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Subject:
From:
Linda Madsen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 12 Feb 2011 07:26:32 -0800
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Dear Ginny,

How unfortunate for everyone involved.  Poor designing on part of the facility. 
It seems so often maternal-child health concerns seem to come as after-thoughts. 
 I wonder if this may not be an attempt for the powers that be to capture 
revenue.  There needs to be NICU level care being done to support the NICU stay. 
Did they provide any reasoning behind such a decision to make 35 weeks the 
automatic cut-off point?  I have had cases were the child goes "miraculously" 
from 35 to 37-38 wks in the space of a few hours. While late preterm infants are 
in need of closer observation, mandatory separation from the mother in the NICU 
is not  the best option for any family. Some late preterm infants may go home in 
2-4 days. So many of the borderline babies do excellently in the first couple of 
days and then may tire and need to stay for a couple of weeks to work on 
feeding/weight gain.  If their nursery stay needs to be extended and Level of 
Care at that point it is not difficult to get the stay authorized based on the 
prematurity standpoint. To make the best of the worst situation, in the 
meantime, hopefully there are comfortable recliners that the mothers can use at 
the babies bedsides. Is rooming-in an option in your NICU or is just for the 
babes ready to graduate to home?  Get the baby skin-to-skin after the delivery & 
do not have a strict cut-off to be transferred to the NICU as long as both are 
stable. I have worked facilities where the mother was brought to the child & mom 
has been on a stretcher. I worked in a referral facility where sometimes there 
was lag time between the time mother could come to the hospital where her baby 
was admitted but the father was able to accompany the babe. In those cases, I 
strongly promoted skin-to-skin care w/dad until mom could be present.  If the 
policy is 5 years old, then the policy needs to be revisited.  Some institutions 
due have automatic review periods for all policies.  

So hoping this can be changed for your families and your staff,
Linda Madsen, RN
Wylie, TX



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