I work in a hospital that has about 2500 deliveries/year.  Our  exclusive 
breastfeeding rate in the hospital is about 20-25%.  I find  unnecessary 
supplementation a real issue.
 
 Many of our moms come in wanting to "do both." (Feed both breast and  
formula.)  After speaking with some of these moms the "both" feedings come  in after 
returning to work or school.  However, because they have breast  and bottle 
listed on their chart, they are sent out with bottles in their  cribs.  A 
little education at the time of admission in L&D doesn't seem  to be happening.
 
Recently our neonatologist has initiated a new protocol for infants of  
gestational diabetics, both diet controlled and insulin dependent.  These  babies 
are to get a feeding of formula upon admission to the nursery.
 
We also have a few pediatricians who tell the moms to supplement "until  
their milk comes in."  Sometimes it is because the baby "might get  jaundice."
 
We have a rather large Russian population who believe in supplementing in  
the hospital as they have "no milk."  They have done this with  all their other 
children.  Recently I asked one of these supplementing  moms how long she had 
nursed their other children.  The answer was for  about 2 months, as she did 
not have enough milk.  Ahh, the risks of  early and frequent supplementation.
 
Judy H.  RNC, IBCLC
Upstate NY



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