An Insider’s View of Tipat Chalav

baby-eye “Nurse Yachne” shared the following in response to the post on Tipat Chalav: What Parents Need to Know.

Tipat Chalav (well-baby clinic) policies are often imposed top-down.  About twelve years ago when I was a school nurse, we all held meetings together with the Tipat Chalav nurses. A decision had been made for the Tipat Chalav gynecologists to push the low-estrogen dose birth control pills, which incidentally cause a high rate of intermediate spotting. All of the Tipat Halav nurses happened to be religiously observant and they pointed this problem out to the staff physicians, who happened to be secular Russians. The doctors in question literally snickered and remarked that this was not a medical problem, and that the health ministry had made policy to push the low-estrogen pills as a preferred birth control method, so that was that.
The moral of the story, for me, anyway, was not to get birth control advice from a secular doctor, but to seek out OB-GYNs who are both knowledgeable about Jewish marital laws and sympathetic to our concerns.
As regards baby care and follow-up that my classmates and I observed in our clinical hours in nursing school, the mothers among us were pleasantly shocked to observe the tremendously sympathetic attitudes of the Tipat Chalav nurses in the deprived neighborhoods where we did our work.
I participated in a home visit to a mother of a baby with potential developmental problems.  The nurse could not have been more encouraging and positive, reinforcing the good before offering constructive suggestions.  After we left the home, she admitted, “Actually, I AM worried about this baby.  But if I make the mother feel bad about herself, then she won’t come back to us, and I want us to stay in touch.”
My classmates participated in a clinic visit by a mother who had been a heroin addict at the time she became pregnant. The nurse was very encouraging that the mother had gotten off heroin (“Do you miss it?  Kol hakavod (kudos) to you, you must really care about your baby! Any time you have any questions or problems, please do get in touch with us, we’re here for you.”).
The mothers among us reflected that it would have been nice to have gotten that kind of positive supportive contact when we brought our babies in, and that in many cases WE had been made to feel that we were suspect heroin addicts!  That was 20 years ago.  I don’t know how it is elsewhere, but my personal experience with subsequent babies was that they had made a major policy decision to be supportive and positive. They are certainly very pro- breastfeeding, and knowledgeable in this regard.  The place is obviously low-budget, but it is very determinedly cheery and pleasant to visit nowadays.
It’s not perfect, but they are working on it.  Also, no mother is turned away for an inability to pay the fees, though they would prefer that people ask for help in payment, which is evidently always forthcoming if there is a need.

Any large institution has good and bad sides. But large institutions can accomplish things that the individual could not.  At its best, Tipat Chalav can be very empowering, all those client moms and nurse moms sharing info and wisdom and positive vibes.  At its worst, they can be intimidating, scary, and closed-minded, but that, as I said, is changing, and the people in charge WANT things to change.

You may also enjoy:

Tipat Chalav: What Parents Need to Know

Screaming Babies Ignored in Maternity Ward

Breastfeeding Late Preterm Babies

Posts on Parenting at “A Mother in Israel”

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  1. Errikkaa says

    I’ve always been happy to have sweet and caring TC nurses. I had a warm relationship with my former TC nurse for over 7 years. She always had her morning coffee out of a MATERNA promotional mug… and when she offered me information about breastfeeding I gently let her know that it was hard to listen as she sipped from a mug that doubled as an endorsement for Israel’s leading formula company. I didn’t hold a personal grudge when my current nurse strongly suggested that I feed my 4 month old daughter baby cereal mixed with my milk so that she “catches up to her graph”… that is the information that they are trained to provide. They follow Misrad HaBriut which is not exactly helping mothers to successfully breastfeed for very long if at all.

  2. I had similar experiences as Errikkaa – I strongly recommend seeking any breastfeeding advice from a lactation consultant and NOT from a tipat chalav nurse. One TC nurse saw my then-11 month boy who had thinned out (due to crawling and being more active, obviously) and was now 75% on the graph as opposed to his earlier 90%, and suggested I start feeding him formula to get him back up to 90%. I almost walked out after trying to explain to her that the kid was breastfeeding as much as he wanted and was eating solids for heaven’s sake! I asked her if my kid (who was bouncing around all over the clinic) looked undernourished and she didn’t really answer, just said I should start him on Materna. That was the last time I spoke to the nurses about breastfeeding. Anything they told me after that went in one ear and went out the other. I sought advice from the La Leche websites and lactation consultants. Other than that, most of the nurses are great for the basics.

  3. In my experience (admittedly only in the US, but the training was here, at Nishmat), I got excellent (pro and con) birth control advice from a yoetzet halacha. Although my not-religious-but-Jewish OB/GYN knew a lot about tarahat hamishpacha from his patients.

  4. It’s better to go to an ob/gyn who, if not religious, at least works a lot with religious population and thus can’t ignore the laws of taharat ha-mishpacha.

    And, definitely, LLL is THE source to get breastfeeding advice, not Tipat Chalav or Pediatricians.