Childbirth has changed a lot in the U.S. in the past 10 years. Where epidurals and formula once ruled the labor and delivery landscape, now more and more women are making a push for natural births, breastfeeding and attachment parenting. To meet this demand, close to 400 hospitals have implemented so-called “baby-friendly” practices that encourage nursing and 24/7 bonding. Calling something “baby-friendly” makes it sound nurturing and loving, but the way these practices are carried out is often anything but.
I gave birth to my daughter in a baby-friendly hospital in 2011. I was a brand-new mom who’d just watched Ricki Lake’s panic-inducing anti-hospital documentary The Business of Being Born. I knew a home birth like Ricki’s wasn’t for me, but choosing a hospital with baby-friendly policies sounded like a good way to blend the medical care I wanted with the special emphasis on attachment and bonding that I felt my baby needed.
According to the Baby-Friendly Hospital Initiative, which started in 1991, hospitals should care for infants using a checklist of 10 “friendly” tenets. These include things like educating moms on the benefits of breastfeeding, encouraging moms to breastfeed within one hour of delivery and allowing moms and babies to room together 24 hours a day. On paper, it sounds beneficial to both mother and child. In reality, it meant being forced to breastfeed at all hours and denied precious rest I needed to recover from giving birth.
My daughter arrived at 3:18 a.m., after 13 long hours of labor. The breastfeeding tutorials started immediately, and then I was informed that even though I hadn’t eaten or slept in almost 20 hours, the staff wouldn’t take my dozing newborn to the nursery because she needed to stay with me to “bond.” From there, our hospital stay was two solid days of never sleeping for more than 30 minutes at a time and having my breast shoved forcefully into my baby’s mouth every 90 minutes, even when my colostrum was gone, my milk wasn’t in and my nipples were cracked from being used like a chew toy.
Baby-friendly hospitals don’t allow pacifiers. And you can bring your own, but then you’ll get a lecture about how pacifiers “destroy” your breastfeeding relationship. They also strongly discourage any formula supplementation. My milk wasn’t coming in, and my daughter lost a scary amount of weight, but any mention of supplementation — even by my visiting pediatrician — was treated like I’d just asked the nurses for permission to give my baby whiskey.
By the time I got home from the hospital, my nipples were so cracked and damaged they’d bleed every time I tried to feed my daughter. I hadn’t truly slept in days, and I was so overwhelmed by how little help I’d gotten in the hospital that I had a complete breakdown. Instead of encouraging loving attachment, my hospital experience actually just left me feeling drained and resentful, and I couldn’t help but contrast my own experience with that of my mother’s postpartum recovery decades earlier.
I have two sisters, and I was old enough when they were born to remember visiting my mom during her hospital stay. I remember how committed everyone was to making sure my mom felt good. They were there for the babies too, of course, but postpartum recovery 30 years ago seemed more about giving women time to recover from giving birth. The idea was to give moms a period of rest and help so they could get healthy enough to take over full-time care at the end of their hospital stay. Now it seems the idea is to force the mom to do as much as possible, as soon as possible — even if it means sacrificing sleep, recovery time and sanity.
Baby-friendly hospitals are undoubtedly hard on moms, but a paper published in JAMA Pediatrics shows they might be a less-than-stellar environment for babies too. In the paper, pediatricians Joel L. Bass, Tina Gartley and Ronald Kleinman said baby-friendly practices put too much pressure on moms, can encourage unsafe sleep practices and actually set moms up for breastfeeding failure by denying them access to pacifiers and supplemental formula. Supplementation, they found, can actually help ease new moms’ stress about their supply and make them more likely to continue breastfeeding.
The idea of being baby-friendly and encouraging breastfeeding, skin-to-skin contact and lots of bonding time sounds good in theory, but in practice you start to realize how absurd it is to treat new parents by using a checklist, as if motherhood is one size fits all, as if a list of 10 simple steps could ever be what’s best for every baby and every mother. In baby-friendly hospitals, we’ve somehow managed to elevate a particular parenting style to the level of nationwide policy. How could that possibly benefit more than a small percentage of moms and babies? And what are the rest of us to do if a baby-friendly hospital is the only one in our area?
If hospitals really want to be “baby friendly,” they should drop the checklist and simply start supporting new moms. For some women, that support might come in the form of baby-friendly initiatives. For others, it might require the baby to spend more time in the nursery, the use of formula or even just giving the baby a pacifier between feedings. A healthy baby starts with a healthy mom, and that means moms need rest and the freedom to make their own choices. Making us feel pressured, stressed, exhausted and judged aren’t what’s best for any new mom, and it certainly isn’t “friendly” to the baby who has to go home with her.
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