In thinking about the discussion that the ethics committee will have in
response to my letter, I can think of two questions that I need some help
with.  I am pretty confident about other issues, but these two (although I
have ideas to counter with) I can use some extra help:

1.  What about giving formula bags to the bottle feeding mothers?

2.  The Nursery Chief has said before that he is the one who gets the calls
in the middle of the night from BF moms who have just gone home and are up
all night with a crying baby.  Of course, his suggestion to them is to give
a bottle from the diaper bag they just took home, and go to sleep.  The
Breastfeeding Helpline that I answer is a warmline that goes to voice-mail
during the night.

I think that we have addressed this issue by initiating BF in the first hour
after birth, encouraging 24 hour rooming-in and BF frequently throughout the
hospital stay.  We explain day/night confusion and cluster feeding to them.
Moms and babies are in much better shape when they first go home.  I don't
think that this is still such a problem for him, but I don't think that he
will acknowledge this.  (He is not always evidence-based...to put it
kindly!)

Understand that this is HIS problem, more than the patients problem, but
that is not the way that he will present it.  Whatever can he do to help
this poor over-tired mom in the middle of the night if he can't have her get
the bottle from the bag?

Any ideas to help we counter these two questions?

Barb Berges BS, RN, IBCLC
Rochester, New York

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