Holly queries,
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Our  CNS has contacted me because the hospital is trying to figure out how 
to best  implement the 'exclusive breastfeeding' portion of the Perinatal 
Core Measures.  As lactation consultants we chart in the computer. This 
charting includes  information about the supplementation of breastfed babies and 
we can run a  report that includes those stats. 

The concern is that her information  about the Core Measures states that 
the supplementation must be documented by  either a physician or a lactation 
consultant, and it must be documented on every  baby not just the 
breastfeeding babies. As lactation consultants, we don't visit  the bottlefeeding 
mothers. (No flames please, we are understaffed and have no  time:-). 
 
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I guess I don't get what the problem is.  Is a formula fed baby  being 
"supplemented?"  If you give a formula fed baby a bottle of formula  (or an 
ounce or two or whatever), the baby is simply being *fed*, not  supplemented.  
So it would be documented as a feed by the nurse who is  caring for that 
baby.  Why would the physician or the lactation consultant  be involved in 
documenting feeds of a formula fed baby?
 
Perhaps I'm missing something here -- but I'm not sure what the  problem 
is.  Unless, of course, there is an assumption that what is in the  bottle of 
the bottle feeding baby is expressed breastmilk, and then if you are  
supplementing with formula, documentation of why that would  be....
 
Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants


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