Hi all,
We just had our JCACHO review and they did not discuss jaundice, thank
goodness. If you can take yet one more comment. How ridiculous that anyone
would consider jaundice a sentinel event. What about situations (which we
see often) of several day inductions for low fluid, hypertension, suspected
large baby, IUGR, convenience of the family, and various other reasons that
babies NEED (TIC) to be delivered at near term as opposed to term? Does
anyone else see these type of deliveries on the rise? Some of the reasons I
hear are fairly casual, others of course ARE needed.
I see more and more mothers being delivered early and I'm afraid that
"spontaneous vaginal delivery at term without complications" may soon be a
thing of the past. Of course these high risk deliveries, turn into high risk
babies who have feeding difficulties and jaundice, bruised caputs from
vaccuum delivieries or forceps, not to mention the increasing epidural
rates, C/D rates and subsequent increase in random formula use. So many moms
just do not make it through these experiences with breastfeeding intact.
Breastfeeding related jaundice at its least can self correct with
lactogenesis and at its worst CAN be avoided by putting in place a program
of early intervention by trained personnel with good assessment and
EARLY followup. This in not a JCACHO issue at all - unless they look are
willing to look at birth practices, including inductions and near-term
infants, whether LC's or staff have enough time to properly do their jobs
and what followup programs each hospital has in place. Insurance companies
and doctor offices that take a casual approach to near term infants or poor
feeding at hospital discharge should be brought to task if they do not
provide or permit early follow-up.
Dare we dream.... a PEDS office visit to be done by an IBCLC. A new parent
clinic that new mothers can come to for advice, a breastfeeding assessment
and weight check. Home vists by well-trained nurses and doctors who take the
time to refer and parents who take breastfeeding seriously enough to seek
help when things aren't quite right, instead of throwing in the towel.
Wow, sorry this sounds so negative. I guess this really struck a cord with
me. Once. again we throw the baby out with the bath water, or rather
breastfeeding out with the US hospital care!
Must be hormonal today!
LuAnn Smith
York, PA
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