Well you would really have to soul search as to whether or not it was a
breach of patient confidentiality. I would imagine the LC got informed by a
staff member and was not snooping around looking in charts. In my hospital,
I go in and check w/ the nursery staff and postpartum staff and they tell me
about the bf moms. They would likely say to me, "Mrs. B wants to bf, but the
doctor and infection control nurse say no due to the hep B. They don't want
you to talk to the mother." I would then look up the hep B info in my ref.
books particularly Ruth Lawrence's Medical Contraindications book. If bf
were not contraindicated in fact, I would then call or fax to the infection
control nurse and doctor in question and say FYI Bf in not contraindicated,
here are the refs. (I would send same info to my director, with a rant).
Personally I would not go in to talk to the mom unless she specifically
asked to see me on her own. In other words, if she has been counseled not to
bf, I would consider her a formula feeding mom whom I wouldn't normally see,
and I would deal directly with the doctor, sharing the info. The doc may or
may not change his plan. If the mother specifically asked to see me then I
would consider her my client and I would do it. I don't have the ref here at
home, but I think she can bf after HBIG / HBV vaccine is given. Hope this is
helpful.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA




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