Your comment just reinforces my conviction that it's cave wars continuously.  If you don't educate the powers that be about things, the good that you do becomes rapidly diluted and disappears.  That's why I wonder if you don't change mind-sets in the schools that control thought processes, how can you hope that a Baby-Friendly approach in hospitals, community and government will be maintained?  Entropy is a fact! 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Rachel Myr
Sent: Tuesday, July 19, 2011 4:30 PM
Subject: not recognizing normalcy

Just so we don't delude ourselves that any country, anywhere, is free of health professionals who are clueless about breastfeeding, I can report that in the last couple of weeks I've personally come across two cases of babies who were given large volumes of formula milk for having lost more than ten per cent of their weight by 48-60 hours of age.  One baby had lost 26 grams in excess of the dreaded ten per cent, and one had lost 13 grams too many.
This happened in a hospital (my workplace) that just three years ago was in fact Baby-Friendly.  If the evaluation team were to come unannounced tomorrow I would die a thousand deaths from embarrassment.  I don't think there is a baby on my ward who can get through a three day stay without tasting formula and it makes me heartsick to think how much better we can be, and are prevented from showing, because of staff cuts, and management who don't have the inclination or resources to enforce existing policy and
procedures.   We used to have whole weeks with no formula use.  If we have a
whole shift now without formula it's a fluke.  Then there's the 'we need to give formula because the baby has lost 8 per cent on day 2 and might not turn around otherwise' supplementation, when we can't even wait 48 hours to start actively sabotaging breastfeeding.  I can't stand much more of this.
I've offered to hold a short inservice for the new peds residents on lactation physiology, if for no other reason than to make them aware that there is such a topic, and I'm hoping the peds dept will take me up on it.
If we are going to improve things we need to get them on board, even though they are mostly so young that my colleagues and I could be their parents or even grandparents.  They still have the power because fledgling pediatricians, with no curriculum on breastfeeding, trump experienced
midwives with plenty of it.   It's not a turf war, it is a struggle
about who defines what knowledge is.

Rachel Myr
Kristiansand, Norway

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