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Date: | Tue, 15 Feb 2011 19:10:05 -0800 |
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Figured this was the best place to vent this. Got a call from an OB nurse today
bc one of my clients was refusing to supplement her 2 day old baby. The baby was
a 38 weeker and had lost 9% in 48 hours and the bilirubin had gone from 6 to 10
overnight. Baby was delivered via c/s. Mom said baby has had at least 10 wet
diapers and six meconium diapers. Mom has no complaints about nursing and is
nursing frequently. As soon as mom called and told me about the wt. loss I
encouraged her to use compressions and lots of short, frequent nursing. Also
suggested mom express and supplement with her own colostrum if they insist on
supplementation. Mom says she is seeing good transfer when baby nurses. No pain.
Nurse had a mocking tone with me. I allowed that the wt loss might be bc of
water retention from labor and delivery as evidenced by the many wet diapers. I
told the nurse what our plan was and the nurse said, "And what if it doesn't
work? What then?" I explained that the mom did not wish to change the
environment in her baby's gi system by adding formula. Without giving a
blow-by-blow suffice it to say that the nurse did ask who my supervisor was and
said, "By the way, the baby has only had 5 wet diapers so far -- Just so you
know." I then told her that if that was true then she might need to ask the mom
about that discrepancy. When I talked again to the mom soon after, she said that
they had not asked about the diapers at all until 10 minutes ago. I told her
they probably had been checking the trash or some such but she denied that they
had.
I am a new IBCLC. I haven't had a confrontation with a nurse before. I found
myself at a loss for words when the nurse asked, "What then?" I did ask her if
the purpose of the supplement was basically to push the meconium out and she
agreed. I explained that supplementing with mom's colostrum should do that as
well and that it was important to this mom that bf go really well. The nurse
said, "Breastfeeding IS going well. The Dr. just wants her to supplement after
every feeding." I did not take the time to explain to the nurse how this could
disrupt bf.
Mom says tonight that they have said nothing else to her and that baby is
nursing a lot. She is hopeful they will send her home tomorrow. The nurse said
they wouldn't discharge until baby was 5#. Just hoping and praying I'm doing
right. Feeling a little wounded from my skirmish with the nurse. Figuring you
all will understand. Any advice or constructive criticism is welcomed and
appreciated.
Liane C. Varnes, IBCLC
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