wonderful things are happening at NMMC. Ganaway reports having dedicated leadership and administration.
“They have a strong desire to live by the standards of care and have been very supportive of lactation,” she says.
NMMC is not currently in active pursuit of becoming Baby-Friendly but they are well on their way to satisfying a long-term goal:
Ganaway and her colleague have taught Healthy Children Project’s 20 Hour Course the past four years, several times each year to all maternal-child staff. The course is also offered three times per year for new employees as well as OB and pediatric clinic staff, WIC and referring, outlying hospitals. Ganaway says that through teaching this course, she has gained credibility among her peers, doctors and administration.
NMMC stopped gifting formula bags to new parents and instead created their own.
The Magical Hour is practiced after delivery and in recovery rooms.
Ganaway and colleagues somewhat recently started a Breastfeeding Task Force with representatives from all areas and shifts. Ganaway says it has made everyone “feel some accountability and responsibility toward breastfeeding.”
The hospital’s lactation staff collaborate with OB/GYN offices and the Healthy Start clinic to decide what infant feeding information is passed to mothers. Ganaway and colleagues work closely with the WIC district and assist in breastfeeding classes at free clinics.
Signs were created to alert visitors when babies are feeding and have decreased interruptions.
Nurses have become better equipped to teach mothers how to use breast pumps.
Breastfeeding mothers are offered an afternoon snack to keep their energy levels high.
Environmental Services offers to postpone cleaning rooms rather than interrupt feedings.
Pediatricians are quicker to refer moms at two week checkups if feeding difficulties are evident.
OBs consult the lactation team about medications before interrupting breastfeeding.
Ganaway and colleagues started a Lactation Newsletter complete with policies, news and research. “This has been most accepted and is so easy,” Ganaway reports.
NMMC media staff plays the Magical Hour on closed circuit TV channels in all delivery suites and observation areas.
“The more our staff hear and learn, the more accepting they get– actually excited– to learn and know more about breastfeeding,” Ganaway says. “So We share, We talk, We discuss, We teach at any opportunity. More to do, but more accomplished than we ever thought just four years ago.”
Ganaway even reports breastfeeding friends popping up in unexpected places.
“When working on World Breastfeeding Week, we discovered a hospital physician liaison who took the clinic/physician breastfeeding support campaign information with our contact information, Dr. Hale’s reference, as well as suggestions on reference postcards to support breastfeeding to over 300 clinics in one week,” she delights.
Ganaway does her part each and every time she encounters a mother-baby dyad. She looks at each encounter as an opportunity to leave a lasting impression that promotes love.
“…I have strongly felt that mothers need mothering as much as babies do,” she says. “I feel that mentoring the mothers, the whole family, and teaching other nurses as well, we can promote not just a start to healthy babies, but promote a wellness and lifestyle in which we promote family bonds.”
For her exceptional work and devotion to mothers, babies and families, Ganaway was awarded The Spirit of Women Healthcare Hero Award 2011.
“This was quite an honor,” she says.
We together, the union of all dedicated birth and lactation workers, will fix our future. One sect of maternal child health workers won’t champion alone. One credential won’t prove victorious. Our energy is too precious not to acknowledge and honor our common goal.
“We is a happier concept than me against you. We has more company, more help and can accomplish much more.”