Dear all,
so far merely been a reader of Lactnet... and learning a lot in the process,
thank you!
Iīd like to comment on Janieīs post on supplementation in a babyfriendly
hospital-to-be (not quite sure what "pyxis system" means - have an idea
though after looking it up in the dictionary.
My workplace is the postnatal ward of a central hospital with approx 2000
births annually on the Finnish west coast. For several years we have
followed supplementation, but recently developed the chart. So far it is
still on paper included in the babyīs file. Electronic documenting is on
itīs way, and perhaps it could be incorporated there too.
For possible future closer study purposes we have included demographic
perinatal information (gestational age, date of birth, time, birthweight,
Apgar score, Aph, type of birth, possible use of epidural and oxitocin,
possible bloodglucose and bilirubin follow up, use of nippleshield and
pacifier + time of discharge, and lowest and discharge weight)
Below all this - which is filled in when mother and baby arrives at the ward
- we chart date, time, amount, type of supplement, reason for giving the
supplement, whose decision to supplement (staff or mother) and
was supplementing motherīs or babyīs need, as we go along. We have NOT used
staff initials - the purpose is not to accuse anybody (handwriting says it
all, though) - or act as some B/F-police, which I know somebody felt
initially, but now it is incorporated in the routines, and doesīt bother
people som much anymore.
We are also NOT including personal charting (i.e. who gives how
much). Anyway we have to document everything else we do or administer,
supplementation should be no exception.
One person - should be more! - is in charge of processing/analyzing the
information, which is done when not busy with other things.
The aim is to make a monthly result sheet and as the sheets pile up, compare
them.
Janie inquired about results: I think this has raised some awareness of how
we supplement babies on our ward. But I donīt think it has changed practise.
I DO feel though that this system is tolerated because Iīm doing most of
this work. Not everybody is behind it (leadership is though), and many
forget to fill in the last important information when mothers are
discharged, which sort of sabotage accuracy and reliability of
the statistics.
Only a fifth :( of mother-baby pairs return home with out having had any
supplements. If into these are counted those who get less than 100 ml, but
not having had any supplements during the last 24 h before discharge the
amount of exclusively breastfed babies upon returning home is 54 %, which of
course isnīt great either. It would be fun to compare with other similar
facilities, informal checking showed that we were not "so bad".
Upon implementing this system in itīs new form last summer I used the
argument that this is to be "the future" anyway, so we might as well start
now. How is it on other postnatal wards?
Merete Willis, midwife/healthnurse, long term b/f support group leader,
Luvia/Pori, Finland
(next challenge IBCLC-exam)
> Our hospital is in the process of becoming baby friendly but we are having
> problems with staff supplementing breastfeeding infants. Reasons given
> range from baby is hungry, we're too busy and baby cries or nurses
> constantly. We are thinking about placing formula in the pyxis system so
> that we can track the nurses giving it and why. Has anyone else done this
> and with what sort of results?
> Janie
>
>
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