Here is a different BF related issue that I have not yet seen raised here or
elsewhere.
Our small 34 bed hospital is about to breakground on a 2.5 million dollar
renovation/improvement project.  We currently use a labor/birthing room and
move moms to a private room after delivery.  The new OB area  will be 3 LDRP
and a nursery.  However the idea of the LDRP is for the moms to have the
baby's all the time.  Except when they need their "rest" (We only do about
100 deliveries a year).  When I asked the planners why we even needed a
nursey if the babies were going to stay in the mothers rooms, I was informed
that the State Code (of Iowa) requires that all hospitals have a nursery (If
they do OB).  This really seems to be to be a bit of antiquated thinking from
the 40's and 50's.  But because of the administrative building codes there
appears little that can happen.  So now we will spend thousands of dollars
for a room that will not be used that much.  I now some of you might say we
need a place to keep a sick newborn but our practice is only to keep the sick
ones long enough to prepare them for transport to the regional neonatal
center and we could do that in one of the other rooms in the OB area if we
needed to.
IMHO it will be hard to enact many of the reforms of the BFHI (Baby Friendly
Hospital Initive) if these nursery building codes are present in all the
states.  Does anybody know about the Joint Commision requirements?  In theory
if the Joint Commision would accept the BFHI as their standard then that
would help in the implamentation in the US.  Katherine D., are the building
codes an area that you have looked at that reflect the cultural influences of
BF practices?  I know about the design assistance that some of the BMS
(Breast Milk Substitue)  Companies have done for hospitals before.  I welcome
others comments and experiences.
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*  Jon Ahrendsen, M.D. FAAFP, LLLI Medical Associate   *
*  215 13th Ave SW                                                        *
*  Clarion, Iowa 50525  USA                                            *
*  515-532-2836, FAX 532-2523, Email [log in to unmask]   *
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