Suzanne wrote "But seriously, how SHOULD I handle the situation of the
malnourished 8 month old, who is not FTT enough to go in the hospital?
(Outpatient workup and management of FTT is still the standard of care in
the US.) Y'all have said specifically what I SHOULDN'T do, but what
SHOULD I do?"
There is a difference between using some formula in an emergency situation
and handing out discharge packs full of free formula to mothers in the
hospital. The intent of the bill, as I read it, is to stop promoting the use of
free formula. That means that hospitals would purchase the formula, there would
be no gift packs of formula, we wouldn't be stocking the moms up with little
6 packs of formula to take home, and so on. Suzanne's case -- a baby (I
don't care how old it is) is in the office and is malnourished. What do you do?
Mom has been breastfeeding, but milk supply is low because baby hasn't been
nursing well. Baby is obviously in distress, but not in a situation in
which she needs hospitalization or ER care. Maybe she's dehydrated. Whatever --
it is a MEDICAL issue, not a PROMOTION issue. If it were me, I'd have mom
breastfeed the baby if she can, give the baby some formula, and then,
depending on the situation, send mom to the grocery store, have her try to get into
WIC, prescribe donor milk, increase her solid food intake, whatever. IF mom
doesn't have enough breastmilk, or she isn't breastfeeding, and you have a
baby that is dehydrated or malnourished, something needs to be done. Now. One
bottle of formula is not going to fix the situation, but I think we have to
see what the difference is between necessity and handing out cute bags in the
hospital for free. Donor milk is a wonderful idea, but unless it is right
next door, that takes time. Perhaps that can be the ongoing solution -- along
with helping mom w/ her milk supply. But Suzanne wants to know what are you
going to do RIGHT NOW? Well, keeping in mind that the first rule of
lactation is to feed the baby -- that's what I would do.
Jan Barger, RN, MA, IBCLC
Wheaton IL
www.lactationeducationconsultants.com
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