Dear Laurie;

I'm sorry that my resonse to you and others took so long but that was a time
constraint and I didn't want to feel stressed.
You have been a tremendous help to me. I have one great skill that can
either help me, my hospital, my unit and my peers or totally kill me
emotionally and that is seeing the" wider picture". I don't think that I am
alone in this or am coming up with anything new.

When things are going good and we are working on positive things in our
unit, it is essential that the whole picture (past, present and future) of
breastfeeding, is taken into account. This is important for direct patient
care, setting up protocol and rearranging systems with management.

However whenever a new curve is thrown my way and possibly having a bladder
and sinus infection doesn't help, I totally see only the broader picture and
forget the baby steps that got us as far as we have.
I have reflected again on what you have said Laurie and others as well (Oh
Lactnet friends we certainly need all of you: the idealists, those who keep
us properly  grounded, those who are sooo encouraging, those who have a
grand sense of humour and those of you who can do all of that at the same
time.) Thankyou.
I also need my colleagues to correct my spelling so that I can catch the
humour of the situation. Anti natal vs. ante natal. I think Doreen probably
thought that I was totally nuts when I really started chuckling about that
comment. Thankyou.

Our biggest problem is the separation of Mom and baby and what separation
really means; length of time in getting baby out with mom,  or skin to skin
( what is really skin to skin) or baby totally wrapped tightly and in a crib
beside mom also being another form of separation.

The dehydration on infant warmers is probably the next thing to tackle after
I finish revamping our protocal before Hospital re-accredition, early March.

Bottling premis while they grow isn't a major difficulty here because the
main thing is that baby always is offered the breast first. Our followup in
our clinic (depending on parent compliance) is usually really good. Most of
our premis are off all feeding devices (bottles just being one of them
depending on the situation) by the time they reach their gestational age. My
main aim in getting the mothers and babies home is that than we can work
with them without other external interferences. However bottling premies or
using any other device is always after innitial attempt at the breast at
each feed and always in collaboration with the mother. I have more thoughts
and comments about this because of our direct experience with seeing alot of
premies, also discharged from other hospital units in the area, but I'll
leave that for now.

Thanks to all again
Attie
PS Teresa P. could you email me privately I have lost your address

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