I agree with the statement that evidence-based practice applies to everything
but infant feeding.  Yesterday's consult....mom's nipples cracked and sore,
low milk volume due to poor latch.  Baby is 3 days old.  Mom states baby's
doctor told her to keep on trying.  Baby's bili on day 2 is 11 and repeat on day 3
is 14.  Why?  Because I deliver a pump on day of discharge from the hospital
with baby 2 days old and try to stimulate milk production.  I'm so glad I had
the resource for a pump because the stores in my area are closed on Sundays.
As a result, I was able to stimulate milk production perhaps 24 hours sooner
than would have been possible, right?  Hmm...I'd say that was a patient-focused
benefit and not an LC benefit.  Then I see this sleepy, slightly dehydrated,
jaundiced baby and I tell the parents they must feed the baby!  Had I not been
there to instruct them to feed baby, what would have been baby's bili level
by Monday?  After all, the parents were continuing to keep trying at the
breast...it's as though these doctors are instructing parents to keep trying to
dehydrate your baby!  Keep trying to elevate your baby's jaundice so perhaps we'll
need to initiate lights by Monday.  Why doesn't this doctor see his impact on
the health of this baby?  Why doesn't he see this as not referring to an LC
for latching assistance as malpractice?  I don't know...but, I'd doubt he'd
tell parents of a baby with a fever to keep trying to bring it down and not
provide follow-up.  It's the same thing!
Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
St. Charles,IL

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