Upholding the right to breastfeed
Hospital keeps exclusively breastfed baby away from her mother
Hospital bans exclusively breastfed baby from her mother
Wouldn’t those be shock-horror news headlines? Well, it’s true. The parents gave me permission to share this story and use their names because they do not want this to happen to other “little people”.
Storm, my daughter, was taken by ambulance to St Dominic’s Hospital, a Life Healthcare private facility, in East London, South Africa, with an appendix apparently about to rupture at around 9pm on Sunday. Driving a vehicle behind the ambulance was her partner, David, with their two-month-old daughter, Skyla, who is exclusively breastfed.
A nursing sister in the surgical ward told David to leave the hospital with the baby and said he would only be allowed to return during visiting hours (11am the next day). David appealed to a staff member in charge to let Storm keep the baby with her. They had not been prepared for this admission, nor the baby being kept away from her mother, and their home was 40km away. At around 10.30pm, the sister said Skyla could stay with her mother, but David had to be back to collect her by 6am.
David spent the night in town. At 6am on Monday, he took his baby home to collect Storm’s clothes, toiletries, baby clothes and bottles. He bathed Skyla and fed her the small amount of milk that Storm had managed to express. He tried to feed Skyla “powdered milk” – but she refused it.
He returned to the hospital with Skyla at 11am. While Storm fed her baby, a sister told David that he should not bring Skyla to the hospital as there are patients with COVID and other infectious diseases in the (surgical) ward.
As David put it to me on Monday morning: “I would have thought that these supposedly top-echelon hospitals where you pay good money would cater for moms with young babies in emergencies, perhaps in a separate area, where they can attend to their babies until they know what is going on – we have still not been told what is happening.”
Banned
He begged the sister to find a way to let Storm continue breastfeeding her baby, and she appealed to the hospital management. He undertook to stay near the hospital and bring the baby to Storm when she needed to be fed.
The hospital’s response was to effectively ban the baby from her mother.
David has a copy of the email from the Patient Services Manager: “As per discussion, unfortunately we don’t have the facility to care for a new born baby. DH [Discovery Health, the medical aid provider] will not allow us to claim for any new born boarder fee’s as we are not a maternity hospital.” Dated 4 March 2024, 11:48
“I was told to take Skyla away and not bring her back to the hospital,” David said. “I was told she would see Storm again once she was discharged.”
The email raised immediate points for me:
- Why would the hospital want to charge for allowing a mother to feed her baby? The baby is not the patient. This should be a service that cares for the well-being of the patient as a whole person, including being a mother exclusively breastfeeding a young baby.
- Why were they laying it on Discovery?
- No-one was asking the hospital to care for a newborn.
- Where is the care in healthcare?
I shared this with several people, including a medical doctor who takes on unfair treatment of healthcare clients. He called the Patient Services Manager, who said she would speak to the matron. By then, Storm was being wheeled to theatre.
Something changed
Surgery took place after 4pm on Monday – close to 36 hours since Storm had sought help, in severe pain, on Sunday morning. A GP had sent her to St Dom’s, which then told her to go to Beacon Bay Life Hospital, where she spent the day being tested and scanned before being taken by ambulance back to St Dom’s. Those delays and shunting back and forth are another story.
In that time, Storm had eaten almost nothing and consumed very little liquid – this is not good for a breastfeeding mother. Not surprisingly, the stress made expressing milk difficult.
After the surgery, something had changed – I suspect the call from the doctor introduced some reason. David decided to take the hungry baby to her mother, even if the hospital tried to boot him out. “If there are people with COVID, they would not be put into the ward with other people,” he said. And guess what? He walked into the ward and handed the baby to her mother. No-one stopped him. Storm fed her baby and the two curled up together.
At 11pm on Monday, David was back at the hospital to collect a bottle of expressed milk. At 6.30am on Tuesday, he walked back into the hospital and left Skyla with her mother, where she remained until Storm was discharged later that morning.
Unnecessary ordeal
Most staff were kind and tried to help, Storm says. “One told me I could not have my baby with me, and I got the feeling that she was doing what she was told to do. Another seemed concerned for the safety of the baby. But there are surely ways to deal with that.”
