Loni et al --
this is certainly a problem of informed consent, and it's also a problem of
maternity unit policy.  Why did this nurse feel a need to give the baby any
supplement?  Was she following the orders of the baby's doc?  Does the
hospital have any kind of policy about how BF babies should be cared for
(e.g. no pacifiers, no ABM, etc)?  The hospital should have such a policy (I
know, dream on, Elizabeth).  These kinds of policies, along w/ some very
basic continuing ed for RN's (inservices, etc) on the benefits of BF, and
risks of ABM, make a huge difference.  I have seen it work at my previous
hospital.

Mind you, I know perfectly well that way too many hospitals are doing exactly
the same thing, including completely inadequate informed consent.  My brother
and sil just had twins in NYC, and one of them was put under bili lights at
36 hrs of age, given ABM by bottle (despite my long-distance urging that they
use gavage, finger feed or SNS at the breast if supplementation was truly
indicated), then pacifiers, then mom was offered "if you want to sleep
tonight, we'll bottle feedthe  babies"  w/o telling her the risks of that
(both re ABM and nipple confusion).  It only got worse after that.  AARGH!
I'm pleased to report that now both babes are nursing well, off ABM
altogether.

Elizabeth Steiner MD

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