Brenda,
I feel your pain/been there/done that. There is no easy answer about how to
correct this behavior (giving formula by bottle for less than perfect nite
feeds). Here are a couple of thoughts. Someone already posted that
management has to be supportive of bf. In my experience, few managers are.
They give it lip service, though. Most managers in my 24 yrs of experience
as a RN worry most about keeping staffing up. They do not want to upset the
regular nite staff. Experienced nite nurses are hard to come by. I, too,
have done the education, but if management does not enforce the policies,
you'll get nowhere. I just accept it now. No flames please, I don't have as
much fight in me as I used to. That is why the 10 steps are needed to really
support bf, and everyone in the hospital has to be on-board.
Also, remember that nursing staff and the mother both bear responsibility.
Granted, the mother is vulnerable, tired, inexperienced, etc. However, I
advise against anyone blaming the nurse as a knee-jerk reaction because very
often the mother was the one asking for the formula or refusing to try a
different position, for example. Often the mother will not tell the story
that way to the LC though the following morning.
We talked a bit recently about sidelying and bf so the mother can rest and
how the baby can often latch better in that position anyway. So maybe begin
teaching and encouraging that.
No easy answers here.

Laurie Wheeler, IBCLC, MN, RN - 24 yrs as a nurse, 21 yrs fighting for bf
New Orleans Louisiana, s.e. USA

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