Ultimately, there was a good outcome. But the stress for Storm was unbearable – and could not be good for her recovery. David took immense strain. At times, I feared this would be the end of the breastfeeding journey for this mother and baby. It was pure trauma.
And it was an unnecessary ordeal. All it required was that the hospital – all hospitals! – have a policy on how to support breastfeeding mothers and babies and ensure that their staff know what to do. It is immoral and unethical to expect a mother to simply stop breastfeeding; it is reasonable that a breastfeeding baby may not be able to be with her mother at all times during a medical emergency.
As Storm says: “I had people fighting for me. A lot of women don’t have that and I wonder how many are forced to stop breastfeeding because of this.”
Precisely.
Official policy
Evidence tells you we should do everything we can to keep a breastfed baby with her mother.
It’s even part of official South African policy. The Infant and Young Child Feeding Policy Department of Health states (Section 6.4.2): “Health establishments should assist in-patient lactating mothers to continue breastfeeding unless medically contraindicated.” Officially, South Africa is committed to promoting “exclusive breastfeeding”, also known as EBF. I do not know how this is applied in public hospitals.
Most authorities recommend EBF – feeding only breast milk (no formula or water) – for the first six months of life.
Hospital owner says so, too
Even Life Healthcare, the owner of St Dom’s, acknowledges the importance of breastfeeding. It says: “Feeding your baby breast milk is recommended by the World Health Organization (WHO) because of the undisputed advantages of breastfeeding. Research has shown that it helps prevent illnesses such as diarrhoea and pneumonia in babies.” Life lists benefits of breastfeeding for mothers, including reducing the risk of ovarian cancer and breast cancer.
Life Healthcare adds: “However, it is also learned behaviour and there is an extensive body of research that mothers and caregivers require active breastfeeding support for establishing and sustaining appropriate breastfeeding practices.”
Right?
Life Healthcare should follow its own advice.
Follow the science
The Academy of Breastfeeding Medicine recommends that “the breastfeeding parent and their nursing baby be hospitalized together if either of them requires a hospital stay”. This facilitates bonding, prevents disruption to breastfeeding, and avoids complications like mastitis.
Most neonatal intensive care units and children’s hospitals have breastfeeding policies in place, the academy says, but many adult hospitals do not.
“The first ABM recommendation is that any institution admitting women of child-bearing age or children age 2 and under should have a written policy in place to support the lactating mother and breastfeeding child. The policy should have components that allow a child and their mother to be together as much as possible, specifying where the infant is permitted to be and which staff members can routinely handle the infant.”
Breastfeeding could even speed up the healing process for the mother. The academy quotes the medical director of Aeroflow Breastpumps, Jessica Madden: “It’s postulated that they may heal and recover faster when they are with their babies due to an increase in oxytocin, a hormone released while breastfeeding that promotes feelings of calmness and relaxation, and a decrease in stress hormones such as cortisol.”
It can be done
And there are best practice models for hospitals to follow. Here’s an example from Buckinghamshire Healthcare in the UK. It says: “If you are admitted to our postnatal ward your baby can usually stay with you providing that you are well enough to care for her/him. Cots and changing facilities are available. Should you be admitted to a specialist ward your baby will be welcome to visit you for feeds but will be unable to stay.
“You will be encouraged to continue breastfeeding your baby as you feel able. Privacy can be provided by drawing your bed curtains. Alternatively, a member of staff may be able to suggest a more private place on the ward if temporarily available (e.g. a side room).”
Now, that is reasonable.
- This story is about the right to breastfeed. I have complete respect for people who choose not to breastfeed or who can’t breastfeed.
South Africans have a knack of making very unsound judgments when it comes to good health practices. We saw this during COVID. Whoever decided that Storm should not have Skye with her in the hospital was being completely illogical. Particularly since the child is newborn. It’s not “rocket science”, as they say, to know why very young babies and their mothers must be in the same place!
This was extremely bad judgement. And I suspect it happens a lot. This baby had what seemed to be a bout of colic for the first time this week – it’s very likely she got dehydrated while being kept from her mother.
I agree wholeheartedly. At the very least, special permission should have been given to David to bring Skyla into the ward for her feed at any time of the day or night necessary.
The small disruption to other patients would have been negligible – you are woken up to take sleeping pills for heavens’ sake.
Exactly! Hospitals are not the quietest places anyway