Inshallah
Posted by realityrounds on November 12, 2009
They were a lovely couple. Recent immigrants from Algeria. A young couple, who were well supported by family. The maternal grandparents never left the room. Grandma (Jadda) was short, beautiful and vibrant in her long robes and head covering. She mumbled frequent prayers, and jumped up to help her daughter at the slightest murmur. She had given birth to seven of her own children and saw her own face in her daughter’s. She knew the facial expressions, and vocalizations, and tears used to bring a new life into the world. She felt her daughter’s pain as her own. Giving birth was a genetic and ancient, and blessed act. “Inshallah,” Jadda whispers repeatedly…..if God wills.
The young mom spent many hours in the final throes of labor. She refused all pain medication, and leaned on her mother for support. She cried, and screamed, and prayed for the baby to be born. The baby would not come. After many hours she was brought to the operating room for delivery. The young mom was petrified and panicked, she could not be calmed. “Inshallah,” Jadda whispered in her daughter’s ear. “Inshallah.”
I met the family on their third postpartum day. All had been going well, and the family was ready to go home. She was nursing well with support from Jadda, who had nursed seven of her own children. Breastfeeding was a natural, an ancient and blessed act. The lactation consultant had seen them and the baby had a very good latch and suck. On day three of life, the lactation consultant had a day off, and I had a day on.
On the third postpartum day, the seeds of doubt were sown. “It does not seem as if the baby has been urinating enough,” the morning nurse tells the family. “maybe we should supplement to see if he will pee.” “I will call your baby’s doctor to let him know your baby may not be getting enough fluids.” “I will intervene.”
No, I will intervene. I intercept the phone call to the pediatrician. I plead to let me examine the baby, and assess breastfeeding before he orders supplementation, or a bladder catheterization of the newborn to check for urine, or a delay in discharge, or a downward spiral of maternal confidence. Please, let me intervene.
I meet the lovely family on their third postpartum day. Mom was quiet, and down cast, staring at her baby in the crib. Dad was very expressive, and adamant that the baby do not receive formula. He wrote down everything I said in a little pocket notebook that he kept. He was desperate and helpful and very inquisitive. I examined the baby in front of the whole family. I explained everything about their vigorous and healthy normal newborn. I showed them how to swaddle, and soothe and change the diaper of the baby. The entire family watched me change the diaper as if I was performing a cardiac bypass. Dad continued to take notes in his tiny pocket notebook. Now, I told the anxious family, let’s see how the baby eats.
I laid the baby stomach to stomach on mom, avoiding her fresh incision. The baby latched on immediately, and nursed. The family looked on, unconvinced that the baby was actually receiving nutrition. I spent an hour and a half helping and counseling the mom on nursing her infant. When I helped to latch the baby on the opposite breast, breast milk started to pour out. I showed the family. “See, your body can, and is, producing milk!”
“Inshallah! Inshallah!“ Jadda shouted over and over again. She grabbed me close and hugged me. I teared up at the thought of bringing such simple happiness to this family, when in reality, I did nothing. I was offered multiple middle eastern sweets and pastries for their gratitude. Of course, I did not refuse in order to not insult the family (at least that’s how I justify eating thousands of calories of sticky sweet pastries!)
I notified the pediatrician and reassured him that all was well with the newborn. The discharge order was written and the family went home.
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Two weeks later the father came to the hospital to revise the baby’s birth certificate, and to ask for more formula to feed his baby…..Those seeds of doubt are powerful and lasting.
Inshallah
RR
Carrie said
That’s terrible. It makes me want to cry.
Star said
Wow. That is incredibly sad. And enraging. I feel sorry for all of them, but especially the baby.
Jill said
enjoybirth said
That story shows the incredible power of words. It is very sad and a great reminder that we need to watch what we say to birthing and new moms.
paula said
I am in tears. What a moving piece. How we can undermine even the best most supportive social environment available. Thank you for intervening. Even if it delayed it 10 hours, it is better.
Akiko said
Some mothers supplement with formula so they can rest. I did. I gave a bottle or two at night so I could sleep a bit to get over the sinus infection and severe high blood pressure I developed. Some mothers decide not to breastfeed after awhile and that is their right. Their decision is their own and no ones business. I doubt this woman was so simple minded the opinion of one doctor overrode her desires and the desires of her family. It is cruel to condemn a woman for bottle feeding. It divides us all.
realityrounds said
Who is condemning her? I don’t read that in any of the comments, and certainly not in the post. Sh*t, I had to supplement with my firstborn. The reality is however, that in the hospital, overworked nurses will often heavily suggest, influence, cajole a new mom to offer formula because it is easier on them. It decreases their workload and the answering of call lights. It is not all nurses obviously, but it does happen, and numerous studies have shown that a lack of breastfeeding support in the first days of life will decrease the likelihood of continued breastfeeding in the mother.
No judgments, just facts.
Ciarin said
Unfortunately RR is very correct. Sometimes, it’s just laziness on the part of the nurses. But things that are said to postpartum mothers have a huge influence in some cases – some, not all. I do not judge women who choose to bottlefeed. My breastfeeding history was rough and didn’t always involve breastmilk. Breastfeeding can be far more difficult than bottlefeeding though, which is why support and encouragement is critical for women who choose to breastfeed.
Akiko, no judgement!
