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Date: | Tue, 4 Dec 2012 11:00:36 -0500 |
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Pat noted one out as far as documentation of not breastfeeding is
concerned. Here's the other one:
Look at what JCAHO says again. There are two statements...
"When determining whether there is a reason due to a medical maternal
condition documented by a physician/APN/PA/CNM or lactation consultant for not
exclusively feeding breast milk, reasons must be explicitly documented
(e.g., "mother is HIV positive - newborn will not be breast fed") or clearly
implied (e.g., "mother is currently abusing alcohol - newborn will be fed
formula"). If reasons are not mentioned in the context of newborn feeding, do
not make inferences (e.g., do not assume that the newborn is not receiving
breast milk because of the medications the mother is currently taking)."
"A mother’s choice to not breast feed must be clearly documented in the
newborn’s medical record in the context of the newborn feeding method in order
to select allowable value “2”. Do not assume that the newborn was not
exclusively fed breast milk due to maternal choice in the absence of such
documentation."
This second one does NOT say this documentation has to be done by
physician, NP, LC -- etc, as it does for reason for supplementation or medical
reason infant cannot breastfeed. This makes perfect sense. If an infant is
unable to breastfeed related to a medical reason, then it makes sense that
the baby's doc/NP should document that WHY on the chart. "Infant may not
receive mother's milk r/t mother on chemotherapy incompatible with
breastfeeding" or something like that. But if the mother says, "No way Jose, I'm not
breastfeeding" then her nurse can document that. It's not a medical reason
we are denying the baby breastmilk...
Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants
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