On a really warm morning I took the U (subway) again to visit another one of my counterparts….a postpartum nurse at a hospital with approximately 2000+ births (similar to the hospital I work at). As in all of Europe (except for some fancy restaurants) there was no air conditioning to speak of. Dyson fans were going, which helped, but it was quite warm. Luckily, I prefer the warmth and hate air conditioning in most circumstances. A general practitioner physician, Michaela, met me outside the main entrance in her pink dress. She spoke English quite well and took me upstairs to the maternity and neonatal ward to meet a seasoned nurse (I'm embarrassed to say forgot her name) who would go on to show me around.
In the morning when I came (11 a.m.) the mothers one by one brought in their infants in a bassinette to see the pediatrician for their assessment. In the US at my hospital, the nurse aid would typically bring the baby to the nursery, but here the mother brings the baby and stays in the room while the exam is being done. They had 3 incubators where phototherapy was done if the infant was jaundiced. Because the postpartum rooms are not private, the baby must stay in the nursery if they are undergoing phototherapy. I asked about what medical conditions they typically see. And just like in Greece (when I visited a hospital there 2 years ago) they rarely see GBS (group B strep) or glucose intolerance/gestational diabetes (GDM). The experienced nurses did mention that they are seeing an increase in GDM and obesity, so if that trend continues, they may see more of what the United States is experiencing.
For a vaginal delivery a mother would usually stay 3 days in hospital and 4-5 days for a Cesarean section. Some mothers may go home at six hours but then arrange for (and pay for) their own midwife home visit follow up. They must get a "stamp" to get financial benefits (showing health tests were done…such as hearing screen, immunizations, etc.), so the midwife can take care of these details. Visiting hours are from 2 pm to 5 pm, even for the dads. Men do not spend the night. The nurse tells me that some people from other countries have a tradition of bringing the entire family in to be with the mother after delivery; it's a celebration and just expected in their culture. But because the rooms are not private (they may have 3-5 other mothers in the same room) this can cause some privacy issues for the other moms. I related to her that we have that, too, where the family likes to gather, but it's usually not a problem because our rooms are private (more like a hotel room).
I was shown a little room off the nursery where the nurses help with breastfeeding issues. They had a Medela Symphony pump in this room, but she said they rarely use. She also related that because mothers take 1-2 years off after delivery, they rarely purchase or use a pump (or just get a hand pump if needed). I suspect the Symphony hospital-grade pump is used for when a premature infant cannot latch. She also shared with me something someone in Austria created for when mothers have sore nipples. Instead of using shells, which are made of hard plastic and are put over the nipple in the bra so the bra material doesn't rub on mother's sore nipples, they cut out the center of 2-3 nursing pads then wrap soft gauze around them to make "donuts". Brilliant! She let me bring a couple home. Click HERE to see how to make your own. The nurse noted that they have two different sizes of nipple shields, but they are discouraged and rarely used (which was the same answer I got from Claudia at Nanaya).
For those who formula feed, the nurse prepares powder formula for the day and stores larger amounts in glass bottles in the refrigerator. I did not see a lot of plastic, and the bottle nipples were made of rubber. In the United States, the formula companies provide (or Baby Friendly Hospitals purchase) ready-made formula in disposable, two-ounce plastic bottles that are given to mothers who are not breastfeeding.
There was a nurse who joined us and through an interpreter I learned that she wanted to become an IBCLC but her hospital did not support it (there were no IBCLCs in her hospital), and the cost was too expensive, especially since you have to re-certify (pay) every 5 years. I offered my assistance in helping her through the process in any way that I could, and I hope she meets her goal. You can tell these nurses were very supportive of breastfeeding and are trying desperately to increase the initiation and duration rates in whatever way they can.
Thank you, Donauspital, and the gracious medical professionals who offered me their time and thoughts on that warm, August morning.
PS: If you're interested in learning how to make your very own Vienna Breastfeeding Donut, visit the link below!
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