I have a question, one that may raise some "sticky" issues, but one I
have really wondered about since the birth of my enthusiasm for and
interest in breastfeeding and all things related (which, not
surprisingly, corresponded to my first child's birth). When a mother
and/or baby are hospitalized, and questionable or deleterious
breastfeeding advice or protocols are practiced, are the parents the
final authority regarding the child's care?  Chanita's post dealt with
what assistance she and other personnel in one institution were allowed
to offer, which is a different, but certainly related, issue. (My heart
goes out to anyone in a situation like this. It must be frustrating and
heartrending beyond words to be so stifled in the expression of your
expertise and awareness!) However, I am looking at this right now from
the view of the *mother* in this situation.  If I were a mother in a
hospital, whose baby indicated some medical need for supplementation,
and I *did not want* my baby to be given an artificial nipple or glucose
water, or was instructed to wean for jaundice (or some comparable
situation),and instead insisted that other means of treatment be
offered, what could I do?? Dr. Newman is always asserting that it is the
mother's decision to wean or continue breastfeeding and not the
physicians when medication is the issue,(my gut tells me that
across-the-board weaning advice is based more on legal issues than
medical anyway...), and there was the suggestion to move baby to another
facility (and then Dr. Dettwyler's heart-chilling reminder of the
possible ramifications of this) But, given the realities of most
family's insurance care and the limits this places on the ability to
change doctors/hospitals, what are the parents' options here?? Do they
have *no* say-so in this matter?  Must they adhere to the prevailing
protocols, even when they have considerable evidence in their favor that
these are not in the best interest of the child/breastfeeding
relationship (same thing)? I am not a medical person so I know nothing
about these issues from a medical or legal ethics standpoint.

 Just out of curiousity, if a woman had a "friend" come in and instruct
her in the use and management of alternate protocols (like
finger-feeding), what could the hospital do? Could they take it (an
alternate feeding device)away from her?  Call child-services? Holler at
her? Refuse further treatment? Then there is the insurance issue--I know
that in some circumstances, going "AMA" can result in the loss of
benefits.  Could this be an issue here as well?

This type of situation is so common. And with the US health care system,
and the limits on care providers most plans impose, the option of "have
you considered another practitioner/hospital" is usually so unrealistic
that families don't even hear it.  Is it the lesser of "evils" to simply
concur with prevailing protocols for the time being and take your
chances that the breastfeeding relationship can be salvaged?

Genuinely concerned and curious,
Andrea Simmons
LLLL, St. Louis MO