Wise ones,
I am involved now in bringing hosp staff up to date re bf practices as we
have cert. of intent and need to move into implementing the 10 steps.
Thursday, Sept 23 we will be beginning the process re revision of old, out
of date policies. I have the model policies from Riordan & Auerbach BF and
Human Lactation. The 3 policies cited are all very similar and state
"infants should be encouraged to nurse at least every 2 to 3 hrs, for a min.
of 8 fdgs every 24 hrs"; AND "time at the breast at each feeding should be
approximately 10-15 minutes" AND "infants should feed from both breasts at
all feedings". (I have the '93 edition in front of me; perhaps the newer
edition is different?). This is contrary to what I teach and what I would
recommend as policy. What would you all recommend?

I have the Joint WHO/Unicef statement of 1989 which I feel is the ABSOLUTE
BEST model. It addresses labor practices, unnec. medications and
interventions very well. It addresses rooming-in very well and is the only
place I've really seen the issue of colonization with family organisms and
chance of resistant orgs when baby in central nursery. It states "the infant
should be permitted to suck freely at the breast, frequenlty and w/o any
fixed timetable." This is what I teach and I use the word "unrestricted." So
second question is: Is there another statement more current than 1989? Or
does this one still
stand? And why would the other policies give the time frames? I feel this is
where problems get started and interventions begin.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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