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Read this report of inspiring stories from Phase One of the Be Our Voice project.

My Daughter’s Best Fed Beginnings

A Message from Karthi Streb, MPH
NICHQ’s Associate Project Director

April 2012


Despite the fact that I have spent the last ten years working to improve the healthcare system for patients and their families, I never interacted with it very regularly as a patient – until I became pregnant last year. Suddenly, I found myself going to regular prenatal visits, birthing classes, and interviewing pediatricians in the community to care for my child. Throughout my pregnancy, all my husband and I hoped for was a safe delivery and a healthy baby. Before we knew it, the big day had arrived – my daughter, Sajel, was born on a Saturday, early in the morning, just as the summer sun was rising. It was the most beautiful moment of my life.

Everything after the birth was a blur and in the blink of an eye, I find myself reflecting on our experience almost a year later. Now that I have perspective, I can hardly believe how lucky we were to have had such a well coordinated encounter with the healthcare system during such a significant time in our lives, especially when it came to making the decision to exclusively breastfeed my daughter.

For the past six months, I have been leading the Best Fed Beginnings project which aims to improve hospital maternity care practices across the country to help moms and babies breastfeed. NICHQ kicked the project off right around the time I returned from maternity leave. With my breast pump and laptop in tow, I came back to work and thought: what a great opportunity to bring together my personal and professional experience!

I would be lying if I said breastfeeding was as easy as making the choice – at least for me. Those first several hours after birth are so critical to helping a mom and baby breastfeed. I know from my own experience that every little action that takes place postpartum counts.

In Best Fed Beginnings, we will be working with hospital teams to make sure that everyone who interacts with the mother – lactation specialists, nurses, midwives, obstetricians, and pediatricians – takes the right steps to keep mom and baby together and help them make the connection to breastfeed, if that’s what the mother wants.

The first days in the hospital went very well for me and Sajel. During that time I made the commitment to breastfeed and the clinicians set us up to be successful. They made sure we were skin-to-skin immediately after birth, never once offered me formula, conducted Sajel’s newborn exam right in the delivery room, and never let her leave my sight during our stay. Looking back, I feel so appreciative of our nurses who gave me the strength and encouragement to continue on even though I was completely exhausted.

By the time we were discharged two days later, however, my milk still hadn’t come in and I was terrified that Sajel was not getting enough nourishment from my colostrum. In hindsight, I am sure that stress just delayed nature taking its natural course and I now know that it is completely typical for it to take a few days for a mother’s milk to come in.

I took Sajel to see our pediatrician when she was three days old and she was still below her birth weight. It brought me to tears. Breastfeeding can be such a complex personal and social issue that affects a mother during a very vulnerable time period. Lucky for me, my pediatrician was amazing and supportive of my decision to breastfeed. She called the hospital lactation specialist who just happened to have a breastfeeding support group that morning. I went right over to the meeting and we never looked back.

I now have great appreciation for the highly coordinated care I received for those first few weeks as a new mom with absolutely no idea what I was doing. Over the last several months I have learned that not all hospitals provide this high level of seamless maternity care and there is a great need to make that change. For something as natural as a mother breastfeeding her baby, it is hard to believe that it literally takes an entire care team of providers to make it work and make it last. Everyone who interacted with us provided appropriate support and encouragement to breastfeed. It helped to make breastfeeding the right choice, the best choice, for us.

I feel privileged to be part of a nationwide effort that will transform a system of care to provide moms and their babies with the support they need to breastfeed and take the first step towards making healthy decisions for their families. Let’s not make luck the deciding factor, but rather education, support and a stronger, coordinated system.




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