>One of the elements that I have come up against is night time
>complementary feeds to breastfed infants whose moms are keen breastfeeders
>but are beyond exhausted.

         When this was looked at locally the administrator asked why the
fatigue?  WHY are the moms so tired? Is it the hospital routine (no
sleeping during the day)? Is it lack of support for tasks not involved in
infant care?.. if so change it.   We ran focus groups with parents and
quickly discovered it was visitors both theirs and their room mates that
were the greatest problem.  The focus groups redesigned visiting hours
making them much more strict than anyone had expected. The moms are in
hospital for such a short time that they need to focus their time on
healing and getting to know this new family member. Of course immediate
support people are welcome at any time. We are talking about great aunt
sadie who you haven't seen in 5 years and her dog (literally!)
         For a short period student nurses actually sat at an information
table by the maternity floor doorway and controlled access. Now the doors
are kept closed (not locked) at all times, a large display explains why
visitors are encouraged to visit at a later date and how the rules were
decided upon. Each room has a white board on it for the moms to write
messages. The messages usually say their names, the baby's name and a thank
you for coming I am tired/sleeping/feeding please come to see me at another
time.  The visitors can write on the boards and leave messages in return
although I don't know how often that happens. While this doesn't fix all of
the problems I would strongly recommend you go back to your hospital
situation and look around to see what you are doing that prevents moms from
getting sleep at any time. IE can noise be reduced mid day so they can
sleep during the daytime if they have a night wakeful infant. What would
happen if they were at home but with the benefit of nursing care, and
meals? Can that atmosphere be reproduced at least partly?  What can be done
to prevent a mom from getting that exhausted in the first place? Prevention
before treatment :)

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