I'm still trying to catch up on posts from last week. That's what I get for
being out of the office for 1 day! I've been trying to find the time to post on
the experience I had last week with one of our peds. I got a phone call from a
mom I had seen in the hospital whose baby was 8 days old when she called
me. She thought nursing was going well until she went for the 1st check-up
when the baby was 5 days old. I admitted to her I was really puzzled by the
ped's concern over the baby's weight. Baby had not lost, but not yet begun
to regain since her discharge weight. Mom's milk was in, she felt softer after
each feeding, baby was content and diapers were right on target. Ped wanted
to see the baby again in 3 days. At that time, weight gain was appropriate
but ped instructed her to supplement with formula so that "baby would gain
more weight". The ped told mom that she wanted her to nurse no longer than
15 minutes/side, otherwise baby was expending too much energy and burning
too many calories. Up until then, mom had been nursing on demand for as long
as baby wanted on each breast and was comfortable with what she was
doing. She was given this advice on a Thursday and was told to bring the
baby back in for a weight check on Monday (3-4 days later). On Monday,
surprise, surprise, baby's weight was 1/4 to 1/2 oz/ day since Thursday. The
ped then told her she must supplement with formula. She called me Monday
after her drs appt, upset with the formula advice. She didn't understand why
nursing on demand for as long as baby wanted was wrong. We discussed - I
told her that I felt strongly that baby was nursing well and encouraged her
to "experiment" and go back to demand nursing until her next weight check 4
days hence, using EBM if she really felt baby did not do well at a feeding. She
called me after the appt 4 days later and said (direct quote: "You should have
seen the doctor's face when I told her I was not supplementing with formula
and had been only nursing, just like I was before!" The baby had gained 4
ounces in 4 days and was a happy baby. She also said the ped felt
she "learned something today"! Needless to say, mom was ecstatic and felt
very empowered that she went with her instincts, instead of poor advice.
With mom's permission I am planning on submitting her experience as a case
study at the next peds dept meeting. For those hospital-based LCs, I would
strongly encourage you to attend the appropriate medical staff meetings (OB,
Peds, Fam. Pract.). These meetings are an excellent "teachable moment" for
the docs and you are on their "turf" which is where they tend to feel the most
comfortable.
Sorry for the length of this post, but this was a "perfect example" of why
demand, unrestricted nursing works!
Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL USA
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