As the Ross data is done by survey weeks to months AFTER discharge from the 
hospital, it UNDERESTIMATES the amount of supplementation in hospitals.  
Mother's may not know their infant was given formula, or may not consider 1 feeding 
of formula in the hospital as mixed feeding. Also, as breastfeeding is the 
politically correct thing to do, I find mothers claiming to do more breastfeeding 
than they actually do!

We did a recent CQI project and I was mortified to find out that more than 
50% of our declared breastfeeding mothers' babies had received one or more 
formula feedings in the hospital  We initiated an education project, wrote a 
specific hospital supplementation policy, had RNs following LCs around for 4 hrs 
each, but have not been able to reduce it much. Despite education, most RNs and 
MDs do not believe that 1 bottle is harmful.  Also, even if they do believe it, 
the perceived short-term needs of the mother for rest and sleep seem to take 
priority.

The long term effect of unnecessary supplementation on the baby is "not my 
problem" for many.

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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