Tina asks:

<<Please talk about your experience, especially if you are in Canada but
really anywhere, if your healthcare system allows for 1:1 teaching of
appropriate formula preparation. 

<<What HCP is doing this? What guidelines do they follow? How much time is
allowed for this?

<<Babies given ABM are an at risk group, for those of us in public health,
how do you address the needs of this group?

<<Tina

<<Port Alberni 

In most hospitals, the Mother Baby RN is the one doing the actual discharge
teaching.  I have listened to them give instructions many times and am in
awe at how quickly they do it!  Or shock.  I would guess it is less than 10
minutes for mother and baby together.  We have a printed sheet of
instructions that they go over and the mother signs.  We also have a a
binder of information that all mothers get with the same info.  That
includes a few sheets of basic breastfeeding info and the WHO patient
handout for formula prep, no matter the feeding choice.  Breastfeeding
mothers also get Amy Spangler's small book in their breastfeeding discharge
bag.  The LC also tries to see every nursing mother right before discharge
to review the basics and answer questions.

I can tell you when I had my son 20 years ago, I clearly remember the
Nursery RN sitting in my room for a long time going over feeding
instructions, including how to terminally sterilize formula.  I sterilized
everything that went into my baby's mouth for a year!!  I can clearly
remember the Postpartum RN sitting at my bedside doing the same thing for my
instructions.  I was a postpartum RN in the hospital I delivered at for 7
years before I delivered there.  We gave all mothers the same individual
instruction.  

So how can mothers these days grasp any of the info given to them as they
are rushing through signing a dozen papers too?  We do teach all throughout
the admission, but the discharge teaching is the most important.  I have
never heard an RN discuss the actual preparation of formula for those that
are giving formula.  They tell them to just read the label on the formula.
Sad, but I think typical in the US where RNs are overworked and understaffed
(and LCs too).

Linda Anderegg, BSN, RNC, IBCLC in Chicago


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