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Wed, 7 Mar 2007 14:26:31 -0500 |
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There was discussion last month about breastfeeding and circumcision.
If your hospital has a protocol to address this issue, will you please share it
with our lactnet community? It is helpful for those of us in hospitals to point
to what other facilities are doing.
My hospital has recently begun using the following check list. I understand
there was a great deal of "discussion" among the physician staff before the
final, watered-down version was approved. However, I am thankful for
anything to draw attention to baby.
Before circumcision can be performed, the following cleck list is to be
completed. Each item is noted with Date/Time of Assessment and Initials of
RN assessing.
Circumcision Checklist
Criteria to Meet
1. Healthy, 37-42 week gestation
2. Infant is at least 18 hours of age
3. Initial physical exam completed by pediatrician
4. No pending lab test to r/o sepsis
5. Inant stable X 4 hours
HR less than 160
Resp less than 60
Temp 97.6 - 99.4 F in open crib
Blood glucose protocol successfully completed (if indicated)
6. Weight loss less than or equal to 7%
7. Voided X 1
8. Stooled X 1
9. Circumcision consent signed
10. Procedure checklist completed
**If any of above criteria not met, please consult with pediatrician for order
to circumcise.
Things are better but life is still rough for the little ones. I am hopeful that the
Academy of Breastfeeding Medicine or the Center for Infant and Young Child
Feeding at UNC-CH will have some formal statement.
This exquisitely painful procedure often derails breastfeeding and causes
trouble and expense for parents trying to salvage it. Sometimes there is an
additional day in the hospital due to feeding related difficulties.....and those
difficulties seem clearly linked to the circumcision to me.
Where is the evidence showing that the procedure does not interfere with
breastfeeding? Where is the evidence showing that feeding (shoving) a bottle
of formula to an infant who is not eating post-circ is risk free?
Thank you for any documentation that you can share.
Pardee Henderson Hinson, MPH, IBCLC, CHTP
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