STORY: “VIOLATIONS TO
EO 51 AND RA 7600”

There is a hospital who is supposed to be a “ Mother & Child-Friendly Hospital”. It is exempted from paying taxes. It has banners, posters and flipcharts inside its Breastfeeding Room that says it is “ Mother & Child-Friendly Hospital” but is it?

Case No. 1
Five years ago, Dax gave a normal birth to a healthy baby girl. They stayed for three (3) days. The whole time the infant was bottle-fed in the nursery. This violation to the EO 51 and RA 7600 was never reported.

When I visited Dax at home, her daughter had jaundice, she hasn’t breastfed and her breasts were very engorged yet she never complained of the pain. It was very difficult but with God’s help, Nona Castillo, IBCLC and I were able to help Dax soften her breasts using massage, warm compress,.breast.milk.expression,
nitiating..breastfeeding,..teaching breastfeeding positions, giving Dax the right indigenous foods to eat, and specifically telling her to offer her breast every feeding and get rid of her infant formula and feeding bottles. Breastfeeding healed her daughter’s jaundice and herself from engorgement. Dax was able to breastfeed her daughter for 2 years and is now breastfeeding her 10 month old son.

Case No. 2
First time parents, Pen and Mex, have been given birthing and breastfeeding lectures, were informed about the laws regarding rooming-in and breastfeeding and have been forewarned about the possible repeat of Dax’ case in the same hospital with the same Obegyne. The couple was confident that the same case won’t happen to them because they have pre-arranged/pre-agreed Birth Plan with their Obegyne and Pediatrician which were stipulated in their Admission Slip "immediate rooming-in and exclusive breastfeeding"

During labor however, Mex was given an Epidural when she was already 9cm dilated and could still tolerate the pain. When the Anaesthesiologist shot her spine with Epidural, her Obegyne was not present in the Delivery Room. Upon the Obegyne’s return, even she was surprised and enraged at such radical action taken by the Aneasthesiologist. Mex gave birth through normal delivery with epidural and fundal pressure to an 8.1lb Baby Girl with APGAR Score of 9-10 (almost perfect).

The Epidural had negative effects on Mex.

  1. During the delivery, she couldn’t feel the contractions so she needed guidance and fundal pressure.
  2. Druggy and drowsy in the recovery room, her Pediatrician immediately concluded that Mex could not breastfeed and instructed her husband to buy SIMILAC infant formula without a written prescription.
  3. Mex was so drugged that when her husband asked her whether or not she could breastfeed, she lost her consciousness before she could give an answer. So her husband went out to buy the infant formula.
  4. Mex got fever and chills as the effect of the Epidural and of almost being engorged

The new born baby girl at 8.1lbs with an APGAR score of 9-10 already had her eyes wide opened, body moving so actively, had rosy-white skin not wrinkled anymore as if she were 1 or 2months old already – all signs of perfect good health.

Despite signs of good health however, pediatrician ordered nurses at the nursery to feed infant formula, do a Blood Culture and to give medication to the healthy infant. They explained that maximum labor time after water breaks should only be 18 hours but Mex delivered her healthy infant after 22 hours. Due to the Blood Culture and Medication, the pedia and nurses did not allow the baby to be roomed-in.

Blood Culture is where they take blood sample and has to observe the blood and the baby for at least 72 hours. But aside from Blood Culture, they kept conducting tests because they were trying to figure out why the baby was so big and so healthy!

Because the baby was under medication and fed SIMILAC infant formula, the baby was full, druggy and asleep for long hours. Thus, Mex could not breastfeed her new born child whenever she went down to the Nursery every 2 hours or so, and so she got sick and weak.

Because Mex hasn’t breastfed her baby, she experienced the following illnesses:

1. Bleeding, which resulted to low blood pressure of 90/50 versus her normal BP of 110/70.
*Breastfeeding could have contracted her uterus to stop the bleeding

2. Engorgement
* She gave birth May 27, 3:30pm. She was finally able to breastfeed only on May 29, 5:30 pm; already 50 hours after delivery – because that was the only time we caught the baby finally awake from a long sleep due to medication and infant formula.

3. Fever and Chill
* Also a result of the breasts’ engorgement


To Quote Mex, “Hindi magiging ganap ang pagkababae ko kung hindi ko mabe-breastfeed ang baby ko.” (translation: “My womanhood won’t be complete if I won’t be able to breastfeed my baby.”)

