Barbara,

I really like your policy.  We had one similar to it in a hospital I work in
GA.  Each of the " special needs - i.e.: low blood glucose etc.) were
actually spelled out with guidelines and limits.  This helped the nurses and
kept the nighttime calls to the Ped. to a minimum.

There was also a limit on the amount and frequency of formula feedings of
10-20cc rather than max of 30cc (1oz).  In addition to this the nurse was
required by policy to inform mother of hospital policy of supplementing,
document in infant nurses notes and state mother's reply.  This documenting
also included the use of pacifiers, each and every time they were found in
the bed also.  If mom insisted on a pacifier a note was placed in the
infant's bed as to mom's request.  This was initiated after a mom got tired
of being asked several times a day and complained to management.  Guess who
got called on the carpet?

I would really like a copy of your complete policy to have on hand and
compare to future policies and for comparison.  Email me privately if you
like.

Thank You
Ann Slaughter RN, IBCLC







___________________________________________________
Date:    Mon, 2 Jun 2003 11:09:37 -0400
From:    Barbara Berges <[log in to unmask]>
Subject: Hospital BF policy and procedure

Our hospital breastfeeding P&P reads:

6.  Newborn infants are given no food or drink other than breastmilk, unless
there is a physician order for a specific medical indication such as:
   Infants with particular nutritional requirements and restrictions in
functional capabilities due to low birth weight or early gestation.
   Infants with hyperbilirubinemia when increased breastfeeding fails to
provide adequate calories or hydration.
   Infants with potentially severe hypoglycemia or who require therapy for
hypoglycemia and who do not improve with increased breastfeeding.

I have been requested to include wording that deals with what to do if the
mom requests the baby be supplemented.  What do you think of the following.
(Do you have any better options to suggest?)

If a mother requests her infant be fed a supplement to breastfeeding, the
reasons are explored by the nurse to help solve any problems that preclude
exclusive breastfeeding:
  Assess for effective latch
  Breastfeeding offered at least 8 times in 24 hours
  Offer suggestions to treat nipple tenderness
  Discuss day/night confusion
  Plans to combine breastfeeding and bottle feeding are best delayed until
breastfeeding is well-established

Offer options to the mother to promote exclusive breastfeeding
   Provide skin-to-skin contact between mom and baby to soothe and quiet a
fussy baby
  Have family member walk and soothe baby
  Take baby to the nursery so mother can rest and bring back for
breastfeeding prn.


If the mother chooses to have supplemental feedings given to her baby:
 Amounts should be limited to 1/2 to 1 oz. of formula.
 The mother should be encouraged to breastfeed first at every feeding.
 If supplemental nighttime feedings are given in the Nursery, the baby
should be bottle fed once, and then taken out to
breastfeed for the next feeding.

Help, please......

Barb Berges BS, RN, IBCLC
Rochester, New York

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