Hello, I am Anne Nans, I have been on Lactnet for many years, but rarely 
post.  I am currently working PRN (10 - 16 hrs/week) as a staff RN/IBCLC at 
a small, fairly rural hospital in Northern New York.  I have been at the 
hospital for over a year and have been very impressed with the way 
breastfeeding is handled.  Breastfeeding moms get lots of encourargement to 
start breastfeeding in L & D, MDs give quite a bit of leeway for babies not 
ready to feed in the first 24 hours, our NICU is very breastfeeding friendly 
and babies able to start real breastfeeding go straight to the breast.  But, 
that's all changing, at least every other week.

We have a new neonatologist who rotates one week on and one week off with 
our other neonatologist.  She has a lovely personality, is very dedicated to 
the babies, and went to medical school when her kids grew up because she 
wanted to "make a difference".  She knows very little about breastfeeding. 
She wants all the breastfed babies supplemented.  She's afraid they will 
"become hypoglycemic and have poor cognitive skills when they go to school." 
She's very aggressive with babies who are a little jaundiced and thinks 
breastfeeding mom's should pump, "because Dad needs to be involved, too" 
She has no patience for the sleepy breastfeeder in the first 24 hours.  I 
can go on and on, but bottom line, breastfeeding is being sabotaged at every 
turn.

So far I have talked to her in person, given her the AAP policy on 
breastfeeding, the American Academy of Breastfeeding Medicine's Policy on 
supplementation, our ILCA policy on infant feeding, and our hospital policy 
(not bad but gives too much flexibility for MD intervention when medically 
necessary).  I've gotten the breastfeeding friendly nurses, midwives, and 
OBs involved, and the full time LC has called Quality Assurance so we can be 
working with them as well.

I have found a very good article in Pediatrics refuting her claims about 
hypoglycemia and poor neurodevelopment.  I'm doing lit searches for other 
issues like the problems of supplementation.  I think we are on the right 
track.

I just wanted to vent to you all who care and ask for any advice, 
information, stories that you have to share.

Thank-you,
Anne Nans, RN, IBCLC
Sackets Harbor, NY 

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