When I walked into the nursery this morning , one of the nurses said she
has a "naughty" baby, i.e. one who has lost too much weight. According
to his chart, he had lost almost 8% of his birth weight by day 2. I
flipped the page to see what has been happening with the breastfeeding
and guess what.....he is a bottle baby, and never got breast milk in his
life, poor kid.
I told the nurse that he is a bottler, and I would go call the mom to
give him a supplement. She asked me what supplement and I said a
breast, of course. She looked at me like I was totally nuts and said "
But she is bottle feeding." So I answered that normally in our
hospital, when a breastfed baby loses too much weight, "we" give him a
supplementary bottle of ABM, so obviously if a bottlefed baby is losing
too much weight we have to give him a breast.
But she argued with me that the mother has chosen not to breastfeed and
we have no right to force her to do so.
So I argued that this is true, but when a breastfed baby loses too
much weight, even thought the mother has chosen not to bottlefeed, we
scare her into giving a supp bottle to avoid intravenous feeds, we
frighten her that her baby will dehydrate, or worse, and sometimes we
even say that her baby will have to remain in the hospital even long
after the mom has gone home, and thus we are forcing her to give bottles
even though she has chosen to breastfeed. I begged for her to explain
the difference to me. She said that she just couldn't force the mom
breastfeed. ( By this time what I was saying was starting to sink
in, and I smiled as if I were joking, but I was dead serious.) "And now
you understand why it is so difficult and illogical for me to tell a mom
to give an artificial supplement, even if the baby is losing weight." (
They always beg me to convince the mom to give a bottle, because if I
say it they listen to me. )
So I asked her to teach me what she does when a bottled baby loses
weight. Her answer was logical:
- ask the mom how the baby is feeding, if he is sleeping through feeds
- watch how she feeds him to see if there is some problem with technique
- sit with the mom and explain how to hold the baby while he feeds, see
if he is sucking properly, etc. ( sound familiar?)
-check him to see if he doesn't have some other physical problem
-if all the above are ok, try another formula
So I asked her why our hospital gives preferential treatment to
bottlefed babies. She said that of course we don't. And I said if only
we would follow those simple steps when a breastfed baby lost weight,
before we crammed a bottle into his little mouth, we could make lots of
moms and babies much happier.
She said that I really opened her eyes with that "game" I played with
her. We have to start using two separate thinking methods with
breastfed and bottle fed babies. And not cross methods so easily.
There have been cases where we have asked mothers who chose not to
breastfed to reconsider because the baby can't digest anything else, but
only after trying everything else first. We have to convince them to
take the same stance with breastfeeders.
I am gearing up for another in-service for our nurses. I think only
lobotomy will really work. They want me to re-educate the entire
bottle-friendly staff in only 6 hours. HAH!!!!
Oops, sorry. I have to learn to write shorter messages.
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
mailto:[log in to unmask]
PS, need a roommate at the ILCA conference in Scottsdale!!
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