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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