I helped Mex by doing the following natural healing methods:

1. Fed her healing indigenous foods:
  • Soup with papaya, camote, tomatoes, onions, ginger, dahon ng sili (energy-giving and helpful in increasing breast milk)
  • Red Rice (which is high in iron and other natural nutrients, for her low blood pressure)
  • Brown Rice Coffee with Pandan Leaves (to contract her uterus and to relax her)
  • Sambong Tea (to detox/cleanse/remove heat and toxins from Cate’s body, thus heal fever)
  • Salabat (ginger, saba, camote and pandan leaves – all boiled together)

2. Sponged Bath her (to lower-down her fever)

3. Massaged her (to relax her and to soften and stimulate the breasts)

4. Assured her that she has enough breastmilk

5. Accompanied her to the Nursery’s Breastfeeding Room and taught her the correct sitting position, latching, and was able to make her breastfeed her child

6. Fed Mex with red rice, soup, and rice coffee / salabat / sambong tea / water after every feeding (since mother will really feel very hungry, and in Mex’s low blood pressure case, dizzy)

So, it was the feverish, low blood pressured Mex who went down to the Nursery to breastfeed. Despite her condition, she had to go down several times to check if her baby was awake/hungry, since the baby was out of her sight. In those times, there were several instances when baby was asleep. So Mex was not able to rest/sleep while baby was sleeping. Mex had to watch the time (when correct breastfeeding must not be based on time but on baby’s need).

Since the hospital had only one (1) wheel chair, several times too Mex couldn’t wait for the wheel chair to be returned after use of another patient so she just walked and rode the elevator inspite of her chills and dizziness (due to fever and low blood pressure).
Even if the parents offered and were willing to sign a waiver, no matter how many times we explained to the people in the Nursery that rooming-in the baby will heal both mother and baby, that...

The mother will be:

  • relieved of her anxiety, can sleep/rest/relax
  • breastfeeding will contract her uterus and stop her bleeding
  • breastfeeding the baby in the mother’s room will not engorge the mother and will cure mother’s fever

The baby: If in case their fear were true that the baby had infection due to 22 hours of labor after the water bag broke, no medication would be better than the baby’s own mother’s breast milk, which contains a lot of antibacterial properties.

To quote Mex


“Intindihin niyo naman ang nararamdaman ko as the mother…”
(translation: “Please try to understand how I feel as a mother…”
“Pampadagdag kaba sa akin yung iniisip ko kung baka gising at gutom na ang baby, baka mag-engorge uli ako pag di ko napasuso si baby.”
(translation: It’s additional stress for me when I wonder if my baby is awake or hungry already, and when I worry that I might get engorged again if baby is fed infant formula before I am able to get to her, to breastfeed her..”
“Nilalagnat, giniginaw, nahihilo at mababa ang BP ko so mahirap sa akin ang bumaba nang bumaba.”
(translation: “I have fever and chills. I’m dizzy and have low blood pressure. It’s hard for me to keep coming down to the nursery.”

Regardless, they still didn’t allow Pen & Mex to sign the Waiver and they continued to give threats and alibis, i.e.:
  • You’ll just have to wait for another 24 hours, let’s wait for the result of the Blood Culture.
  • Let’s just do the “New Born Screen Test”.
  • Let’s finish the “Hepa Screening” before you room-in the baby, so we finish all the tests. When asked when is the “Hepa Screening”, they answered, “We don’t know. It depends on the availability of the equipment/items/person to conduct the test.
  • If you room-in the baby and the baby gets infected from external sources, that will be another 7 days of antibiotics which means 7 days of rooming-in the baby
  • Once you take the baby out of this Nursery, you may no longer return the baby here, for us to take care/cure
  • After already 78 hours/3 days and 6 hours of Blood Culture, they said “Not yet 72 hours, but just 2 days and 5 hours”!
  • Upon counting in front of them, their next alibi was, “The Medical Technologist isn’t here to sign the result of the Blood Culture.”

It was already on May 30 at 10:30pm, exactly 79 hours after birth that the baby was finally roomed-in with the mother. They check-out the next day.

