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Thu, 17 Mar 2005 08:45:39 EST |
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Lucy has described a scenario that begs the question of informed consent and
poor understanding of the relationship between pain management and
breastfeeding. If a penile block was given to the baby then why is he crying from
pain? Could he be crying because he is separated from his mother, restrained, and
being handled roughly? It is well known and reported in the literature that
sucking at the breast modifies pain significantly. The baby should have been
placed at breast to reduce the crying and allow pressure on the bleeding
circ. He could also be given tylenol for pain. Shoving a bottle of D5 into the
baby's mouth without permission of the mother is battery. The combination of
fasting (which I bet happened before the circ) and hard crying drops blood
sugar levels. Blasting with D5 is known to bounce the blood sugar levels around.
Did anyone check blood sugar levels sometime after being given the D5?
At this point, the mother with limited English was not consulted, nurses did
not follow unit policy, the baby refused to breastfeed, and the mother has
had information withheld from her. An incident report should be filed. If the
baby is unable to complete 2 successful feeds at breast prior to discharge,
then community standards for discharging breastfed infants has not been met.
Perhaps an inservice should be scheduled with a protocol for this scenario
created as a result. Nurses should be required to read the published articles on
the relationship between pain relief and breastfeeding. A physician's order
should be required before any sugar or artificial nipple is given to a
breastfed infant. The risk management department should be informed of this and
asked if they could foresee a lawsuit for battery, infant health risk from not
being breastfed, and nurses who do not follow unit policy.
Marsha Walker, RN, IBCLC
Weston, MA
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