This is a first for me.  I have been providing training to hospitals in the
state for a year now.  One hospital scheduled for next week has phoned after
the MD's on staff went over the AAP Statement on Breastfeeding line by line.
They have asked that I teach their staff that the medical conditions for
supplementing newborns are as follows:  1 .  5 cc water will be given to
establish patency ( I questioned why this couldn't be done at the breast and
then was told that it wouldn't be routine for the breastfeeding moms and would
only be done if the baby was too ill to come to the breast for the first
feeding).  2.  no urine output for more than 12 hours they will supplement.
3.  if the bilirubin is elevated they will supplement.  ( I gave her
information from the AAP parameters on treating jaundice and that 1/3 of all
healthy newborns had elevated bilirubins at 72 hours and this was normal) 4.
they will supplement if the blood glucose is low. (she did not provide the
level when I asked. I then shared with her the colostrum mixed with D5W and
fingerfed)  and the big one that covers all .... 5.  MD judgement .. if the MD
feels it is necessary to supplement then they will.

They also asked will Medicaid pay for the 24 to 48 hr follow-up visit
post-discharge.  They also order fluoride to breastfed babies if the
fluoridation in the water is low.
I did tell the hospital representative that I would teach best practice.  That
I would concede that hospital protocols may require supplementation ordered by
the physician, however I hoped that it would be done in a manner least
disruptive to breastfeeding.  I also, told her it was obvious that the
physicians did not recognize that there were risks to formula feeding and that
may take a while for them to recognize.

My question for ya'll " Am I sunk before I even go?"  "What kind of beginning
statement should I make that will be non-threatening but establish that I am
providing the most up-to-date researched based information on breastfeeding?"
Any guidance is much appreciated.  Thank you,  Camille Foretich

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html