Yvette,

It seems time for this family to request a patient advocate to become 
involved. Most hospitals have one or some other designation of a person who 
is a go-between or mediator. This person helps to iron out the differences 
or open up communications between families and hospital staff or 
administrators.

The family needs to be clear about what criteria the neonatologist is 
looking for prior to ordering baby's discharge from the hospital. The usual 
criteria are: weight of 4 pounds or more, ability to maintain temperature in 
an open crib with no more external heat needed like from an incubator or 
radiant warmer; ability to feed independently on a breast or bottle and not 
needing gavage feeds; ability to feed in a *reasonable* length of time (say 
30 mins); steady weight gain over several days; stable vital signs 
particularly respirations, no further need of oxygen or iv medications or iv 
fluids. In my experience these are the usual milestones.

Next, the parents must declare what their desires are and ask about options. 
For example, they may want to spend alot of time skin to skin. They may want 
to do all of the feedings. They may want to room in for several days prior 
to discharge. They may want to give the bath.

I suggest they ask for a "primary nurse" if they have found one or maybe 2 
that they have a rapport with. This nurse or nurses can be assigned to this 
baby/family whenever possible. I suggest that they not be confrontational 
but rather approach it from a standpoint of being anxious to participate in 
their baby's care and wanting to become ready to take him home. Ask what 
else can they be doing to get ready, for example taking a cpr class.

Unfortunately, nicu units are quite medicalized (of course) but sometimes 
neglect the family/parenting part. Some staff are not very comfortable with 
attachment-style practices, in my experience. Sometimes they become quite 
possessive of these babies and feel they know what is best. It is a 
difficult situation and a very big problem in nicu units, in my opinion.

Laurie Wheeler, IBCLC, MN, RN
former nicu nurse/head nurse
Mississippi USA

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html