there is no logical reason why what what kathleen suggests cannot be done
(test weighs, adjustikng iv intake to accomodate breastmilk intake, etc.),
but, my observations about the NICUs here include responses such as "we can't
do that" (why not? that scale thatso you just heft them in your hand to
guesstimate how much they weigh?) and "the doctor says you can't finger-feed
because there is no way to measure how much they take" (oh, really? what are
those funny little markings on the side of the finger feeder, then? what do
they mean? ancient writings in a language we now longer understand?) and out
and out refusals to use breastmilk "formula is better, we know how many
calories are in it, and this is special preemie formula," "we couldn't find
mom's milk in the freezer" (didn't check carefully enough, you can guess what
i tell clients to do now), and "the milk sat out too long (for a healthy
baby)" (sat out for an hour, boy, that's really dangerous).

since i don't work in these hospitals, and for some strange reason the LCs
that work for these hospitals seem to be barred from the NICU, there is not
much way to try to change things, other than by setting an example ("she's
the SECOND mom who wanted to use donor milk!" yeah, its really bizarre, its
such a strange thing and so difficult to obtain since the milk bank is one
block down the street).

frightened and uninformed parents are not likely to protest about policies
that they don't even know are harmful (and boy are they angry later). that's
why i like the concept of "informed consent." such as "we want to give your
baby formula by bottle instead of having you breastfeed. we want to do this
because we don't really think it makes any difference if you breastfeed, and
we can tell from the statistics that you are highly unlikely to ever
successfully breastfeed this baby anyway, because of our policies; it doesn't
matter if your baby is at a much higher risk of getting NEC and other
life-threatening diseases or complications because, heck, we put in g tubes
every day and you can still feed your baby that way for the rest of his life
after he loses a bunch of his intestines from the NEC, and they don't all
die, anyway; we know you can't be here to breastfeed every time the baby is
scheduled to eat because we do everything we can to drive you away and make
you really uncomfortable when you ARE here, so you can't exactly expect US to
nurse him when you are gone, and we don't know how to use anything except
bottles; if you try to feed the baby, we can't measure how much he gets and
you take so darn long since we don't know how to teach you anything that will
help with breastfeeding, so your baby gets too tired and has to go back in
the isolette to REST (and you can't do kangaroo care), and anyway,
breastfeeding is so stressful and tiring to your baby that, even though some
nut published some so-called scientific studies showing that bottlefeeding is
more dangerous and more stressful and more tiring, we are going to insist
that it is really breastfeeding that is worse, and that when you insist on
"doing that" you are really causing your baby to get so overtired that he
might die; and if all those things haven't convinced you about why we oughta
to give your baby formula, just remember, if he's a preemie, he's already
gotten some in the form of "fortifier," which we put in your milk because it
isn't good enough, so it won't matter if he gets more formula now anyway, and
if he has allergies and all those other health problems for the rest of his
life that we know are associated with introduction of formula, well, so what?
lots of people have those things and still live their lives. what are drugs
for, anyway?

pardon me, you can see i just can't stop. and while those that do this kind
of stuff seem to believe that they support breastfeeding, it just ain't so.
they are willing to indulge moms about breastfeeding "if" everything else is
okay.

carol brusssel IBCLC

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