EDITOR'S NOTE: Breastfeeding provides undeniable health benefits to infants and mothers, but for many new mothers it isn’t easy. In Day 2 of our series on infant-mortality rates and local efforts to improve birth outcomes, columnist Sara Foss writes about Schenectady County’s new Baby Cafe and two local hospitals that have worked hard to expand their resources for nursing mothers.
The 36-year-old is paying her first visit to Schenectady's new Baby Cafe, a drop-in center for nursing mothers at the Phyllis Bornt Branch Library and Literacy Center on State Street.
On the first and third Tuesday of the month, one of the library's smaller, private rooms is transformed into a place where nursing mothers can ask questions about breastfeeding and receive support and encouragement.
There are pamphlets and books about breastfeeding on a table, and a scale where people can weigh their babies — something Cooper does soon after entering.
Perhaps most importantly, the cafe is staffed by an international board-certified lactation consultant, Sarah Tice.
Tice works for Schenectady County Public Health Services, where she assists mothers with the sometimes tricky process of breastfeeding. On the Tuesday morning I visit the Baby Cafe, she greets Cooper and asks whether she has any questions about breastfeeding.
DAY 1: 'Any death hurts': In Schenectady and Albany, being born black is a fight against the odds
DAY 1: Birth Justice Project hopes to see more Capital Region women use doulas
DAY 2: Glenville, Albany women form Black Breastfeeding Empowerment Network
DAY 3: Improving birth outcomes should be a priority
As it so happens, Cooper does, even though she's been breastfeeding Maggie since birth.
"I have a question about comfort nursing, about how to break the habit at night," Cooper says.
Tice nods, as if she's heard the question many times before, and says, "I kind of let the mother guide when to end that. [Maggie's] a great size. Every time you look at her, you can say, 'I did that.'"
The Baby Cafe has a lofty goal: Making Capital Region babies healthier.
It's one of many new initiatives that aim to improve local birth outcomes — to reduce the number of babies who struggle because of preterm birth, low birth weight and other ailments.
Some of these initiatives are spearheaded by county health departments, others by local hospitals and still others by non-profit organizations.
Almost all of them emphasize breastfeeding, which provides undeniable health benefits to infants and mothers, as a substantial body of research can attest to.
One of my questions, when I started researching local efforts to improve birth outcomes, was whether these breastfeeding-promoting initiatives might be too heavy-handed or aggressive in their approach.
Breastfeeding isn't easy — at least, not for everyone — and some women either can't do it or find it difficult and painful. I worried the emphasis on breastfeeding might make these women feel guilty — a consequence I viewed as counterproductive, at best.
I needn't have worried.
In my interviews and visits with local programs, I encountered knowledgeable professionals who were well aware of the challenges and difficulties women who wish to breastfeed face. They spoke of a desire to educate, to make mothers aware of the resources and assistance available to them.
This is a big change — in the past, there were few resources available for mothers who wished to know more about breastfeeding.
Today, a woman who wishes to nurse her baby can attend classes on breastfeeding at local hospitals, which employ teams of lactation consultants to assist women who need help getting the hang of it. These consultants are available to visit new moms in their hospital rooms, and they are also on call.
Earlier this year I visited two Capital Region hospitals that have worked hard to expand their resources for nursing mothers: Bellevue Woman's Center in Niskayuna and St. Peter's Hospital in Albany.
St. Peter's is the first hospital in the area to be designated a Baby-Friendly hospital by an organization called Baby-Friendly USA, and Bellevue is working to attain the Baby-Friendly designation.
I chuckled when I first heard the term Baby-Friendly — shouldn't all hospital birthing centers be baby-friendly? — but it means something very specific.
The Baby-Friendly Hospital Initiative was launched in 1991 by the World Health Organization and United Nations Children's Fund, with the goal of increasing breastfeeding rates and encouraging mother-child bonding.
Hospitals with the Baby-Friendly designation must meet a list of criteria that includes keeping mothers and babies in the room together, a practice known as "rooming in," rather than sending babies off to a nursery, whenever possible, making sure mother and child have skin-to-skin care immediately after birth, and promoting breastfeeding.
