In a message dated 11/6/00 4:04:38 PM Eastern Standard Time,
[log in to unmask] writes:

<< For the hospital LCs. What are your thoughts on the H....... Newborn Flow
 Records?  Under the breastfeeding section, we are to document the length of
 feeds. IMO, I am pleased to know that the baby latched and suckled for 3,
 5, 7, 9 minutes on the first or second days of life.
  >>

On our nursery flow sheets most nurses write that baby nursed for x number of
minutes & what time the feeding occurred. It is of little use most of the
time because as I question the moms I find that sometimes the 10 minutes
means that the baby was rooting at the breast or just in contact with the
breast, or just sucking but not necessarily having a nutritive feed. My other
"pet problem" is the mom who tells me (and it's also charted on the NB
record) that the baby is nursing really good for 10 -30 min. each feed. Then
when I go in to check latch-on, the baby is sucking his own tongue & not even
latched onto the breast!!!!

On the log sheets that we hand out to moms, they do not write in the time of
the feeding nor the length of the feeding. We are trying to educate them with
these logs so that they don't panic & give formula because the baby "is not
getting enough at the breast." Then they have a nurse who may tell them that
the baby is dehydrated because only 1 wet diaper is charted & the baby has
lost almost 10% of his birthwt. I can then use the log & reason with mom that
this baby is OK based on many other assessments. Many parents are changing
the diapers themselves & often don't see any urine when it is full of
meconium. This is why there was only 1 urine charted. Also, the baby may have
urinated twice before anyone even changed the diaper. (This was a situation
that I encountered this morning.)  While the numbers on the log can be
guidelines, it is important to look at the baby to see what he/she is doing.
Only the LC's give out the logs & give an explanation of what a feeding is &
talk about cluster feeds & it's OK to soothe baby at the breast. We also
encourage them to call us so that we can observe latch on & swallowing.

the best thing that we can do is to require all nurses working with new moms
& babies have some verification/certification of correct breastfeeding
knowledge. Too many nurses are still giving out information on what they
think worked best for them when they were nursing their babies---20 some
years ago! I must stop this ranting! But who else will listen and really
understand what I see on a regular basis.

Laura Hart
Winter Park, FL

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