Anne's lament about random supplementation of breastfed babies in the hospital
is a topic I lectured on in Vancouver last month. In my preparation for the
lecture I talked with a couple of lawyers who explained that there was a legal
term for the act of supplementing a baby without the mother's permission---it
is called battery. I have had numerous calls about consent forms to help both
staff and patients understand the ramifications of just one bottle. I bet the
nurse who gave the baby a bottle of formula did not inform the mother of the
increased risk for cow's milk allergy that she just gave the baby, nor the
three weeks it will take for the gut flora to return to normal, etc.

Unit 3 of the Lactation Consultant Series is the one on "Legal Considerations
and the Lactation Consultant." I found it was nice to review this as it helped
sort out some of our responsibilities. We health care professionals have the
responsibility to render due care. Not to do this could be construed as
professional negligence. Thus, not speaking up enables this behavior to
continue.

I have had the best results in changing this situation when I advised nurses
and lactation consultants to contact the hospital's Quality Improvement
Department (or whatever term they use) to form a QI multidisciplinary team to
address the identified problems. We cannot withhold information from mothers.
Contact your hospital's attorney if you need clarification about what you can
and cannot say.

Muzzles must be on sale somewhere for the holiday season. I expect to receive
a few from some of my "fans."

Marsha Walker
Weston, Massachusetts