-- [ From: Phyllis Kombol * EMC.Ver #2.5.1 ] --

Yesterday was supposed to be a quiet day: only 14 lactational
difficultiy patients to see in my inpatient setting after my
"administrative and teaching duties" took the first 2 hrs. of the day
(That's about as quiet as it gets where I am.).  However this one case
took at least a couple hours in multiple episodes and it was odd enough
that I wondered if anyone else has worked with similar situation and
what advocacy was tried/worked and what was the resolution.

Woman from a nearby community was arrested in our community a few days
ago on a very serious charge, high bond set (so her family couldn't
afford to post bond to get her released), went into labor (was about
term) and was brought from the jail to our hospital to deliver.  She'd
been involved in WIC in her home community, took breastfdg classes and
committed to breastfeed her baby, so has been doing so since the baby's
birth w/o problems.

During hospital stay, had guard posted in her room, and of course will
go back to the jail at discharge, awaiting re hearing on bond in a
couple days, then the hearing on the charges in 6-8 weeks.  She's hoping
bond will be reduced so she can get out on bond and continue
mothering/nursing her baby.  Seemed reasonable to me that since family
members will take baby to home community to care for until mom's hearing
, mom should be supplied a pump and maintain milk supply by pumping
until she and baby are reunited if possible (hopefully only a matter of
a couple days, but could potentially be several weeks).  WIC peer
counselor took it on to try to locate a pump and find out if the milk
could be stored at the jail until familly could pick it up...rec'd
response from jail nurse that "absolutely not" to storage and "no way
could she have a breast pump; it's contraband and could be used as a
weapon."(???)   She (the pc) called me back to report this and was upset
that the nurse said "It's not like it's a health issue." (!!!!)  So I
got into the act and called the nurse...who used the word "impossible"
frequently.  I first suggested the milk be discarded if they couldn't
store it, then backed down from electric to pedal, to manual plastic
pump, to pump (whatever kind) being kept in the medical area of the jail
and she being taken to it every few hours.  Then we got into the "not a
health issue" again.  Well, by this time, I was fairly irritated as
she'd backed me down to the only alternative being that "the woman could
do anything she wants to her own body there in her pod" (group room), so
she would not be disallowed from relieving herself by manual expression.
 She also indicated that other women who'd come from the jail to deliver
babies had NOT done any such thing....

So when I got off the phone, I called the peds, a breastfeeding
supporter who gave me some names of medical supervisory MD's at the co.
health dept. who work at/oversee health issues for the jail, and
encouraged me to take it one step further.  I did manage to track them
down, explained the situation and asked for any help they could give.
They seemed supportive of breastfeeding as a health issue, but truly
stymied as this has never come up before.  I did basic teaching w/ mom
re hand expressing or manual pumping, and left a plastic manual pump
(which incidentally, the guard saw no problem with her having in her pod
, and stated she thought there was no reason this shouldn't be allowed).
 I also left a note for mom's MD, asking them to make pumping part of
her discharge medical orders, hoping it could be handled like any other
medical treatment an inmate might need.  WIC pc folks were to follow up
today, and the mom to be discharged.  I've been at my home office most
of the day, w/o phone calls so I don't know how it all worked out.

My feeling is that since this woman has been charged but not convicted,
she should still have some rights.... and that we should not be
punishing the baby or adding more to the state's health care costs by
denying the baby mom's milk, and it sure IS a health issue!  Any
thoughts?--Phyl, RNC, MSN, IBCLC and CC ("certifiably crazy" after that
kind of a day!)