Hello. I have had 3 cases in the past week in which the mothers had been
discharged either early, or when bf was NOT well established. In all three
cases, children became moderately to severely dehydrated. One required 4 day
hospitalization with IV therapy. One had a severe ventricular septal defect,
and was d/c not bf well, ..when I saw her, she was dusky in hands and feet,
and around mouth, and had not voided well in 24 hours. Depressed fontanel,
suture lines showing.

With early discharge being a fact, how can the system function so that
mothers and babies are monitored well.. Good latch/bf is NOT a criteria for
discharge in the hospital here.  Babies are routinely seen at 14 days. A LOT
can happen in 14 days. One mother who I worked with last week had a baby who
was slowly dwindling..down to 5 lb.  When she called the pediatrician, she
was told to give the baby TYLENOL. Some office nurses are NOT skilled in bf
phone management, and this is a grave concern.

I am truly worried that it is going to take a baby's death for someone to
realize that early discharge is not necessarily a good thing if there is no
SKILLED follow up...

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Kathleen B. Bruce RN, BSN, IBCLC
Williston, Vermont USA
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To err is human, to really screw up you need a computer..
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