Ann, that sounds maddening!

Maybe it would help to do the same thing we're taught to do with upset
mothers: meet the other person where she is, empathize, reflect feelings.
"You sound very worried."  (Then waiting attentively for the response, and
reflecting what that is.)  Etc.

It would be interesting to get a clearer sense of whether the staff are
worried about the baby's health, or their own accountability to hospital
rules.  If the latter, then that might explain why it made no difference
when you pointed out the baby's signs of health--you weren't actually
addressing their real concerns.  If accountability and protocol are what
have them so uptight, then those are the fears that have to be addressed.
They sound scared that someone will see those numbers on a chart and land
on them like a ton of bricks.

One approach (more stick than carrot) might be to provide information on
the damage done by *any* formula supplementation, and to remind them that
the mother's say-so is binding and that giving formula against her written
& spoken wishes could legally be considered battery.  The mother should
also be aware of these facts.
The problem with emphasizing those elements too strongly is that
introducing new ways to get reprimanded or sued won't have the effect of
getting the pediatrician to relax and open up to new information and ideas.

Maybe more thorough guidelines would give her some of the structure she
seems to require.

Ultimately, it sounds as if a more thorough hospital protocol is needed,
one that among other things (1) clearly emphasizes the importance of
resolving breastfeeding problems as the first step in cases where intake
may be low, (2) defines several acceptable types of supplementation
starting with better breastfeeding and moving on to expressed milk
(apparently they believe only formula counts), and (3) addresses different
possible scenarios including steps to take when there is conflicting
evidence.  For example, if there's an improbable weight loss recorded and
the baby seems fine, then do another series of weights, either a certain
number of hours apart, or test weighs before and after breastfeeding.
Is this unrealistic?  I'm still not very familiar with hospital policies
and procedures...got a lot to learn.

And if they don't have highly accurate scales, they should get them, if
they're going to depend on them this ... ah ... heavily.


Elise
LLLL
Bath, NH

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