I feel uncomfortable at the notion of HCPs telling a mother she 
'shouldn't breastfeed'  or 'can breastfeed' (if given permission (!) 
after a negative sample), and mothers 'complying' or not being 
'compliant'.

Christine, how would your committee react to discussing how best to 
bring the mother's own wishes to breastfeed into any protocol, and 
instead of the language of 'should/shouldn't' , using different 
phrases *in the actual protocol* which reflect respect and concern 
for the mother's own agency?

Isn't that more likely to engender the sort of trust and relationship 
which will enable a mother to consider safer behaviours when 
breastfeeding?

Of course I would be surprised if any caring HCP marched up to a 
woman and told her directly 'we cannot allow you to breastfeed' 
unless there was overpowering evidence of immediate, serious harm - 
encouraging better interactions between mothers and their HCPs starts 
with the protocols, IMO.

Heather Welford Neil
NCT bfc, tutor, UK



>Hi, I looked at the responses to the question of marijuana and 
>breastfeeding from last year and wrote to some of the posters for 
>additional information. I have been on a committee looking at how we 
>are going to proceed when mother and/or baby have a positive UDS. We 
>all agree she shouldn't be breastfeeding based on the available 
>literature but we also agree that even if she doesn't breastfeed 
>while inpatient, there is nothing stopping her from breastfeeding 
>after discharge. We have been instructing mothers to pump and dump 
>for 10 - 14 days, obtain a UDS and if negative can breastfeed but 
>can't find the reference to support this recommendation. We also 
>suspect there is litte compliance.
>Most mothers, when told that the medication they are on is 
>contraindicated, will either try to find an alternative medication 
>or not breastfeed. Marijuana is a totally different drug re how 
>mother's respond to being told that it is contraindicated. I checked 
>with our social worker and positive UDS results are referred to the 
>Bureau of Child Welfare.
>I'd like to hear from you re:
>1. what your policy is and share it if you can
>2. if you instruct mothers to pump and dump, how long and what is 
>the reference that this recommendation is based on
>3. what has been your success rate in mothers complying with 
>abstaining and then obtaining a UDS or breastfeeding successfully 
>after.
>Thank you so much for your time.
>Christine, RN, BSN, IBCLC
>Milwaukee, WI

-- 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome