I work in a small community hospital.  We are a level 2 nursery, but
transfer out all babies under 2000 gms or usually about 34 weeks gestation.
 Most of our patient go to a tertiary care  teaching hospital about a hour
away if NICU care is needed.
Recently, I had a mom of twins deliver there by cesarean section at 33
weeks.  Mom was started pumping for the babies right after birth, but in
almost 3 weeks of hospitalization never was helped to put babies to breast.
 In addition, one baby was diagnosed with reflux, and had multiple different
formula supplements tried to help with vomiting.  Babies were discharged
without ever going to breast, and with no medical comment at all from the
neonatologist about whether providing milk/breastfeeding was even worth it.
At home, mom was soon overwhelmed by caring for two infants on apnea
monitors, pumping, and bottlefeeding, so she gave up pumping.  The babies
were discharged while I was on vacation, so I didn't get the chance to try
to encourage her to keep going at least for a few weeks.
I wonder if there is any way to affect policy at a referral hospital?  This
is by far not the first time this has happened.  It saddens me that at the
same time moms of premature or ill infants should be getting great support
to give their babies breastmilk, they aren't even getting basic information
or help.  Any ideas about anything I could do to encourage this place to
provide some better support?
Perhaps Nancy Wight can comment on neonatologists reluctance to encourage
breastfeeding?  It seems at this NICU at least to be seen an eccentric
parental behaviour to be tolerated as long as everything goes well with
baby, but formula is encouraged to fix every medical concern.
It's frustrating for me to have these babies back in follow up, and for moms
to feel so much like their milk doesn't matter a bit.
Jennifer Tieman
Family Physician
Mom to 4, including my toddler nursling Caroline Rose

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