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Lactation Information and Discussion

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Subject:
From:
Cynthia Rux <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 26 Apr 2001 12:54:16 -0500
Content-Type:
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Catherine, Winnie, and a few others were asking if anyone had in place a
consent to supplement form. We have one currently in use at our
facility. It is not all encompassing as far as formula risks, but one
that with some tweeks I was able to get our pediatric dept to agree to.
It has worked well by us for the past 3 years. Initially staff was
hesitant, but I explained to them it was for protection of the hospital
staff as well. (I'd get phone calls from discharged patients stating
"The nurse said it was okay". The staff nurses response was I informed
her of the risks. Uggh!) The form also helps to show documentation of
the patient's informed consent which was not always done in the chart's
nurses notes. I would have liked to see pacifiers included with this
form, but that of course was rejected. Hope this helps some of you.

Cindy Rux
New Berlin, WI

WEST ALLIS MEMORIAL HOSPITAL
NURSING DEPARTMENT

Consent to Supplement Term Newborn Infants

The American Academy of Pediatrics recommends that routine supplements
of formula for breastfed infants should not be used.  The nursery at
West Allis Memorial Hospital does not routinely supplement babies with
formula for the following reasons:

· The suck on a bottle is different from the suck on a breast.  A
breastfed baby can become nipple confused and have difficulty latching
on to the breast.
· Formula is slower to digest than human milk which increases the time
between breastfeeding sessions
· Studies have shown feeding a healthy term newborn frequently on demand
without supplements encourages early milk production (24-48 hrs.).  The
increase in number of feedings and early milk production will decrease
the chance of jaundice and provide better weight gain for infants.
· Exclusive breastfeeding may decrease the risk of allergies.


DATE: __________________        TIME: ___________________

I,____________________________, authorize the nurse to supplement
                (Mother’s Name)

_____________________________, with formula in the following
                (Baby’s Name)

situations:
 ______ at mother’s discretion once during the night
 ______ if baby continues to cry after nursing

________________________           __________________________
Signature of Mother                           Witness

             ***********************************************
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