Maureen,
Unfortunately, I KNOW this is happening in our hospital!  I have moms reporting to me that they smell formula on the breath of their babies and staff that tell me of specific co-workers that give babies formula without mom's permission because they think babies are "starving"!  I have tried the "false charting by omission" argument and the wrath of Joint Commission.  So, as you have mentioned, our exclusive stats are probably lower than reported and the stats at our hospital are already abominable!  They avg 20-22% exclusive.  The stats we gather nationally and by state are probably inaccurate as well!  Hard to get a true number.
All this actually makes me feel a wee bit better about our stats being so low.  I gather them and it takes at least 2-3 hours to go back over the months deliveries (85% whom I have seen) to confirm and document exclusivity.  Very discouraging to see the final numbers especially seeing all the documented supplements that were not medically necessary.  Wondering if the pressure of Baby Friendly certification, Joint commission, etc.. works it's way in to hospital employees feeling they have to hide these unnecessary feedings?
Anyway, thank you for your comments. I learn so much from the LACTNET community!  I have renewed fervor to rid our csection moms of Demerol PCA pumps.  Wish me luck!

Holly


-----Original Message-----
From: Maureen MINCHIN <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Sent: Wed, Apr 3, 2019 1:51 am
Subject: Re: exclusive pumping and health benefits

Bigger numbers designed badly is worse than smaller numbers designed well. 
So for example, a small study of truly EBF from birth, nothing else given,  is better than a larger population experiment where say, not more than one bottle is allowed for the child to be designated EBF months later. Where exclusive breastfeeding is concerned, there are almost no good studies because even if the hospital records are searched, there is not the attention to detail that would disclose the fact that baby was apart from mum for long enough for some nurse to give the kid something she thinks harmless and useful, even prophylactic…. and that happens. I still quote the Danish study (Milk Matters, pp.96-7)
By the mid-1980s, infant formula was accepted in most hospitals. One centre in Denmarkset up a study of allergy that provides information about comp feeds. It was a prospectivestudy of 1749 newborns. In this 1985 Danish cohort, none of 210 children who were trulyexclusively breastfed in hospital developed cows’ milk allergy under twelve months, and allof the thirty-nine partially breastfed children who did develop allergy under twelve monthshad been comp-fed ‘significantly more often in the first month of life’ than others in thestudy. The full study also revealed that only nine of that thirty-nine developed symptomswhile still solely breastfed after discharge: in the other thirty, symptoms emerged after other foods were introduced. And scandalously, only one of those nine mothers was awarethat her child had been comp fed in hospital. The amount fed in hospital ranged from 40to 830 ml, or eight teaspoons to most of a litre, which makes it hard to posit any safe orbeneficial level of exposure! 299However, note that even here, only 210 of 1749 babies escaped hospital without beingexposed to cows’ milk protein, i.e., were probably exclusively breastfed from birth.Thankfully, only thirty-nine of the 1539 breastfed infants exposed to bovine milk in thefirst month went on to develop the particular symptoms that in this study defined allergy,a low rate compared with later studies, perhaps because of the intergenerational effects oftheir mother’s feeding. Thirty of the thirty-nine developed allergy only after foods otherthan breastmilk were fed. But it is physiologically certain that the other 1500 who did notdevelop certified allergy or intolerance did develop an altered microbiome, and may havehad other health problems to deal with as a result. No one assessed the timing of onset orseverity of colic, or reflux, or abnormal behaviour, or otitis media, or unexpected infantdeath, for example.


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