Dear all,
I am requesting any and all help from you that I have found to be so
supportive and helpful on this list. I have recently posted about the
hospital where I am working part time as a breastfeeding nurse. We had our
first task force meeting in January and will have another later this month.
We also went to the Pediatric Strategy group meeting with the AAP statement
and now need to work on some basic breastfeeding education and policies.
For background, our midwestern hospital delivers about 2500 babies/year
and does have a NICU. The NICU support of breastfeeding is very lacking,
but we need to improve our "normal" breastfeeding support first, we think.
We have a very open OB unit, with three hallways. The current policy now is
that for the baby to be in the mom's room, someone must be awake. This is
due to "security"...we have had an infant abduction in the past. We have a
BS policy with a level of 50 and much supplementation, by bottles. We also
have much pacifier use, but have recently added a place on the baby's
profile if the parents consent to pacifier use. The amount of time that the
babies must be monitored under the warmer has also decreased, and our
breastfeeding initiation within the first hour has improved.
I know we have many staff educational needs and it really is
overwhelming. At the first task force meeting, we had copies of several
articles for staff to review. These included articles about the assessment
tools LATCH, IBFAT and MBA, as well as the Riordan/Koehn article that found
none of these to be reliable and valid. I would really like to know in
reality how other hospitals assess infant feedings. Right now, ours are
rated with G(ood), F(air), P(oor), R(efused) and possibly an amount of
time. And, to make things even worse, the nursery nurses often just phone
the mothers to ask about feedings/diaper changes, etc. instead of even
going into the room! I think the idea of having a tool at mom's bedside for
staff and parents to use sounds great, but would like to hear any feedback
from any of you who have used any such thing. Also, even though none of
those tools may be great, I think they would be much better than what we
have now! Or, if any of you have any other tools/suggestions to share, I
would be most grateful!!
We have been trying, but not too successfully, to supplement by
cups/finger/lactation aid, etc. (Remember, we have that 50 BS level to
fight with...and, yes, I really hope that will change, but it was
instituted due to the request of our neonatologist.) We are trying to get
some Foley cups instead of the plastic medicine cups we now have, and
periodontal syringes which I think the staff would be more inclined to use
than the SNS. So, we also need educational tools to teach staff about cup
and syringe feeding. (Our two lactation nurses recently shadowed LCs in a
nearby town who used these and were pleased with the results.) Then, again,
we don't want to spread the news that you need a lot of gadgets to
breastfeed. But, if we don't use these things, we'll continue to see many,
many bottles fed to our babies.
I have searched the archives on assessment tools, pacifiers, policies,
etc. etc. Many others have asked for such help in the past but most of the
replies have been sent to the asker. So, I hope I didn't take up too much
space, but really would like any policies/assessment tools/educational
tools, etc. etc. that any of you would share!
Our manager said at the first task force meeting that we would not ever
become "officially Baby Friendly" due to the "cost" involved. I feel the
frustrations daily that I read about on Lactnet, but sure do appreciate
being able to come here for support and encouragement! I have read that it
is best to work on easy steps first. I can only dream of getting rid of
formula discharge packs, etc. But, our management does seem to be fairly
supportive of making some changes for the better, and we have one wonderful
pediatrician who is lending us much support. Mostly now I would very much
like any hospital breastfeeding policies you might share. I know there have
been recent discussions here about not needing them, but believe me, in our
hospital, we have to get something in place for a starting point! I would
also be very interested in any newborn nursery admission policies you may
have re: baths, temps, etc.
Again, thanks to all of you for all the help! If you have anything you
would like to fax, you could send it to 417-625-6628 attn: Kathy Wright
Kathy Wright, RN
Columbus, Kansas
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