Exclusive breastfeeding is exclusively feeding an infant with breast milk for the first 6 months of life. No solid or liquid food is given during this period not even water. This is the World Health Organization recommendation for the first 6 months of life. It is proven by evidence to have health benefits to both mother and infant. The benefits are protection from diarrhea and common childhood diseases such as pneumonia. It gives long term health benefits to both mother and infant, such as reducing risk of obesity in childhood and adolescence. The benefits are many compared to the risks and you can have a whole blog post on this.
When a mother is discharged from post-natal care, one of the key messages is exclusive breastfeeding. There are special instances when this cannot be achieved, however we will stick to instances where it applies. The nurse expects the patient to follow these instructions. During the next visit they look forward to knowing how the mother and child are doing with exclusive breast-feeding. The irony is that most nurses are not able to practice the important information they share because of workplace factors.
In most countries around the world, a mother is entitled to 91 calendar days/12 weeks or 3 months maternity leave. This translates that if the mother did not have extra leave days they will resume work with a 3-month-old infant. In case she had extra days, she will resume when the infant is four to five months, which is a deficit to the 6 months. So why then do mothers (nurses) find it hard at times to practice one of the key messages they teach?
Most of the hospitals do not offer rooms for expressing mothers, most hospitals do not have them at all. You will find a nurse occupying the office or kitchen in the ward to express milk for storage to ensure their infant get milk for exclusive breast-feeding. There is a silent rule that says that nurses with less than 6 months infants cannot do night shifts. Some hospitals follow this while others do not and you will find a nurse with an infant less than six months infant doing night shifts. Some facilities do not have flexible shifts for the nurses who are breast feeding so that they can be able to ensure their infants are well taken care of and the nurse performs optimally at work. It is common for nurses to even go to the extent of taking unpaid leave to ensure their infants are given proper care. Some have resigned because of the difficulty of balancing caring for their infants with the pressures of work. They hope that when they are ready to get back, they can apply and get another job. These difficulties make many nurses not to exclusively breast feed their infants as they advise their patients.
Hospitals should have a structured pattern to enable nurses to exclusively breast feed. They should start by having special rooms for expressing mothers and storage facilities for the milk. The nurse who is breast feeding should be able to express with comfort. Shifts should be flexible so that the nurse fulfills work requirements while being able to exclusively breast feed. This should not be confused to mean they should work fewer hours, they should be able to cover the hours needed at work. You just need to get flexible shifts. Night shifts should be delayed as much as possible, especially for less than 6 months mothers. The nurse should resume night shifts after one year. This should be structured and put as a policy. The nurse should be able to get the service they offer and advocate for.
The policy-makers and implementer should be able to provide the nurses with an enabling opportunity to enable them exclusively breast feed their infants. It is important for the nurse to implement what they teach to their patients. You should allow and enable nurses to exclusively breastfeed in your facility or company.