Nurses to do a risk assessment before allowing mothers to breastfeed lying down, says coroner.
Nurses must ensure new mums are alert enough before letting them breastfeed in bed, an inquest into the smothering death of a baby has found. New mums must also be educated about the dangers of accidentally suffocating their newborns, Coroner Annette Hennessey says.
Zelia Blomfield gave birth to a healthy baby girl, Bela Heidrich, on February 28, 2008, at Rockhampton Hospital in central Queensland.
Blomfield was breastfeeding Bela for only the second time, about two hours after her birth, when she awoke to find the baby dead. A nurse had placed Blomfield, who felt sleepy but was responsive, in bed on her side, with a pillow behind Bela.
Bela's post-mortem examination found she died due to asphyxia, due to "over-laying".
This could have been a result of part of the bed or bedding blocking her airway.
Hennessey recommended that all Queensland Health birthing services have a specific policy on bed sharing, and be made aware of three deaths in similar circumstances.
The existing policy should be updated to make nurses do a risk assessment before allowing mothers to breastfeed lying down, she said.
This would include noting how lucid she is, giving her information about the dangers of lying down and a buzzer to contact staff if she gets tired, and determining how much supervision she needs.
The coroner also recommended every prospective parent in Queensland be given information about bed sharing, and that nurses be trained in new procedures for consistency.
Maurice Blackburn senior associate Christine Mercer, on behalf of the Heidrich and Blomfield families, said they were pleased with the findings.
She said the coroner had highlighted systemic failures in Queensland hospitals, from the lack of training, lack of consistent policies and failure to properly keep patient records.
"It is just sad that it takes a tragedy like this to bring about change," Mercer said.
"Queensland Health have a lot of work to do to make sure that no other baby dies in these circumstances."
The inquest looked into staffing and workload at the hospital, and sought expert opinion on whether Blomfield should have been allowed to breastfeed lying down. One expert said the supervision was not adequate, given how tired Blomfield was.
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