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Lactation Information and Discussion

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Subject:
From:
Karla Loppi <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 24 Mar 2009 18:27:41 +0200
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Hello everybody. I'm a returnee to the list after a few years off. I 
used to be a volunteer bf peer counsellor and project worker developing 
Finland's national bf support helpline service. Now I'm a student 
becoming a RN / health nurse here in Finland, and also I'm the president 
of Finnish Breastfeeding Support Association.

As a school project and together with the breastfeeding coordinates of 
HUCS (Helsinki University Central Hospital) I am now trying to come up 
with "Safe reduction of Supplementary Feeding - Instructions to Care 
Personnel".

I turn to you in hope someone knows of good practises somewhere? Have 
you heard of or do you use some kind of decision tree or protocol when 
moving from supplementary feeding (medically indecated or not!) to 
exclusive breastfeeding? Any new research (I trust I have found the 
older ones concerning my main questions of "how much should a baby eat" 
and "how to know how much the baby eats") that you know of?

In Finland it is very common to give supplementary milk to healthy full 
term babies without a medical indication. It's a kind of cultural thing 
although we at the same time have very high bf initiation rates 
(virtually all women choose to breastfeed at the hospital).  SO we have 
lots of babies and mothers who are discharged with an intention to 
exclusively breastfeed, but not really doing so at the moment of 
discharge. When the follow up on health centers is not always very 
swift, and when the staff there sometimes has next to no knowledge in 
how to assess breastfeeding, this leads to risk of either unnecessary 
continuation of supplementary milk OR ceasing the supplementation even 
when the baby is not breastfeeding efficiently (oh yes I have read a lot 
about hypernatremic dehydration, and it's a big big worry of Finnish 
pediatricans....).

That's why the need for basic instructions. I kind of know what  the 
instructions would include: weighing the baby, keeping an eye on the 
elimination, enhancing breatsfeeding, but I have a big work in pointin 
out the evidence-basedness of all this :-)

Thank you for help and thank you for you kind thoughts that I KNOW you 
send me, even if you don't have anything concrete to help me with :-)

Yours,
Karla Loppi
in Finland

karla . loppi at viapori . fi

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