Rachel Myr, Laurie and Ann Perry, Thanks for the reply to my demerol
dilemma.  Ann asked the question, "What brought this on?"  I had to take
time to think about it.

As you know, most of the hospitals around the country have been and are
looking at the effectiveness of demerol.  Its effect on the newborn was a
big part of what our review committee was looking at two years ago.

At that time, Hale's 2002 classification for demerol was L4 in the neonatal
period. While I think Hale's intent was that demerol is best not used during
that period, some drew the conclusion that if demerol IS used then baby
should not be breastfed until demerol is discontinued.

As you all know, it is very frustrating when a baby does not nurse well
despite following all or most of the correct breastfeeding protocols.  It
just seems that there are so so many babies who do not nurse well.  We see
many babies and mothers who struggle mightily with breastfeeding.

It is heartbreaking to go on the postpartum units at 9:00 am and be met by
bleary eyed, exhausted parents who have been up all night with a frantic
screaming baby.  The parents are totally frazzled, the staff is frustrated,
and the pediatrician is frowning at the rising bili level and scanty
diapers. Meanwhile, baby is snoozing deeply, waiting for round two to begin
at sunset. Everyone wants to point a finger, find something or someone to
blame.  Demerol is what got the blame at our hospital.  Some think that
surely this drug must be the cause of all of our problems.  I think Rachel
Myr sums it up well, "A bizarre perversion of knowledge".  Sad but true.

Luckily, NOT breastfeeding while on demerol is not a hospital-wide policy.
Laurie is right, there are alternatives to demerol and we have a need to
educate parents, staff and physicians so that this un-official policy can be
"discussed and abandoned" as soon as possibe.

Again, thanks for the input, I just needed to be sure that I was not missing
something important before I take this bull by the horns and wrestle it into
the dust.......

Laurie, I definitely will be seeing you at the conference in
September.........Warmly.........Judy Welborn RN IBCLC

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