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Whose Oxygen Mask Goes on First?

Published:September 22, 2022DOI:https://doi.org/10.1016/j.nurpra.2022.08.026
      When my spouse and I decided to start our family, breastfeeding was in the plan. As a nurse practitioner (NP) who was already a specialist in women’s health, who had best practices in breastfeeding included in my NP program and continuing education, and supported many mothers in initiating and maintaining breastfeeding, I felt well prepared and competent to nurse my own children. For our first child, everything went smoothly. It was an uncomplicated birth and all the “golden hour” recommendations for initiating breastfeeding were followed.
      International Federation of Gynecology and Obstetrics
      FIGO Statement—Harnessing the golden hour: breastfeeding recommended within first hour of life.
      The baby was a good nurser and latch on tenderness resolved in about a week. The next birth and breastfeeding experience was the same up until the baby was 2 weeks old, when the “spitting up” started. At first I didn’t think much of it because the first baby did the same thing until 6 months of age. The volume and force gradually increased; I thought it was because my milk was plentiful and the baby was overfull. I tried nursing more frequently with shorter times at the breast. When fever and lethargy appeared, we went straight to the emergency department. During the 4 days it took to diagnose the cause, our little one was NPO (taking nothing by mouth) and on intravenous fluids. Surgery at 3 weeks and 5 days of age to correct the problem was followed by bottle-feeding breast milk to facilitate documenting intake. By the time we were cleared to resume direct breastfeeding, the baby absolutely refused to nurse at the breast, with screaming, crying, and back arching. I bottle-fed pumped milk but my milk dwindled. So, it was formula from then on. With the trauma of our tiny baby being ill, then surgery, the usual postpartum baby blues, and now “failing” at breastfeeding, I was discouraged and anxious.
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      References

        • International Federation of Gynecology and Obstetrics
        FIGO Statement—Harnessing the golden hour: breastfeeding recommended within first hour of life.
        • Diamond R.
        Why breastfeeding isn’t the solution to the formula shortage.
        NBC News, 2022 (Published May 12, 2022)
        • Stuebe A.M.
        • Grewen K.
        • Pedersen C.A.
        • Propper C.
        • Meltzer-Brody S.
        Failed lactation and perinatal depression: common problems with shared neuroendocrine mechanisms?.
        J Womens Health. 2012; 21: 264-272https://doi.org/10.1089/jwh.2011.3083
        • Rueda C.
        • Bright M.A.
        • Roussos-Ross D.
        • Montoya-Williams D.
        Exclusive breastfeeding promotion policies: whose oxygen mask are we promoting?.
        J Perinatol. 2022; 42: 1141-1145https://doi.org/10.1038/s41372-022-01339-z

      Biography

      Section Editor Denise Link, PhD, WHNP-BC, FAAN, FAANP, is a clinical professor emerita at Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ. She can be reached at [email protected] .