Beth said
It may have been the pediatrician who, despite your first intervention, later decided that the baby was not growing/eating/peeing/whatever enough. I had to practically fight my pediatrician on the idea of “supplementing.” I actually ended up keeping a log of every nursing, how long, how many diapers, etc… during the first few weeks as ammunition in my conversations with the ped. My son had jaundice and I understand the fluids issue, but I had a huge supply and my son was a champion nurser. My SIL was one of those completely undermined by her son’s pediatrician. He had them nursing and then offering a bottle for EVERY feeding. The kid was off the charts huge. She stopped nursing because the pediatrician told her the baby was spending too much time at the breast. “It is amazing how much more time he has to do other things!” they said once they stopped nursing him at 6 weeks. How the heck much does a 6-week old have to “do” EXCEPT nursing! Peds can also seriously undermine a mother’s and family’s confidence.
Jessica said
I agree, what else is a 6 week old supposed to do??
Dou-la-la said
Heartbreaking to read. I want to scream at that morning nurse.
Thank you for at least trying to do damage control, RR.
Sarah said
That is so very sad. I was told with my first, that since she was tongue tied and my milk started drying up before she got it clopped and could get a good latch, that I would not be able to breastfeed. I wanted to give up but I wanted to breastfeed even more! I was able to overcome the negative comments and being told my body probably was never meant to breastfeed anyway. I made it 9 months with her before I was talked into quitting because the doctors didn’t think she was getting enough and convinced me I needed to stop to be able to take some meds. I still regret listening to them and stopping when I did.
My next baby was a preemie and I pumped from the start. Being reminded of my problems with my first by my doctor and being encouraged to just let the NICU nurses give her formula so I could rest, I was determined to make it work! I was pumping 60-70 ozs of milk a day! That’s insane. Now tell me that the baby wasn’t getting enough!
Kayce said
Every time we took my daughter to the ped, because she wasn’t on the graph for weight, he would try to talk me into supplementing. Then when she was 10 months old we went on WIC and at the first appointment, they told me that I would have to supplement and they wouldn’t give me anything but the formula tickets. I refused and haven’t been back.
I could pump 6 ounces out of each breast every 3 hours and my baby needed to be supplemented?? I hate when people tell a new mom, or even a mom of a baby that is older that they aren’t making enough milk and to use formula. It makes you worry and wonder and this, imo, is the reason so many babies are formula fed. Nursing is so hard when you are doing it for the first time, and it is even harder when you have to fight everyone to succeed.
RehabRN said
Yes, being able to resist the family is tough. I nursed even though many of my family dissuaded me.
My biggest supporters were my great aunts, who had nursed all of their kids (6 among them). They were mostly moral support, but I really needed that. The lactation consultant (and a lot of books) kept me going.
My child nursed for 18 months before weaning. It was hard, but I can’t complaint–never really been sick outside of ear infections and one case of pink eye.
Best of the Birth Blogs - Week Ending November 15th | ICAN Blog said
[...] Rounds – Inshallah: A bittersweet post on how early seeds of doubt sown during birth can affect a new [...]
Gert said
Attended a baby shower yesterday and the mom-to-be said she would “try” to breastfeed. I learned the hard way that merely trying leads too often to giving up too soon.
And, another mom at the shower couldn’t wait to say she hadn’t been able to breastfeed any of her three children. You can’t question why, either, in case you’re thought to be casting aspersions…
Good for you, for really trying.
Jessica said
I was strongly for nursing, even extended nursing, when I had my first child. He ended up in the NICU for 32 days and I pumped so he had breastmilk (although right after they removed his feeding tube they had to supplement him with formula mixed into the breastmilk because of weight gain, which I wasn’t thrilled with). When I took him home it took about 3 weeks to get him switched from bottle to breast. I had significant difficulties keeping my milk supply up, my body is very sensitive to very small changes and 1 day of not quite enough food or water and my supply would plummet. Plus my little one wanted to eat every hour and his latch was horrible. Breastfeeding was painful, time consuming (although not as much as bottle feeding was by the time you heated up the stored breast milk!) and wonderful. I breastfed 20-24 times a day until he was 7 months old, and, unfortunately, would have to supplement with 1 or 2 bottles of formula in the early morning hours because he was hungry and I was dry as a bone. Even after starting solids he still breastfed for several months 12-16 times a day/night. Despite a great deal of pressure from my extended family I stuck with it. We were down to 3 feedings a day and 3-5 at night by his 13th month when he got a protracted head cold that turned into a sinus infection. He was so stuffy he couldn’t nurse for a week. By then my milk had dried up. I ‘only’ nursed until he was 13 months. Despite the near constant feedings, the painful and even bloody nipples, the necessary daily formula, the lack of sleep, and the family disapproval, I consider myself to have successful nursed my first child. And look forward to nursing my second (hopefully with less pain!) If I hadn’t had my husband’s support, and the initial support of great lactation nurses in the NICU and my midwife, despite all my wishes, I probably would not have made it through those first 3 weeks were I was trying to nurse, then giving him a bottle of breastmilk, then pumping…repeat every hour.
Sarah said
:’(
How absolutely wonderful that you chose to intervene. How very sad that the family was forced into a choice they didn’t want, either by the doubt planted that day, or later by a pediatrician.
I had great nurses when i had my child, and i was grateful. You make a difference, even when maybe it seems like you don’t.