Posted by My OB said WHAT?!?.
Nov
27
Posted by My OB said WHAT?!?.
“It’s Time To Breastfeed Your Baby Now!”
It’s time to breastfeed your baby now!” – L&D Nurses to mother whose baby had been born with a soft cleft palate. Mother had intended to breastfeed, but baby was physiologically unable. At the nurses’ suggestion, the mother agreed to try, thinking that the nurses surely know. In fact, the mother had the correct information, the baby was unable to breastfeed and the mother was left hysterical.
There are 17 comments to this post.
Proserpina had this to say,
Nov 27, 2012 @ 7:20 am (Quote)
A little background on this:
I didn’t have a pleasant childbirth experience for reasons I won’t go into. It had culminated in an episiotomy + forceps delivery, which I really, really hadn’t wanted. DD was my first and I was already feeling overwhelmed by the whole new parenthood thing.
When DD was laid in my arms for the first time, the nurse announced that she appeared to be in good health apart from having an umbilical hernia. As I looked at my daughter for the first time, this horrible thought came into my head that I just couldn’t shake. I felt so stupid for asking it; I felt like I was telling these people they weren’t doing their jobs or something. But I had to say it. So within about five seconds of her being in my arms, I blurted out, “Does my baby have a cleft palate?”
The nurse and the OB-GYN both looked at me like I was crazy. “Could you take her and check?” I asked insistently, handing her back to the nurse.
I’m sure they were expecting to get back to me with a quick answer in the negative, because crazy mom is crazy. Instead the nurse said, “Actually, I think there might be something here. Can you come take a look, Doctor?” The OB-GYN checked her as well, and told me she didn’t think it was a cleft palate, but she wasn’t sure. This wasn’t her area of expertise.
A short time later, after I’d been moved to my recovery room, a pediatrician came into the room and confirmed to me that my daughter had a cleft palate. He said it was a partial soft cleft palate, the smallest kind of cleft palate that there is (next to a microcleft, which doesn’t have to be repaired), and that it was very easy to miss. He wanted to know how we had caught it so early. I told him I had called it. “That’s amazing. Are you a medical student?,” he asked me. I had a BA in classics and was working on an MA in American history. Science has always been my weakest proficiency.
How did I know about the cleft palate? I am a deeply religious person and I believe that God told me. That is all there is to it.
It was a short time after my visit with the pediatrician that the L&D nurses showed up (sorry, they were L&D, not neonatal, my mistake; I didn’t know what they were called). “It’s time to breastfeed your baby!” they said as they entered my room. I felt confused because I hadn’t thought that a cleft palate baby could breastfeed, but this time I think I was too shy to speak up. I figured that these were professionals and they knew what they were doing and they had read her chart, so maybe I had heard wrong.
I think we spent about a half hour trying to get her to latch, and it just wasn’t happening, and I began sobbing and wondering what was wrong with me. So they left me with a breast pump and encouraged me to pump colostrum/milk to try and bottle feed her, and said we could try again later.
It was much later that night that the hospital arranged for a nutrition specialist to come and see me. She was very kind and gentle and carefully explained to me how I would have to feed my baby. She confirmed to me that I couldn’t breastfeed. “Then what the heck were those nurses doing earlier today?!” I asked, feeling a little shocked.
The nurses may have sucked, but the nutritionist was great, and later did a home visit to check on how the feeding was going. I started my daughter on Johnson-Mead squeeze bottles and later switched her to Habermans, which were great.
So, that’s my story. Guess that wasn’t a “little” background at all.
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Kathryn Reply:
November 28th, 2012 at 7:46 pm (Quote)
You’ve got the story up twice now! 
I’m sorry that the nurses were either uninformed about the cleft palate, uninformed about what that entails, and insensitive to your pain. I’m glad, though, that the nutritionist was so helpful and supportive.
Also, I fully believe what you believe about how you knew about the cleft palate. I hope your daughter is doing well now.
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There is nothing wrong with trying to breast feed anyways, on the off chance that it might work. However what IS wrong is commanding the mother to breast feed and setting the expectations so high when the odds were clearly not in favor. A better approach would have been: “Do you intend to breastfeed? There is a high chance your baby will be unable to do so because of the cleft palate, but if you’d like to try you have our full support. Here is our LC, she can answer all your questions. ”
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Proserpina Reply:
November 27th, 2012 at 10:37 am (Quote)
Babies with soft cleft palates cannot breastfeed. It’s physics. With a hole in the roof of their mouths like that, they are unable to create the suction needed to breastfeed. I went over this carefully with the nutritionist later on. She said she knew some moms with cleft palate babies who were trying to breastfeed anyways because they were so zealous about it, but their babies weren’t getting proper nutrition.
My daughter was never able to keep a pacifier in her mouth or suck on a normal bottle on her own, even though she badly wanted to as she got older and was able to grip.
