"I was reminded of our policy and the possibility we could be sued if a baby
became dehydrated in the first day or two because of insufficient fluid
intake and policy wasn't followed."

Correct me if I'm wrong, please, but is it not the case that normal,
full-term healthy babies (I'm not talking about preemies, IUGR, infants of
diabetic mothers, etc.) really are not going to become "dehydrated" in those
first hours or even day or two after birth? Isn't that what their "extra"
fluid", the 10% or so they lose in the first day or two after birth, is
there for?

I know that hospitals have to have a policy on everything, to cover their
sweet assets, but they need to be evidence-based, and implemented by people
who understand what goes on with newborn babies and moms. I'll bet that your
hospital also has 50 million "policies" about medications and
anesthesia/analgesia during labor - none of which protect the baby's normal,
natural, and necessary need to be in fit condition to nurse soon after
birth. So they take a normal, natural physiological function (giving birth),
routinely medicalize it, and then have to make "policies" to deal with the
product of the medicalized deliveries (the baby) - without even
acknowledging what a "normal" baby might be or do or need.  Does this make
sense? Maybe to hospital administrators, or to those who have been "in the
system" for so long that they've forgotten to think about normal babies and
mothers. Or have never had any experience with "normal" human birth, outside
the hospital system.

I'm neither naive nor a dope about these things - I've been an OB nurse for
many years, and I'm not unaware of the scary things that can go wrong in the
process. But I've seen so much of the problems we *create*, and the more
interventions we add to our protocols and policies, the more problems we
make. Except maybe for the legal department, who of course manage to
intimidate the people in the system who should know better. YIKES!

Hang in there, Pam - the hospital needs people like you! Consider it your
stint in public service.

Cathy Bargar, RN, IBCLC Ithaca NY

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