There is very clear repeat violation of:

1. Executive Order 51, which prohibits the marketing of breastmilk substitute
- when the Pediatrician ordered for the immediate feeding of SIMILAC infant formula, without the consent of the drugged unconscious mother, and without trying other means and ways to feed breastmilk to the new born child (Mex had 1 sister and 2 sisters-in-law who were breastfeeding mothers and there was always 1 of them with her at the hospital.)

2. Republic Act 7600, which is the Rooming-in and Breastfeeding Act
- the Pediatrician and the Nursery didn’t allow them to room-in the healthy baby.

*History repeats itself if this is the daily practice of same hospital and doctors and nurses there, and if nobody will correct this by filing a report to the Department of Health.


Labor, Delivery, Recovery

ENSURE BREASTFEEDING AFTER LABOR & DELIVERY

What happens during labor and delivery may possibly make doctors order fathers to buy infant formula.

WHAT TO PACK
First and foremost, your signed Birth Plan (see “Birth Plan”)
And Natural Child Birth Certificate (if you are going to have one)

For the Mother:

  • BOSOM BUDDY Breastfeeding Dress Shirt or Pajama Set
  • BOSOM BUDDY Breastfeeding Pillow
  • 4 Extra Pillows (hospitals only provide 2 thin pillows)
  • Bath Towels
  • Face Towels
  • Betadine Feminine Wash
  • Maternity Pads
  • Underwear
  • Waist Band (so air won’t go inside your tummy and to help tuck-in tummy to flatten again)
  • Socks
  • Sleepers
  • Edible Oil (Olive Oil or Coconut Oil for massage)
  • Hot Bag
  • Air pot
  • Toothbrush & Toothpaste
  • Shampoo & Soap (if you will take a bath – Western style)
  • Comb
  • When checking-out already:
    • Blouse with bottons/opening at the front or blouse with low v-neck or blouse with stretch cotton material you can raise, or BOSOM BUDDY Breastfeeding Blouse for discreet and comfortable breastfeeding.
    • Breastfeeding Bra
If giving birth in a birthing clinic, also pack:
  • Blanket
  • Bed sheet
  • Pillows
  • 2 rolls of bathroom tissue
  • 4 huge bath towels for wrapping baby and for bathing baby
  • 4 small face towels to support baby’s head as it comes out, also for bathing baby, and for wiping mother's face
  • 3 or 4 plastic bags for the placenta and dirty clothes and things
  • Baby Oil or Mineral Oil – used for the baby’s skin

For the Baby:

  • Baby Shirts (with sleeves and without)
  • Mittens
  • Socks or Booties
  • Bonnets
  • Baby Receiving Blankets
  • Baby Bath Towels
  • Baby Face Towels
  • Diaper (Cloths and Disposable)
  • Diaper Pins/Clips
  • Cotton
  • Cotton Buds
  • 70% Ethyl Alcohol
  • Baby Soap (Johnson’s/Dove White/Cetaphil/Lactacyd Blue)
  • Baby Oil

For the Father:

  • Blanket
  • Change of Clothes
  • Toiletries
For your Hospital Stay:
  • Drinking Water
  • Dishwashing Soap
  • Hand Towel
  • Cups
  • Paper Plates
  • Spoons & Forks
  • Snacks for Guests
WHEN TO GO
Go to the hospital only when you see any of the following symptoms:
  • Water
  • Blood
  • Very regular frequent contractions

Don’t go too early. Obstetricians and their resident doctors base the need to induce or to give a caesarean delivery on the hours you’ve been on labor in their delivery room.

They will also automatically place the baby on medication out of fear of infection if:

  • The infant has removed bowel due to the long hours of labor
  • The delivery time exceeded doctor’s maximum of 18 hours after the water bag broke

Most Pediatricians and hospitals will not allow rooming-in because they are still observing the baby and worry of catching further infection once brought out of the nursery. These Pediatricians and hospitals don’t know the benefits of breastfeeding. They don’t know that breastmilk contains antibacterial properties greater than their synthetic antibiotics. They don’t know the need and benefit of mother and baby bonding for their immediate recovery and for breast milk stimulation.

WHAT TO WATCH-OUT FOR:
Anaesthesia and other medications given to the mothers are possible obstacles to breastfeeding.

If mother is sedated, and mother is asleep for long hours after delivery, pediatrician might ask the father to buy infant formula (without a written prescription, because this will be an evidence of their violation to EO 51).

