Hello All:

Sorry I don't remember who posted the original letter,
but I was so thrilled to see an ICU staff standing up
for a nursing mother.  I remember once being called to
the ICU where I used to work for a consult where the
staff (both male & female) had been dealing with the
mom's engorged breasts by throwing warm towels over
her breasts & leaving it at that until someone thought
to ask for assistance.

I don't have any current material on-hand, but worked
in Neonatal ICU & Pediatric ICU for years.  With the
patients at risk for additional central nervous system
damage from increased ICP, it is essential to keep
pain under control, body temperature within normal
limits, and prevent any secondary infections from
arising.  Sudden weaning would place the mother at
risk for all these complications.  Denying this
patient access to regular breast emptying &
disregarding her preferences in regards to how she
chooses would further raise her ICP in addition to the
risks from sudden weaning (I think my ICP raised just
from reading the neurologist's decision).  IMO, it
would also benefit the mother to have regular pumping
because it would cause the hormones to be released
that cause relaxation associated with breastfeeding.
Has the patient been attached to ICP monitoring
equipment so far?  What trends have they seen at
pumping times?

It is perfectly acceptable & required by law for the
nursing staff to question any physician's orders that
may put their patients at risk of harm.  I would be
prepared with current citations from ICU texts &
journals to cover current treatment to prevent
increased ICP as well as from the breastfeeding
literature to cover the rapid weaning dangers beyond
the infant losing out on his mother's milk.  It is
possible to provide the literature to the MD & he may
or may not choose to give it attention.  Either way,
it's a great opportunity to raise his education level.
 Life does go on even if the MD doesn't react kindly
to the staff info.  (Been there more than one time
myself!)

Linda Madsen, RN, CPN, IBCLC
Anchorage, AK

P.S.  I survived the exam & think I did okay.  Thanks
for all here for the positive thoughts & congrats to
all my fellow survivors.  I was so happy I studied
while I was in Texas for the 2 weeks prior to Monday.
My books are following behind via snail mail.  ;)

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