Pat noted one out as far as documentation of not breastfeeding is  
concerned.  Here's the other one:
 
Look at what JCAHO says again.  There are two statements...
 
"When determining whether there is a reason due to a medical maternal  
condition documented by a physician/APN/PA/CNM or lactation consultant for not  
exclusively feeding breast milk, reasons must be explicitly documented 
(e.g.,  "mother is HIV positive - newborn will not be breast fed") or clearly 
implied  (e.g., "mother is currently abusing alcohol - newborn will be fed 
formula"). If  reasons are not mentioned in the context of newborn feeding, do 
not make  inferences (e.g., do not assume that the newborn is not receiving 
breast milk  because of the medications the mother is currently taking)."
 
"A mother’s choice to not breast feed must be clearly documented in the  
newborn’s medical record in the context of the newborn feeding method in order 
 to select allowable value “2”. Do not assume that the newborn was not  
exclusively fed breast milk due to maternal choice in the absence of such  
documentation."
 
This second one does NOT say this documentation has to be done by  
physician, NP, LC -- etc, as it does for reason for supplementation or medical  
reason infant cannot breastfeed.  This makes perfect sense.  If an  infant is 
unable to breastfeed related to a medical reason, then it makes sense  that 
the baby's doc/NP should document that WHY on the chart.  "Infant may  not 
receive mother's milk r/t mother on chemotherapy incompatible with  
breastfeeding" or something like that.  But if the mother says, "No way  Jose, I'm not 
breastfeeding" then her nurse can document that.  It's not a  medical reason 
we are denying the baby breastmilk...
 
Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants
 
 
 



             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome