In answer to the question, "Why is it an anesthesia issue?"  That is a good
question that I presented also.  However, when one works within a hospital
setting, one must deal with politics, and managers do not like to see notes
on charts that the nurses are not being compliant with "doctor's orders."  So
we seek to head off the problem.  A bright note for breastfeeding women in my
hospital is that the nurses involved knew we (LC's) knew more about the
matter than the anesthesia department.  Ultimately playing institutional
games is necessary to improve care in hospital for these moms and babies.  We
do them no favors to put them at odds with their physicians.  Much better to
win their doctors over so we can all sing the same song.  One of my important
roles as a hospital LC is to improve the standards of care and practice of
all the staff because I am not there 24/7.  An example of that occurred
yesterday.  2 months age, a nurse had unnecessarily supplemented a breastfed
baby with 2 (ugh) ounces of formula because he was "feeding constantly and
not satisfied."  When I pointed out the harm that could have been done, she
was very upset.  Yesterday she called me saying, "This lady wants a bottle
and I said no, hold off, the LC is coming to help."  Seeing growth in staff
is as exciting as seeing a mom succeed when she wanted to quit!
Judi Hall, RNC, IBCLC

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