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From:
Linda Madsen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 11 Apr 2010 21:18:33 -0700
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Another general rule to remember when charting is try to use plain language. Some of the people who may be doing the reviewing unfortunately may have limited maternal child health experience. Chart as if a lay person will be reading your notes.

I don't think every late preterm needs to be separated from his parents in the NICU--I like giving them the benefit of the doubt until he proves which way he'll go as he will be much better off with as much time possible with mother. As for Henya's example of the mother who may be ambivalent about breastfeeding--another few days in the hospital will not fix that problem. If she isn't willing to room-in and the baby can safely feed by another means, then there isn't a reason to continue the inpatient stay.

I haven't seen any charts with it written for babies to take two consecutive "successful" feeds prior to going home...I'm not even sure how that would be objectively quantified...and I cannot speak to how any other plans.  Of course, this is far from the only AAP or other governing body guideline to be torqued around by outside interpretation. I think the two bottle feed rule may belong in the same book of mythology  that had us bottlefeeding premature babies before letting them go to breast for so many years.

On my wish list: Ban elective c-sections before 39 weeks.  Some may act mature, but  how many have been harmed for convenience sake. Stop force feeding of babies. We have all known the staff members who could pump 45 ml of formula into almost anyone. If no one was assaulted that way, then the bottle would stop looking like the magic cure-all to some. If a baby does feed effectively whether at the breast or by artificial teat, it needs to worked up sooner rather than later. I also have a dream about formula vending machine.  Moms come into the hospital toting their own breasts; why should we be providing them a substance that can be harmful.  Parents could start bringing their own formula; bottles; etc., with them or hit the vending machine in the hall. In dreamworld, we would have enough donor milk for those had a need.

Oh well, it's getting late here & I have to be at work bright & early.

Linda Madsen



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