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Lactation Information and Discussion <[log in to unmask]>
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Thu, 13 Jan 2005 17:59:48 EST
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Suzanne  wrote "But seriously, how SHOULD I handle the situation of the
malnourished  8 month old, who is not FTT enough to go in the hospital?
(Outpatient  workup and management of FTT is still the standard of care in
the  US.)  Y'all have said specifically what I SHOULDN'T do, but  what
SHOULD I do?"




There is a difference between using some formula in an emergency situation  
and handing out discharge packs full of free formula to mothers in the  
hospital.  The intent of the bill, as I read it, is to stop promoting the  use of 
free formula.  That means that hospitals would purchase the formula,  there would 
be no gift packs of formula, we wouldn't be stocking the moms up  with little 
6 packs of formula to take home, and so on.  Suzanne's case --  a baby (I 
don't care how old it is) is in the office and is malnourished.   What do you do? 
 Mom has been breastfeeding, but milk supply is low because  baby hasn't been 
nursing well.  Baby is obviously in distress, but not in a  situation in 
which she needs hospitalization or ER care.  Maybe she's  dehydrated.  Whatever -- 
it is a MEDICAL issue, not a PROMOTION  issue.  If it were me, I'd have mom 
breastfeed the baby if she can, give  the baby some formula, and then, 
depending on the situation, send mom to  the grocery store, have her try to get into 
WIC, prescribe donor milk, increase  her solid food intake, whatever.  IF mom 
doesn't have enough breastmilk, or  she isn't breastfeeding, and you have a 
baby that is dehydrated or malnourished,  something needs to be done.  Now.  One 
bottle of formula is not going  to fix the situation, but I think we have to 
see what the difference is between  necessity and handing out cute bags in the 
hospital for free.  Donor milk  is a wonderful idea, but unless it is right 
next door, that takes time.   Perhaps that can be the ongoing solution -- along 
with helping mom w/ her milk  supply.  But Suzanne wants to know what are you 
going to do RIGHT  NOW?  Well, keeping in mind that the first rule of 
lactation is to feed the  baby -- that's what I would do.  
 
Jan Barger, RN, MA, IBCLC
Wheaton  IL
www.lactationeducationconsultants.com

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