Dear Lactnetters I made some notes for my Course for tomorrow and thought I
would share some news from 3 major teaching hospitals  I have taken out the
names for privacy purposes.

NOTES FROM 25/11/1997  phone calls


Hospital 1

Michelle   LC  NICU    Ex student

1 ml by 4 hourly
1 ml by hourly 2ml hourly 3 ml hourly
Oral toleration 
Then human milk fortifier to bring up from Cal of 20 – 24 calories  aware
of delayed emptying
Many of these babies also have SGA  IUGR


FOLLOW UP SUPPORT
Postnatally ring up 
Refer to NMMA
Ring MMC any time
No liaison

CUP FEEDING
H mm ……Sometimes
Resisted  by doctors and staff

Human milk banking may be implemented soon

KANGAROO CARE 
Earliest  29 weeks  if seeking
33 weeks  35/36 weeks  usual

Tube bottle rarely cup then breast

ANECDOTE

26 weeker rang up to state that she needed help in weaning but went on to
18 months initially did not want to breastfeed




Hospital 2 
Carolyn 
NICU
Is first public hospital to achieve BFHI
Kangaroo cuddle with ventilators
If seeking may be drips milk
Milk fortifier up to 1500 grams
If the mother insists on no bottles then we offer cup

LIAISON

Ring for support
Setting up this week  "Hospital in the Home"
Previously domiciliary  care

Hospital
Heather  Educator 
Judith  mothercraft
Cup feeding 150 staff in NICU attending continuing ed. has 9 to go 
resistance strong  but getting there  Lots of interesting stories about
resistance to idea of
cup feeding

Comment from HH
"Mother is lactating for 7(Septuptlets) not trying to breastfeed 7"

HOSPITAL 3 
Going for BFHI

Pam in NICU   Ex student
Anita and Keri  LC for hospital  90 % initiation 

Kangaroo care the norm
cup feeding the norm 

Pam nicu     -   Cup feeding is almost normal offer instead of bottle

Simon and Andrew Med Reg very proactive
Turned breastfeeding around  

32-34 weeks sometimes tries  earlier 
 resistance from nursing staff

 oral breastmilk almost with first hour of birth even with littlies
Liaison  in scn
Has reservations about fortifier  knows about delay

Adelaide have a study going on cup feeding for 12 months
Hospital 3 will join study

Beverley Walker
Melbourne Aus
ANECDOTE.
2-3 women refuse to provide breastmilk in the last few years one with
implants, one needed to smoke.

ANITA   ex student  hospital LC
Cup feeding accepted and almost the normal
Liaison domiciliary 3 in team half IBCLC
visit the home from hospital