Hi Jane
This bothers alot of us. Many of our moms state "both" and this usually
means they predominantly bottlefeed but will offer the breast occasionally,
or they breastfeed daytime and send baby to nursery for bottles at nite.
Some mothers, though, mean they will bottle feed once they return to work.
I suggest that a mother doing *any* breastfeeding (or wanting to) be checked
"breast" on the medical record. This indicates the mother will need a
lactation consult and followup appointment and teaching. The details can be
sorted out during her hospital stay.

Today we had a mom who said she wanted to do "both." She started out
predominantly bottlefeeding and had very little support from family, in fact
they were outright defensive when I offered mom plenty of help and
encouraged mom to consider exclusive breastfeeding. The baby came for an
early followup appt and was still feeding "both ways" and had lost a little
weight. We helped mom position and latch and encouraged her to go with
exclusive bf, and we'd see them again in 48 hrs. I was truly surprised today
when this dyad was totally bf and baby had gained 3 oz in 2 days. This was a
mom who had stated "both" but who needed alot of encouragement and support.
I would rather see a space on this part of the medical record for comments,
where the nurse can state a little more about mother's goals or beliefs.
I also see the Nicu babies who are listed NPO (nothing by mouth). I've
encouraged the nurses to make a comment that mother is or desires to express
milk for the baby. I make it a point to just go and briefly talk to mom and
ask her about expressing milk for the baby. Most have made up their minds
one way or the other but some don't know that expressing is an option and so
we get some more breastfeeders this way. I just make a note on the daily
census sheet that mother is pumping.
Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI USA

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