I am faced with a dilemma that I would like some advice on.  I am a newish
LC who has been placed in charge of coordinating the BFHI for my
hospital.  One of the elements that I have come up against is night time
complementary feeds to breastfed infants whose moms are keen breastfeeders
but are beyond exhausted.  I myself was one of those mom's who on day
three of having my son hoovered on to my breast I "broke down" and gave
him 10cc of formula. Now mind you I had had about 9 hours of sleep in 4
days, I still have guilt about it, believe it or not, even though he is 4
years old and still nursing.  The problem comes with how to gracefully
address this issue with the staff and the policy.  By the strict BFHI
guidelines as I understand it one must have medical indications for
comping a baby.  Is maternal exhaustion categorized as a medical
indication?  And if it is how do I make sure that this is not used as an
excuse by the staff to start handing out formula willinilli.
It is a hard one for me and I usually handle it case by case.  If I feel
that a mother has reached the end of her tether and would do much better
once she had a chance to sleep for a few hours then I will consider it.  I
will first try to get her to use ebm but that isn't always a possibility.
The real issue is how do I handle this from a policy and teaching
perspective.  Help I need guidance.  Thanks ahead of time,
Mandi Porta, RN, IBCLC
p.s. we do have informed consent forms for formula usage.

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