The Baby-Friendly Hospital Initiative began in 1991, as a partnership between the World Health Organization and UNICEF, to increase the rates of breastfeeding internationally. There has been criticism of the initiative—some say it puts undue pressure on new parents to nurse their babies—but I can directly correlate my breastfeeding success to delivering at a designated baby-friendly hospital and interacting with the the lactation-educated staff employed there.
I, like so many others, assumed feeding my baby was something that I would just figure out.
Hospitals that are designated as baby-friendly, and participate in the initiative, subscribe to the tenets outlined in the Ten Steps to Successful Breastfeeding. The first two steps—“Have a written breastfeeding policy that is routinely communicated to all health care staff” and “Train all health care staff in the skills necessary to implement this policy”—were especially crucial for me, though I didn’t realize it when I chose my medical provider and hospital. The baby-friendly designation seemed like a bonus, a nice-to-have label that was mostly marketing, but seeing the initiative in action made me realize it was so much more.
I, like so many others, assumed feeding my baby was something that I would just figure out. No matter how much research you do in advance, it’s really impossible to know how the experience will go, and frankly, I didn’t hear much about how difficult it could be. I also didn’t know much about how things like nipple shape and breast size can factor into the experience.
There were a number of things working against me from the start: The lactation education class that I’d planned to take at the hospital was canceled and rescheduled for after my due date. I discovered after the fact that my nipples were relatively flat, which made latching more difficult. Despite my desire to skip the epidural, necessary interventions led me to get one, and the required IV fluids to go along with it caused my body to swell, another factor that can contribute to latching problems. And I had a little baby. At only six pounds and 13 ounces, my petite peanut had a small mouth, completing the trifecta of our latch issues. (A tongue or lip tie may also have been an issue, but it was never confirmed.)
Despite all that, I was determined to make it work. Right after delivery, one of the labor and delivery nurses helped me initiate breastfeeding. I was tired and in a daze, but she helped guide my daughter to the breast, and we were off. With her support, I thought, I’ve got this. I can do this.
Anyone who has delivered a baby in a hospital setting can attest that nurses are the true all-stars of the experience.
But I couldn’t do it. At least not on my own. After sleeping for a long time immediately after birth, my daughter spent the next 12 hours nursing constantly. I struggled every time. Earlier in the day, the staff lactation consultant had come by briefly, but when her shift had ended, I still had a baby to feed.
Anyone who has delivered a baby in a hospital setting can attest that nurses are the true all-stars of the experience. It’s the nurses who are there during the long hours of labor, being present and supportive, while the doctor or midwife shows up to do the delivery bit at the end. And at my baby-friendly hospital, it was the lactation-educated nurses who were there throughout my stay to help me make breastfeeding possible. They knew how breastfeeding worked. They knew about colostrum and how much a baby actually needs in the first few days of life. They knew to look out for wet diapers and signs of satisfaction instead of just looking at the clock and how soon my baby was hungry again. They knew that a crying baby wasn’t necessarily a sign that she needed a bottle. They knew, and they told me.
The nursing staff gave me the confidence to keep trying. More than that though, they were able to give me a list of specific things to try. I started to call for help every time I needed to feed, and every nurse had a different piece of advice to impart.
One taught me to make a C-shape with my hand to prepare my breast. Another showed me the football hold and the crossbody hold. They showed me how to use my nipple to encourage my daughter’s mouth to open and pointed out when her lips weren’t flanged the right way and how to fix it. They acknowledged that breastfeeding was hard and helped me find ways to make it work.
The confidence I gained from the nursing staff, and the knowledge that it was possible to make it work, stayed with me.
Another major reason that I was able to successfully breastfeed? None of the nurses suggested I quit and switch to formula. And while formula may be the right solution for some women who struggle to breastfeed, for me, support and education were exactly what I needed. The nurses knew I wanted this to work, and they helped me get there.
I wish I could say that I learned so much from the staff at the hospital that I went on to have a blissful breastfeeding experience, but the reality is that I struggled a lot for four months before things finally clicked. But the confidence I gained from the nursing staff, and the knowledge that it was possible to make it work, stayed with me. Even when my baby was crying as I tried over and over to get a good latch, I knew that I had done it before and I could do it again. Four months in, something changed and suddenly breastfeeding was easy. Perhaps it was just that my baby was bigger and had better neck control, but I never would have gotten to that point without support from the start.
I nursed my first baby for 22 months, stopping when I was pregnant with my second, whom I nursed for 28 months. There are many factors that led to my breastfeeding success. As a cisgender white woman, I didn’t have to look hard to find breastfeeding support. My family was supportive and I was able to find medical providers who wanted me to succeed. I was also lucky to have no issues with supply, and even when I struggled to get a good latch, I was able to produce enough milk for my daughter to thrive. If I hadn’t, this could have been a very different narrative.
Parenting is hard. Nursing is hard. But with the right support, it gets a little easier. And I’m thankful the nurses were there to help me along, right at the beginning.