>In a message dated 1.11.05 11:09:14 AM, Heather writes:
>
>
>>  I am not sure what community  HCPs would do here if they thought a
>>  baby needed formula instantly because the baby is malnourished - prob
>>  admit to hospital, and the hospital would give formula.
>>
>WHOA! I would HOPE that they would give a starving baby food IMMEDIATELY,
>anything else would consistute malpractice. Certainly this type of 
>incident would
>not be considered "giving free samples"
>
>Lynn Shea Rn,Bsn,Ibclc
formerly Franklin,Ma......now Lakewood Ranch,Fl

Yikes! Let me clarify, Lynn : )

A *starving* baby needs treatment now - of course!

But this might not mean shovelling formula down straight away - my 
understanding is that the treatment of *starvation* needs careful 
and expert supervision, starting with rehydration, and not food. This 
might well be done best in a hospital - wouldn't you agree?

Immediately giving formula to a baby who is *starving* may well be 
inappropriate.

My word was not 'starving' but 'malnourished' and in the UK, there 
simply would not an available sample of formula to give *in the 
community*....at least, not routinely (some baby clinics do have 
formula on sale under our welfare foods schemes, but not all 
community HCPs work on the same premises as a baby clinic, and in any 
case, baby clinics are only open at certain times).

So in the situation we were describing - an 8 mth old presenting 
'malnourished' in the community in the UK where we have universal 
free health care  - HCPs would probably admit to hospital if they 
thought there was no other way they could be sure this baby would be 
fed. This would also have the benefit of allowing a proper diagnosis, 
in the event that the apparent malnourishment was not the result of 
some other organic condition.

In fact, UK  babies diagnosed with faltering growth - I think it 
almost impossible for a baby aged 8 mths to present literally 
starving, because all parents are in contact with community HCPs - 
will be referred to a paediatrician, either in the community or the 
hospital. If it turns out the baby is simply not being fed adequately 
because the mother is routinely diluting the formula, then a free 
sample of the formula is not going to help that baby 
long-term....surely...or even short-term, unless the mother is asked 
to give the formula to the baby then and there, and observed while 
doing so. It may be appropriate for the HCP to ask the mother to do 
this, and to obtain  the necesssary formula for her.  This is not the 
same as having a cupboard full of free samples given by formula 
manufactuers.

Cupboards full of free samples - whatever the samples are - usually 
come equipped with an invisible neon sign saying "Give Me Away and 
Make Your Patients Adore You".  HCPs like giving stuff away! And 
don't the formula people know it!!


Heather Welford Neil
NCT bfc,  tutor, UK

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