Don't have experience with BFHI hospitals, but my observations are these:

Insurance has their coverage parameters and they don't always match the AAP. If mom is medically able to be discharged, she goes home. If baby is medically able to be discharged, and can be fed by breast or by bottle, baby will be discharged.
Is there a hospital in the USA that will keep a mom/baby pair occupying a hospital bed after reimbursement ceases in order to make sure breastfeeding technique is perfected? That's one unreimbursed hospital day each for TWO patients! And insurance companies aren't generally concerned about long-term benefits of BFing for either mom or baby. They know that the vast majority of patients are not on their coverage rolls long term, so their focus is on keeping a lid on expenses short term - i.e. this particular hospital stay.

Again, this is MY observation and MY opinion. I would love to hear about any insurance provider that does consider effective breastfeeding to be a basic parameter for discharge.

Phyllis


---- Linda Bubeck IBCLC <[log in to unmask]> wrote: 

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The AAP Policy Statement---- Hospital Stay for Healthy Term Newborns (Feb. 2010) states as one of the minimum requirements for discharge; the infant has completed at least 2 successful consecutive feedings, with assessment to verify that the infant is able to coordinate sucking, swallowing, and breathing while feeding.

I am being told that this means if a baby does not latch, then the mother will have to pump and bottle feed.   Alternative feeding methods such as spoon, cup or finger feeding are not acceptable.  The baby needs to be breastfeeding as mom intended.  If that is not accomplished before discharge then that is too bad!  Pump and bottle feed.  IBCLC support will continue after discharge but they will be bottle feeding as per our physicians until the baby comes around.

Was this the intention of the AAP?  I don’t interpret the statement that way.  Do Baby Friendly Hospitals send problem babies home bottle feeding?

Respectfully submitted,
Linda Bubeck IBCLC, RLC
In the Carolinas

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--
Phyllis Adamson, BA, IBCLC
Glendale, AZ.
[log in to unmask]

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