I attended the webinar on this new exclusive breastfeeding perinatal core
measure which takes into account the mother's choice.

My boss is going to extract the data after reading my progress note on the
baby's chart. My understanding is that the new option looks at mothers who
truly want to exclusively breastfeed, but the measure asks did the baby
receive any other food in spite of this mother's wish.

Unfortunately, it is an everyday occurrence, if not a several times a day
occurrence, for moms to state (in their OB assessment at admit to Labor and
Delivery) that they wish to breastfeed, but refuse to bf and change to
formula in the delivery room, or after offering the breast for
approximately one minute. This is with support and encouragement by the
nursery, OB, lactation nurse and the pediatrician and obstetrician. Skin to
skin (frequently refused), rooming in is in place.

Maybe we will have to do a much better job of asking the mother what her
wishes are, explaining exclusive vs partial bf, and the ramifications.
Unfortunately again, the feeding practices of infants are so culturally
entrenched, and the high level of WIC (public assistance program)
participation is a factor shown in research many times to be a factor NOT
associated with exclusive bf. Parents report all manner of solids being
given to even 2 and 3 wk old infants also.

Since we've been doing the data (and excluding the sick and premie type
infants), we have about a 19% exclusive bf rate, which the pediatricians
are very happy with.

Laurie Wheeler RN MN IBCLC
Mississippi USA -- if you are looking for a challenging place to work with
bf moms, come to Mississippi!

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