I wanted to thank everyone on the list, especially Morgan, for their direct
and indirect help.  There is such a plethora of knowledge on this board and
I am learning so much.  Last year I moved from Seattle to a rural ski town
in Colorado .  I was disturbed by the use of formula while the RNs boasted
their success at BF rates...well it was NOT exclusive.  I saw ABM dripped on
the nipple to "help latch", supplementing at night so that mom could "rest"
and even a couple of times sneaking the baby some ABM (!).  Yes we also hand
out "the bags".  Day shift would get annoyed at night shift for overfeeding
the baby's and have to deal with the consequences.

I work night shifts and was outspoken about what was going on.  As a result
my manager asked me to teach a section of this years skills day on
supplementation.  As I started to learn this was a LARGE topic and could
take over days of teaching, I narrowed it (with much help) to nutrition need
in the first 24-48.  I focused on the stomach size of newborns and not
undermining mom's and making them feel inadequate.  I was able to slip in
some "evils" of ABM and emphasize how colostrum is perfect.  In great timing
the one and only LC (who gets maybe 8hrs/wk as LC) was putting out new
policies on BF and BF the first 24hrs.  I used this as my premise.

The response was amazing.  I got a lot of oohs and ahhs even from very
seasoned RNs.  I have even heard comments about stopping formula kids (by
choice of mom) at certain amounts.  I strongly encourage the RNs to teach
mom to rest while baby rests instead of taking them to the nursery so that
they are better prepared for home.

It is a small change but I could not have done it with out you.  I have
attached my PP presentation and I want to say most of the 30-45 min (all
that I was allowed) was taken up by interaction.  There is a game and then
after I compared it to an adult stomach.   I asked who was willing to drink
a 20oz protein drink (holding up a Coke bottle) in 20 min (about 2 cups and
the same size as an adult stomach).  Next I asked who would volunteer to
drink an almost 2L protein drink (holding up another bottle) in 20 min.
Funny no volunteers.  I said this was the same as giving a 3 day old 50cc.
Then I handed out another visual.  I put a grape (NB size) in a condom and
put in 20cc and tied it tight so you could see the distension (cut off the
excess condom so it was a ball with the grape floating).  Then I did the
same with a cherry tomato (3day old) with 50cc.  Especially the seasoned RNs
liked this one the best.  They wanted me to make them for the moms!  I
talked about nutritive suck and how babies may not stop and can seem to be
able to eat a lot, but is this necessarily good (think Thanksgiving dinner
tummy as I put on the PP).

I wanted to share my PP with you all because I could not have done it with
out you.  I also have to give special thanks to MORGAN!!  She helped me
through every step of this and gave such inspiring ideas that touched many
learning styles.  She helped me to keep focus and on to intimidate my peers
by just bashing ABM.  I was able to let them draw their own conclusions and
I think it hit home better.

I still have a long way to go, but this is definitely a start.  AND my
manager was very impressed...she attended the second of my 2 presentations.

If you have any other questions on how I presented this feel free to email
me.

Thanks again
Kristi,
Special Care Nursery RN
aspiring IBCLC

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