Babies with hard cleft palates can breastfeed with the help of a plastic insert that goes in on the roof of the mouth. But the soft ones are out of luck.
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*physiologically* unable? How about *physically* unable.
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Proserpina had this to say,
Nov 28, 2012 @ 6:52 am (Quote)
I am the OP. I tried to comment twice on this yesterday, but it seems my comments went to spam and I haven’t been able to get anyone in admin to rescue them. So, sorry you haven’t been able to get the full story thus far.
Leaving off the URL field of this comment to see if it fares any better.
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Proserpina had this to say,
Nov 28, 2012 @ 5:01 pm (Quote)
The background on this:
I had an unsatisfying childbirth experience for reasons that I won’t go into here, but it culminated in an episiotomy + forceps delivery, which I did not want. When my daughter was placed in my arms for the first time, an awful thought came into my head that I couldn’t shake. I felt so stupid for blurting it out, but I said it anyways, within five seconds of holding her:
“Does my baby have a cleft palate?”
The doctor and nurse both looked at me like I was crazy, until I said (insistently), “Would you please take her and check?” and handed her back to the nurse.
I’m sure they expected to get back to me quickly with an answer in the negative, because crazy mom is crazy and how could I have known that? But the nurse came back with an uncertain answer and asked the doctor to check her. The doctor checked her and was also uncertain.
A short time later, after I’d been moved to recovery, a pediatrician came in and confirmed to me that my daughter had a cleft palate. He said it was a partial soft cleft palate, the smallest kind of cleft palate that there is, and said it was very easy to miss. He wanted to know how we’d suspected it so quickly. I told him I’d made the call. He was impressed and asked if I was a medical student. (No–BA in classics, was working on an MA in history at the time. Science has always been my weakest proficiency.)
How did I know about the cleft palate? I am a deeply religious person and I believe God told me. That is all.
So, I was feeling pretty overwhelmed by all of this. My daughter already had at least two things wrong with her that would require two surgeries (cleft palate, large umbilical hernia), I was sore from the episiotomy and birth, and I was feeling overwhelmed by becoming a new mom and being entirely responsible for another person’s life for the first time ever. That was my state of mind when the nurses showed up.
Then came the L&D nurses and the quote from above as they entered my room. I thought I had heard or read somewhere that cleft palate babies can’t breastfeed, but this time I think I was too shy to speak up on my misgivings. I figured that these were healthcare professionals and the cleft palate had already been diagnosed, so they knew what they were doing.
We spent a half hour trying to get my daughter to latch without a lick of progress until I was just sobbing. They left me with a breast pump and encouraged me to pump colostrum, and said we could try again later.
It was much later that night when a feeding specialist came to visit me bringing special cleft palate baby bottles with her, and she informed me that my daughter was physically (physiologically? I have no idea which, remember, I suck at science) unable to breast feed. She said it was a matter of physics and with a hole in the roof of her mouth, my daughter could not create the suction she needed to latch. I was a little shocked. “Then what the heck were those nurses doing?!” I asked.
The feeding specialist was very kindly and gentle and later paid me a home visit, and she really helped me come to terms with what it would take to feed my daughter.
[Reply]
Proserpina had this to say,
Nov 28, 2012 @ 5:05 pm (Quote)
My comments keep on getting grabbed by spam regardless of what I enter in the URL field. I need someone from admin to rescue them or I can’t tell my story.
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Becca Reply:
November 27th, 2012 at 5:24 am Becca(Quote)
A-freaking-men.
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Jane Reply:
November 27th, 2012 at 5:37 am Jane(Quote)
I mean…it’s good the NICU nurses are pro-breastfeeding, but in cases where breastfeeding isn’t possible for any reason, they should know this and support feeding by whatever alternative method the mother and doctor have decided on. The fact that the mother ended up “hysterical” means they pushed her beyond what they should have, resulting in her feeling overwhelmed and at fault, at a time when she was already vulnerable. Not cool.
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Kathryn Reply:
November 27th, 2012 at 8:31 am Kathryn(Quote)
Well said.
OP, I’m so sorry.
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Jense Reply:
November 27th, 2012 at 5:43 pm Jense(Quote)
You know, when I worked in medicine and hospital settings, this was always the FIRST thing I did. Mainly because charts DO get mixed up and you want to make sure you’ve got the right name. Walking into a room and going “Susan?” when you have Jenny in that room can be such a disaster. It’s common sense, but you’d be surprised how many of my colleagues never checked the chart until AFTER the patient was gone.
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Kasondra Reply:
November 28th, 2012 at 6:42 am Kasondra(Quote)
Fun story. I had that happen a few months ago at a military appt. I was there for allergy medication. I’d told the intake girl that (she’s not really a nurse so…) The PA walked in saying “So we got the results of your sleep study.” I just went “uuuhhhhh…” Thankfully HE was just as annoyed that he’d been given the wrong chart and handled my medication requests with no problem. It was the best visit I’ve had with a mil doc…and it was because of a screwup
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