In response to Laurie's query about model breastfeeding policies.  I believe
these policies were set up to counteract old hospital policies which involved
inadequate breastfeeding and rigid schedules - e.g., 5 minutes every 4 hours,
etc.  The "at least 8 times in 24 hours" and "every 2-3 hours for at least 15
minutes" or whatever were designed to provide a more realistic schedule for a
breastfed baby.  However, those of us who know breastfeeding know these can
only be rough guidelines; whereas a less knowledgeable nurse (or other HCP or
parent) will tend to interpret them literally and interfere with the natural
process too much.  That's why WHO's statement: "Place no time limitations on
breastfeeding" (or something to that effect) makes more sense to us.  Yet we
also know that hospital practices and birth events can make some babies
sleepy and disorganized for a day or two; and that some of those babies will
be compromised if we simply wait until they "demand"; or, as also happens,
allow moms to put off feedings indefinitely because they have visitors, etc.,
so that at the end of the shift we realize that the baby has not fed at all.
That's why our protocol (the one I sent you, Laurie) has statements such as
"Place no limitations on frequency or duration of feeds", followed by
elaborations such as : "Instruct and assist mothers to attempt to feed baby
at least every three hours", and examples of hunger cues, normal variations,
etc.  These are, in the guise of "what to teach parents" also intended to
teach nurses.    Miriam Levitt RN, IBCLC

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