Having a handout for med-surg floors would be very valuable.  As a
HBLC, I would visit hospitalized bf moms on any floor.  We kept
trying to teach the nurses how to order/use a breast pump, but the
info never seemed to "stick".
Personally, I would not put "weaning" as the first option on the
list.  Too many moms and HCPs think this the only or best option in
all cases and putting it first merely reinforces this.  I would
start with "How to protect the breastfeeding relationship when mom
must be hospitalized."  You could present the options in decending
order of how much they might impact the breastfeeding.  Perhaps
something like this:
1-Baby rooms in with mom (with a family member or friend on hand to
help with baby care-this is not the responsibility of the nurse
caring for the mom).  Baby continues to nurse "on demand"
2-Baby is brought to mom as frequently as needed to nurse-maybe
staying with mom during the day and being taken home at night.  Mom
would need to pump as often as feedings would be missed.
3-Mom pumps and milk is taken home to baby.
4-Mom pumps and dumps due to a medication which may not be safe for
baby.*
5-Mom weans and support is given to make this as comfortable for her
as possible.

*One of the biggest challenges for hospitalized moms is the
abundance of misinformation, especially about the safety of her
milk!  The biggest is the notion that mom must pump and dump for
24-48 hours after anesthesia.  See Hale for the truth about this.
Basically, the reason you "wake up" from anesthesia is that the drug
is leaving your body.  Therefore, if mom is awake enough to handle
baby, her milk should be fine for the baby!  Then there is the
question of pumping and dumping after various tests.  Again Hale is
an excellent source.  A few do require time to leave the milk
sufficiently to be safe, but nowhere as many as the radiologists
would have you believe.  Lastly is the question of meds in general.
Most uninformed docs and nurses take the attitude of "we don't know
if it's safe, so mom shouldnt nurse while getting the med".  While
some do have concerns, the majority are fine or minor concern is far
outweighed by what is good about her milk.  Again, Hale as the best
resource.

One of the roles of a HBLC after working with new moms and babies,
is staff education-first for the mom/baby staff, and then for staff
in general.  I really think a copy of the latest Hale should be on
every floor that might have a nursing mom (or baby/child) as a
patient.  It should be considered just as necessary as the various
nurses' drug books, PDR, Formularys etc.  Next would be for LCs to
provide information to asesthesiologists and radiologists in
particular to help them make appropriate recommendations to moms.  I
have found that this is the biggest challenge, but keep working at
it.

I hope you will let us see the final form of your handout.  Lastly,
it might be helpful to develop a Policy/Procedure for supporting the
hospitalized nursing mom and/or child.

Good luck.

Winnie

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