The nurses in the nursery will follow doctor’s order and feed infant formula to baby every feeding time. Every time mother goes to the nursery in the hope to breastfeed, baby is sound asleep as baby is full with infant formula. As mother is not able to breastfeed, mother gets stressed, depressed, engorged, fever, postpartum blues.

Breastfeeding will heal both mother and baby.
If mother was given epidural, mother may also have fever.
If mother gets engorged, mother may also have fever.

Note: It is alright to breastfeed when mother is ill with fever or any illness or disease. Breastfeeding will heal the sick mother, and breastfeeding will give antibacterial properties to protect baby from getting infected.

If mother underwent Caesarean


There are doctors who believe that mothers who underwent a Caesarean delivery cannot and shouldn’t breastfeed. But this is false.
I myself had a Caesarean delivery on my 2nd child and I was able to breastfeed as soon as we were both roomed-in.
Even if I couldn’t move yet, there is the lying-on-back breastfeeding position (see “Breastfeeding Positions”)
If it’s the medications/antibiotics doctors are worried about, infant formula or any milk formula for that matter contain much greater dosage of antibiotics which are too heavy for human to bear.

 

WHAT TO ASK

1. Baby’s APGAR Score
  • Taken 5 minutes after birth
  • Here’s how they get the APGAR score:
     
    0
    1
    2
    Appearance (color) Pale or Blue Body pink,Extremities blue Pink
    Pulse (heartbeat) Not detectible Below 100 Over 100
    Grimace (reflex irritability) No response to stimulation Grimace Lusty cry
    Activity (mscle tone) No or weak activity Some movemen of extremities A lot of activity
    Respiration (breathing) None Slow, irregular Good (crying)

Any Apgar score of 7 or over indicates that baby is in good condition.

If baby’s APGAR score is lower than 7, it means the baby needs careful watching, but still very likely to turn-out fine.

2. Immediate Latching on the mother’s breast

  • in the delivery room as soon as baby comes out, baby will be brought and laid on to mother’s breast

3. Immediate & Exclusive Breastfeeding

  • No glucose water, no formula, no vitamin shall be given to the baby

4. Immediate Rooming-in

  • baby should be immediately roomed-in to the mother – 30 mins. after a normal delivery and as soon as the mother is awake, around 4 hours after a Caesarian delivery

5. New Born Screen Test

  • blood sample taken from baby after 48 hours, for early detection and intervention in case of any abnormality

MOTHER’S WAY TO FAST AND EASY RECOVERY



1. Recovery Room
There is great value in staying/resting in the recovery room. It is very important for mother to rest. Don’t struggle against sleep.

2. Breastfeeding Heals Mom and Infant
Every time baby demands to be fed, the mother’s breast is supplied with breast milk. Thus, mother should breastfeed every time baby demands for it. This will prevent mother from getting engorged and feverish. An engorged breast is also one that will be very hard for infant to suck breast milk from, and people always think they don’t have milk, but truth is baby can’t pull-out the nipple and breast milk becomes solid like frozen ice/cement inside the breast.

Breastfeeding will contract the mother’s uterus and will stop bleeding/haemorrhage. Also, as uterus contracts, mother’s shape returns to its previous shape and size.

Breastfeeding will give the baby antibacterial properties against any possible infection. In fact, just a teaspoon of breast milk contains 3,000,000 germ-killing cells.

Breastfeeding will remove any fear, anxiety, stress both baby and mother may have.

3.Foods & Drinks

  • Brown Rice Coffee – will stop bleeding and will cure fever
  • Salabat (Ginger Tea) – will heal any colds, cough or fever
  • Pandan Tea - will relax mother and child up to a restful sleep
  • Mongo – will remove any swell off mother’s body
  • Sweet Potato – is energy-giving and will make mother fart and remove bowel which are among the things
    . ..
    doctors wait for before doctor will discharge the mommy-patient
  • Malunggay Leaves and Green Papaya – are helpful in increasing breast milk
  • (See “Vegan Recipes”)

    4. Guava Leaves
    Indigenous and effective way to heal wounds for normal/natural delivery. Boil guava leaves.  The guava leaves with the water may be used for washing and/or placed in the toilet potty and you sit on the potty and your wound gets steamed.

    5. Massage
    Massage will relax the mother, stimulate breast milk production, remove toxins from her body, help recuperate from child birth and may help in bringing mother’s body back to its previous shape


     
       
     
     


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