My gosh Ann, you are so right!
Until I started working at my present hospital every
hospital was similar to what you described.  My
present hospital is an American  military hospital in
Germany and is trying to obtain the Baby friendly
status through the BFHI.  Amazing to me is that as a
directive from the pediatricians all formula babies
are to mimic the breastfeeding pattern and not feed
over 10-15cc's until "milk comes in day" (about 2-3
days) then only increase in very small increments to
where they are eating about 1.5-2.5 ounces each
feeding at about 1 week.  They are to feed between
8-12 times in a 24 hour period and, well, you know the
rest.  I must say the formula babies seem to have less
gas and spit up and seem to arouse every 2-3 hours
instead of having to be woke up those first 2-3 days.
But you still see so much formula left over in their
tummies when they spit up after 2 hours.  That stuff
must just sit like a ROCK! Its also very helpful for
the breasfeeding moms to see that breastfeeding is the
gold standard by which our care is given.  I am not
saying we are perfect but I am so pleased to see such
support from some of our pediatricians and remember
these doc's usuually move to a new hospital every 2-3
years.

I was not here when it started so I am not sure how
they went about it.  I sure it was a collaboration
with some strong breastfeeding supporters on the
nursing staff as well as pediatric support.  I am sure
there are references that you could use in the
Evidence Based Practice Guidelines for the first 14
days put out by ILCA.

I hope this helps, and good luck.
Theresa Johnson
Heidelberg Germany



--- Ann Perry <[log in to unmask]> wrote:
> Dear Wise Ones:
> I know I am not alone with the battles of:
> "perceptions of low milk supplies
> and infants not getting enough at breast".  Then
> there are supplements of
> large quantities of formula and scheduled feedings.
> The approach I have tried to use is to educate the
> mothers and staff.  But
> this is not working.  So I started to watch more of
> the formula feeding.
> Starting right after birth, the assumption is made
> that the newborn needs to
> eat within 3-6 hours, 30-60 cc.  Then they are feed
> every 3 hours after that
> with bottles filled with 120 cc (or more) and
> allowing the babies to consume
> whatever amount drains in.
> This feeding schedule is not based on feeding cues:
> rooting; mouth to hand,
> if these are observed before the scheduled 3 hours,
> pacifiers are used.
> When these babies are being feed, the nipples are
> sometimes forced into the
> corner of their mouths and the jaw or throat is
> massaged to encourage
> continuous swallowing.  If a set amount is
> determined to have to be
> administered, all means are used to get this in
> without any observation of
> how the baby is handling this.
> I have observed gagging, eyes widening, spade hands
> and the formula pouring
> out the sides of the baby's mouth and the nurse
> continues to push the feeding.
> I asked a nursing instructor if I could observe her
> teaching her students how
> to bottle feed and she said she really does not
> teach this.
> I am sorry for the length of this post but I am
> pleading with this group on
> the need to approach this long standing thought
> process on bottle feeding.
> How did this all start?  Any ideas to best approach
> this?  PLEASE I need your
> input.
> Until bottle feeding mimics breastfeeding, I think
> we are fighting a losing
> battle.
> Ann Perry RN, IBCLC
> Boston, MA
>
>
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