I work in an outpatient pediatric clinic. We are working to get our
exclusive bf rates up after hospital discharge.
One big issue is that frequently in the hospital or first week or two,
babies are started on formula supplementation for a number of reasons, from
jaundice, wt loss, etc.
Most of our pediatricians look at the baby's weight as gaining enough or
not, and don't actively "manage" or advise parents on if the baby can now
decrease supplementation, even when the baby is gaining at excessive weight
velocity and/or conditions such as jaundice have resolved.

So we are trying to come up with some sort of guidelines on how a provider
can recommend decreasing "x" amount of  supplementation on "y" amount of wt
gain, especially in the first month.

While I do this supplementation management with each baby I see, there are
many more infants in the clinic than I have time to see. (yes, more LC
staffing would be better, but this is where we're at...)   My
recommendations on how much and how often to give in addition to
breastfeeding are based not only on wt gain but also observing feed
efficacy, etc.  So I'm finding it challenging to tease out how to make
these recommendations for MDs who only have 15 minute appointments and no
training in bf assessment. Academy of BF Medicine's supplementation
protocol is good, but doesn't address decreasing of supplemental feeds.

Anyone already have this sort of guideline or protocol? Or have suggestions?

Thanks for the wise hive mind ideas-
Susan Lawrence, RN, IBCLC

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome