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Date: | Tue, 24 Mar 2009 18:27:41 +0200 |
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Hello everybody. I'm a returnee to the list after a few years off. I
used to be a volunteer bf peer counsellor and project worker developing
Finland's national bf support helpline service. Now I'm a student
becoming a RN / health nurse here in Finland, and also I'm the president
of Finnish Breastfeeding Support Association.
As a school project and together with the breastfeeding coordinates of
HUCS (Helsinki University Central Hospital) I am now trying to come up
with "Safe reduction of Supplementary Feeding - Instructions to Care
Personnel".
I turn to you in hope someone knows of good practises somewhere? Have
you heard of or do you use some kind of decision tree or protocol when
moving from supplementary feeding (medically indecated or not!) to
exclusive breastfeeding? Any new research (I trust I have found the
older ones concerning my main questions of "how much should a baby eat"
and "how to know how much the baby eats") that you know of?
In Finland it is very common to give supplementary milk to healthy full
term babies without a medical indication. It's a kind of cultural thing
although we at the same time have very high bf initiation rates
(virtually all women choose to breastfeed at the hospital). SO we have
lots of babies and mothers who are discharged with an intention to
exclusively breastfeed, but not really doing so at the moment of
discharge. When the follow up on health centers is not always very
swift, and when the staff there sometimes has next to no knowledge in
how to assess breastfeeding, this leads to risk of either unnecessary
continuation of supplementary milk OR ceasing the supplementation even
when the baby is not breastfeeding efficiently (oh yes I have read a lot
about hypernatremic dehydration, and it's a big big worry of Finnish
pediatricans....).
That's why the need for basic instructions. I kind of know what the
instructions would include: weighing the baby, keeping an eye on the
elimination, enhancing breatsfeeding, but I have a big work in pointin
out the evidence-basedness of all this :-)
Thank you for help and thank you for you kind thoughts that I KNOW you
send me, even if you don't have anything concrete to help me with :-)
Yours,
Karla Loppi
in Finland
karla . loppi at viapori . fi
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