From: coleb                Fri Feb 16, 1996 -- 06:38:27 PM
To: [log in to unmask]@
Hello again,

Thanks for all the ammunition re: birth control pills for the docs here.  Now
I have another dilemma to present.  (My knowledge base is being challenged
constantly now;  I've been at this hospital in this LC position for a little
more than 3 months.  God & fellow Lactnetters help me!)  I know BF and MgSO4
are compatible.  So do the nurses and doctors here.  We had a mom who was put
on continuous magnesium sulfate infusion (mag) around 17 hours post-partum
(10am) for a BP of 180's/108, brisk reflexes and clonus.  Last breastfeeding
was at 6am.  Obviously mom was in critical condition for a while.  Was on mag
until next day at 10am.  OB had written for no breastfeeding because of the
stimulation to mom.  I was OK with that order because she was so sick.
Pediatrician had OK'd breastmilk for baby.  Nobody thought to pump this mom
when she became stable during the night.  When I brought this up the next day
after mom came off the mag and was transferred back to her PP room from L&D,
none of the nurses thought she should have pumped while on mag because of the
stimulation it would have caused her.  Of course, the first comments out of
mom's mouth when I went in to see her were, "Obviously breastfeeding isn't a
priority here!"  My thoughts to the staff were when vital signs and reflexes
were stablized during the night, the nurse could have assisted mom with a
double-pump system where she wouldn't even have to move.  Breast stimulation.
Baby had been cup-fed all night and when he was put to breast the next day,
around noon, he refused the breast because he couldn't get any milk (I
assume).  Mag sulfate does decrease milk supply anyway and I think the mom
should have been pumped.  But the lactation educator who has worked here for
years does not agree.  The head nurse tends to agree with her.  Any thoughts
out there from nurses or doctors who have been there?  BTW, mom quit
breastfeeding a week later because it was so difficult for her to cope with
her baby who never did well at the breast after this.  (Mom was a little
nervous and high-strung, too.)  I will appreciate any thoughts very much.
TIA.

Barb Cole, RN, IBCLC, Marshfield, Wisconsin  (who is not trying to endanger
mom, just help her out for future feedings and an easier start, considering)