Date:    Wed, 30 Sep 2009 11:41:21 -0400

From:    "Westra, Mary" <[log in to unmask]>

Subject: any IBCLC's from large (4000+ bitrths/yr) US hospital need rapid feedback



Dear All,



 



I need feedback in a hurry for meeting with administration on Friday concerning babies of cesarean sections being able to breastfeed within the first hour of life.



Background information: c/sec rate climbing near 40% in large tertiary care center.  Average 5-7 per day on weekdays (of course).  Mother baby floor and admit nursery separated from OR and PACU by 7 floors. Baby brought to nursery from OR by L&D nurse.  Mother to PACU.  Baby and mother not together until mother leaves PACU in average of 2-3 hours.

PACU unit usually full and staff ratio is 1 RN to 2 patients.  They cannot be responsible for the newborn.  Administration will not budge on this, even if they are not full.  Administration is not allowing baby to be unassigned to a RN, and RN in nursery can not take care of the baby being 7 floors away.  Hiring another nurse for the baby is also "out of the question".  So my friends in the big office want to know how it is done in other big hospitals.  Please please respond to me privately to the following questions.



1)       Does your institution follow step 4 of the 10 steps for c/s

deliveries (Help mothers initiate breastfeeding within a half hour of giving birth)? Yes





2)       Does your institution follow step 7 with stable cesarean

deliveries? (Allow mothers and infants to remain together 24 hours a

day) yes, if mom wants



3)       If answer is no to questions 1 and 2, does your institution

have provisions for the baby to remain together and breastfeed and for how long?



4)       Does baby feed in OR or PACU or both, if able? PACU



5)       How many hours, on average, is the dyad separated if they are

not together? 1-2



6)       If baby is with mother in OR or PACU, what staff member is

responsible for assessing the baby and assisting the baby to breastfeed? PACU nurse, can call me is struggling



7)       Please send me the name of your institution, the number of

births per year, approximate c/s rate or number annually or monthly. PRMC, 33%, 2300







J. Ellen Pinker, RN, BSN, IBCLC

Lactation Consultant

Peninsula Regional Medical Center

[log in to unmask]

410-543-7199

pager 410-219-2472

AFFORDABLE HEALTH CARE BEGINS WITH BREASTFEEDING



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