Kamloops Breastfeeding

Quiet Time on the Maternity Ward

November 4, 2016

There are many changes to maternity care that have occurred in hospitals in the last few decades.  These are often labelled “family-centered” interventions such as having mom and baby room-in together 24/7 and removing restrictions on visiting hours.  They also include trying to keep moms and babies together after caesarean sections when possible.  These changes have been mostly positive and have had good effects on bonding within families as well as supporting breastfeeding.  However, I believe there is another change we could implement in our hospital that would help mothers and families recover and would also support breastfeeding.  Implementing a period of quiet time in the afternoon each day where interruptions are minimized and there are no visitors allowed would help promote rest and healing for families.  Also, if a mom was wanting to try breastfeeding in a calm environment with a good guarantee of no interruption she could do so, without worrying that someone might walk in at any moment, either to interrupt the process or offer their help and advice (wanted or not).

Mothers typically stay in hospital for 24-72 hours after having a baby.  They have a lot of people coming in and out of their room in that short amount of time.  At RIH you are likely to have the lab, public health, hearing screening, dietary, housekeeping, doctors and nurses all in and out of your room.  When you count, there is easily the possibility of someone coming in and out of your room 20 times or more in one day.  That is just hospital staff, and only if there are no nursing students or resident doctors around at that point and you have had no other complications requiring anything extra during your hospital stay.  Then add in any visitors and you can see how the day in a hospital ward could be exhausting for a new mom.  When would they have time to rest and learn to breastfeed and bond with their new baby?  Unfortunately, the days are busy, with little time for rest and newborns are frequently awake for much of the night, leaving no time for parents to sleep.

There have been numerous studies on implementation of a quiet time in acute care wards but very little research so far on the impact of a designated quiet time on maternity wards.  However, the limited literature does suggest this would be beneficial and may even help decrease the amount of night-time formula supplementation because parents would have a chance for a rest in the afternoon before the long night of being up with a baby.  Unfortunately, to date, there are no large scientific studies backing this type of change.  Even so, it’s a low risk change that could have positive benefits and outcomes for families.

What would quiet time look like at the hospital?  I would suggest a time from 1-4 pm in the afternoon each day that it be implemented.  During that time the only interruptions from hospital staff would be medically necessary ones, which obviously still need to occur.  However, lab, public health, hearing screening, nurses, dietary, housekeeping and doctors could all work to schedule their checks and visits to not occur during this time.  Nurses could check in with their stable patients, who need less monitoring, before quiet time starts to ensure they have everything they need and are doing ok.  Instead of instituting set visiting hours this time period could instead be considered “No Visiting” hours.  It’s much less restrictive than having set visiting hours and is only 3 hours during the day, leaving lots of other time for visitors to come.  Lights could be dimmed in the hallways and attempts made to keep any other extra noise on the ward to a minimum.  If patients during this time needed or wanted assistance from their nurse of course they could still use their call bell and get help with whatever they need.

I remember how surprised I was when I became a patient after my C-section and was the one to have so many people in and out of my room all day.  As the nurse, I was mostly only aware of when I came in and out, which already could be quite often.  I hadn’t thought of how many other interruptions there are for new moms.  It would have been nice to know there was a period of time when I could have napped or breastfed during the day, knowing there was little likelihood more people were about to walk into my room.  Having a baby is hard work, whether you had a vaginal delivery, a C-section or if it’s your first or fourth baby.  Quiet time in our hospitals could help support all families who are adjusting and recovering after they’ve had their babies.  Shhhh 

Research Articles

Adation, S., Law, S., & Haggerty, J. (2014). Room for improvement: noise on a maternity ward. BMC Health Services Research, 14, 604. DOI:10.1186/s12913-014-0604-3

Driver, R.L. & Colbert, T. (2010). Shhh…Implementation of Quiet Time on the Mother/Infant Unit. DOI:10.1111/j.1552-6909.2010.01119_5.x