Skin-to-skin care entails placing the baby on the mother's chest after birth; the idea is that this contact warms the baby, helps regulate the baby's temperature, reduces stress and facilitates breastfeeding.
"There's been a cultural shift," Sandra Michael, manager of community integration and lactation services for the Women’s and Children’s Services division at St. Peter’s Hospital, explained to me. "In the old days, babies were taken and placed in a warmer. A lot of times they were whisked away. ... Now we give the baby to the mom."
Under the new system, weighing the baby, bathing the baby, conducting the newborn screening — all of these things are now done at the mother's bedside.
Bellevue embarked on the process of becoming a Baby-Friendly hospital in 2012, and hopes to complete the process by July 2018.
Women who give birth at Bellevue already get the Baby-Friendly experience: Mother and child stay in the room together, skin-to-skin contact occurs almost immediately after birth and breastfeeding is strongly encouraged.
Because this approach to childbirth is relatively new, an effort is made to educate families so they know what to expect, both in and outside the hospital.
"Our goal is to make sure the mother leaves here as well-prepared as possible," Kelly Duheme, a lactation consultant at Bellevue, told me.
"The staff works to educate and support the mom, not to pressure them," said Dr. Phillip Pan, who serves as medical director and chief of Bellevue's neonatal intensive care unit. "If the family isn't counseled on the signs that breastfeeding isn't going well they might fall into a situation where the baby is not nursing well and getting the nutrition they need."
Some health experts and mothers have criticized the Baby-Friendly Hospital Initiative.
They say that the focus on breastfeeding is too consuming, especially for moms who are struggling with it. Some mothers have complained that rooming in makes it harder to rest after labor and delivery, and that both mom and baby would benefit from some time apart.
Pan was aware of these criticisms, and he emphasized that Bellevue aims to be flexible and respond to the needs of mothers.
"Baby-Friendly is still the healthiest way to begin for the child," Pan told me. "There are always a few babies who have problems."
Flexibility and education are key to making something like Baby-Friendly work. If families are surprised by the rooming-in concept, they are likely to be less comfortable with it. And if moms really do need a break after an arduous delivery, it's important that they get one.
I like the Baby-Friendly concept, and while it might not be what every family wants, I suspect there are a lot of people who like the idea of rooming in with their baby and partner, learning how to nurse and receiving advice and feedback from lactation consultants and other professionals.
In the spring, I dropped in on the breastfeeding support group at Bellevue. It was hosted by Duheme, a cheerful and gregarious woman who is good at putting people at ease.
The setup is simple: a blanket on the floor, where moms and babies can gather, talk and ask questions. The discussion isn't restricted to breastfeeding: The moms discuss how much time they plan to take off from work with their babies, and how their new nannies are working out.
One of the moms at the group, Glenville resident Justine Ochal, told me that breastfeeding came easy to her newborn boy, Brody.
But that wasn't the case with her first son.
"He struggled," Ochal recalled. "After eight days he stopped nursing. Eventually he came back to it, but I pumped and bottle-nursed him for four months."
Given the difficulty involved in nursing her older son, I asked Ochal why she considered breastfeeding a priority.
"I just know it's the best thing for the baby, that closeness and that bond you build with your baby," she said.
A lot of women feel this way, and the research suggests that they're on to something.
Breastfeeding is good for babies, and it's important to make sure mothers and families understand the benefits. Hospitals and county health departments are making an effort to educate and support nursing mothers, and it should be applauded.
Reach Gazette columnist Sara Foss at firstname.lastname@example.org. Opinions expressed here are her own and not necessarily the newspaper's. Her blog is at https://dailygazette.com/blogs/thinking-it-through.
- Breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections, such as ear infections.
- Reduced risk of obesity.
- Reduced risk of sudden infant death syndrome. A study released in October suggested that breastfeeding for at least two months can cut the risk of sudden infant death syndrome (SIDS) nearly in half.
Source: U.S. Centers for Disease Control and Prevention