Hi Wendy--
In my hospital's level III NICU, nearly 100% of the moms initiate pumping to
provide milk for their babies. Part of this is due to a high bfdg rate in
the Pacific Northwest, part is due to a well-established NICU lactation
program that has been going for at least 15 years, and part is due to the
fact that our neonatologists will go to the bedside of even the most
reluctant moms and say: "Your milk is like medicine for this baby, and we
need it to help ensure his survival and good health. Are you willing to
pump for even a few weeks?"
The finances of this are another story. At this point in time, our hospital
has some policy that does not allow us to own and distribute/rent any
durable medical equipment for use by outpatients. Our solution is that we
own a fleet of pumps for inpatients to use, and for discharged mothers of
NICU infants to use during their visits in the NICU. For after discharge,
We have an arrangement with a local medical equipment company who keeps a
supply of rental pumps stocked in a closet here at the hospital. Every mom
who is pumping gets a rental pump when she is discharged. We have the
pediatrician or neo sign an equipment rental prescription, which we fax to
the rental company, who bills the mom's/baby's insurance. I think the
reimbursement on pumps is inconsistent for the families, and for the ones
who truly cannot afford it, our social service dept pays the bill.
But your point about the ethics of providing formula is an excellent one.
We have had one local HMO argue along similar lines, that they should not
have to pay the cost of pump rental, since the pump is necessary to provide
food for the infant, who is a hospitalized patient, and we provide meals for
all our other patients. Many hospitals, including my own, have departments
of ethics or organizational integrity. We should all be in contact with
these departments about this type of ethical breach.
Martha Johnson RN IBCLC
Eugene OR
-----Original Message-----
From: Wendy Thomson, Rn,Bsn,Ibclc [mailto:[log in to unmask]]
Sent: Friday, June 07, 2002 12:42 PM
Subject: NICU cost of formula vs cost of a pump
Hello everyone,
I am an RN,IBCLC for many years. I have been advocating breastfeeding until
I got tired of the brick walls.. Over the last 6 months, I have rejunated
and
refocused my direction and goals. Advocacy and change is my motivation
once
again. I have an interesting situation that I would love some input.
The NICU in my areas has been moving toward the Paula Mier protocols for
breastmilk and premie babies.. we all know about that concept so I won't
detail it. Here is the situation. A wonderful nurse, breastfeeding
advocate
and soon to be IBCLC, working and spear heading this change needs all the
moms to have a breastpump. Seems like a no brainer if the hospital is going
to this policy. The dilema, the dept renting the pumps is not willing to
provide pumps unless the moms pay full rental price. As we know, many NICU
babies are from families that cannot afford pumps, let alone rent, food, or
phone, but this is really irrelevant to this argument!! I pose this
concern,
If the hospital buys formula, which costs money, how can the hospital
refuse
to provide a pump, also costing money? In other words, is it ethical or
discriminatory for the hospital to spend money on formula and "give" it,"for
free", to a baby, but refuse to "give" a pump to a mom so she or they can
provide free food to the baby?
I know this can be expanded on, but my ethics, conscience, or whatever you
want to label it, say if a hospital buys something and gives it to a
patient
like formula, then the hospital can "buy" (which means rent) a pump and
give
it to the patient, like breastmilk!!! Give us ideas to present and argue!!!
I have to think that this has been argued before, i just can't be the first
to think of it!! This is discriminatory, there is no difference b/w buying
ABM from a company or renting a pump
from a company. Anyone know how much ABM a premie takes on average and
what
it costs a hospital to buy it? COntinue on with the side effects of that
formula that adds to the babies stay!!! and so on, and so on, and so on.
I better stop because the more I write, the more I am getting upset. I
anxiously await the suggestions and debate!!!
Wendy Thomson, RN,BSN,IBCLC
<A HREF="http://www.naturalbeginningsinc.com/">NaturalBeginningsInc.com
Breastfeeding Supplies, consultation and information</A>
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