I agree with Dr. Jack, but how do we go about convincing other people
including MD's staff RN's and parents that there is more to the picture
than just the % of weight loss?
        I was soundly scolded at work today (hospital LC job) by a staff nurse who
said I "made a mother upset" yesterday by telling her it was probably not
necessary to supplement her 9 1/2 lb newborn with formula when "the doctor
and all the nurses" had told her it was ok to supplement since he had lost
"almost 10%" of his weight. The baby was latching and suckling effectively,
but wanted to feed a lot. I had explained supply and demand to the mom and
suggested that she nurse as often as baby wanted to and not give any more
bottles as long as baby continues to nurse well. This was the information
that supposedly "made her feel guilty and almost cry."
        The same nurse who scolded me gave abm today as a first feeding for
another baby (without asking mom) because the baby's dextrostick was 40 and
the baby was "sleepy from all the meds used in the CS"; mom was alert, a
3rd time breastfeeder, could express colostrum easily, and was eager to put
baby to breast, but baby had been taken from her right after birth and got
the abm just before coming out to mom for the first time.  I have been told
(by a fellow IBCLC) that I should not give the moms any information that
might make it appear that someone else on staff might have done something
incorrect or given wrong information. All I could do was to encourage this
second mom to keep her baby with her as much as possible and get the baby
breastfeeding so that further abm would not be needed.
        I guess this is mainly a vent, but if any of you have solutions to this
type of situation I'd really like to hear them. I'm supposed to be
responsible (with 2 other LC's) for educating the nursing staff about BF,
but I've even been scolded for telling nurses that abm can have potentially
negative effects on babies and should only be given to BF babies if it is
medically indicated. (After all, we can't offend the abm reps!) Now I'm
really venting.:-(  Any ideas would be greatly appreciated!

Anne

: From: newman <[log in to unmask]>
: To:
: Subject: 5% or 10%
: Date: Tuesday, December 22, 1998 12:26 PM
:
: I wish to reiterate that the idea of going by percent weight loss is not
a
: good idea. I think it will lead to bad practice, including interventions
: when they are not necessary and reassurance when it is not warranted.. .