Betsy Wells-Gephart RN, IBCLC wrote:

"In the guidelines is written that "no baby being breastfed will receive
formula
except for medical reasons", and that no baby will be given bottles unless
there is a written informed consent from mother stating that is OK with her.
  My director wonders how this can be implemented.

    What sort of consent form have you used and what wording do you use,
when is it signed, etc.  Also, is there someone out there that has charted
the feeding of formula to a breastfeeding infant on the med sheet?  If so,
for what reasons. If not, where is it charted and how do you write that
there is consent?  Are there legal concerns? "

I am very interested in this as well, this is the same guideline our
hospital has, it is on our standards of care documentation as well.  As I
see it,  we nurses seem to skim right over it and not pay much attention to
it.  If a nurse sees it necessary to give a baby formula, then it doesn't
take too much convincing to get the mom to ok it, whether it is a medical
reason or not.  It bothers me, and I think one day when my children are not
so little and I am working more hours I will speak up a little more about
these things!!! (that shows my lack of backbone!!)

I don't see any effort at enforcing that there is a documented medical
reason for formula, or anyone who is checking to make sure that with each
case the baby did not get formula without a medical reason.

Janette RN, mom-baby unit

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