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LACTNET  March 2000, Week 4

LACTNET March 2000, Week 4

Subject:

Re: Ethical Dilemma

From:

"Johnson, Martha (PHMG)" <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Mon, 27 Mar 2000 14:42:54 -0800

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (77 lines)

Dear Janet,
Yes, in our practice, we do share the hazards of artificial feeding openly,
beginning with the first prenatal visit, when all our pregnant moms receive
a handout titled "Choose Wisely".  The first item on it says, "Infant
formula is an inferior substitute for breastmilk." This page goes on to
outline some of the other hazards of artificial feeding, as well as the
benefits of bfdg.  Then at 28 weeks, we do an informed consent process with
each client.  This addresses which feeding method she wants for the time
after she delivers and before she goes home from the hospital or birth
center.  At that time, we also make sure they are aware of the bfdg support
services we offer, give more info on hazards and benefits, and refer them to
bfdg class, if it will be their first time to breastfeed.
  We haven't always worked this way, and it took time and education even for
our pro-bfdg staff of CNMs to fully support this approach.  It has really
helped, because it is policy, every expectant mom goes thru the same
process.  This means we don't cave into the temptation of not discussing
breastfeeding with those moms who we know didn't breastfeed their other
children.  It also has helped with reducing the number of our hospital-
birthing babies who get pacifiers, because the informed consent papers go
into the hospital record along with the rest of the client's prenatal
records, and we've pointed out to hospital staff that it's really not okay
to give those kids a pacifier when the mom has signed a consent saying she
doesn't want that to happen.
  So, Janet, hang onto your values, though it may be a long road, it's worth
the trip.
Martha Johnson RN IBCLC
Eugene, Oregon
-----Original Message-----
From: Stuart Black [mailto:[log in to unmask]]
Sent: Sunday, March 26, 2000 12:22 AM
Subject: Ethical Dilemma


Dear fellow Lactnetters:
I am writing a paper for university, the subject being an Ethical Dilemma.
Of
course I chose breastfeeding. My question to all of you is this: Do you
openly
share the information about the hazards of artificial baby milk with your
clients? Im not saying the benefits of breastfeeding here - the studies
showing
the potential hazards. I am not "allowed" to include this in prenatal BFing
classes. I am a contract employee working out of a Public Health Unit as the
Breastfeeding Consultant.

The old "we dont want to make anyone feel quilty" is in my face again. Also,
is it right to subject a woman to the "hazards" when so many things/people
stand in the way of her successfully BFing?

The Moms and Dads were most often not breastfed and "were all doing fine".
How
do you debate this? I tell them about longterm health benefits, that we
really
are not a very healthy society etc and that it is more than just milk.

Back to the original theme here - I am struggling with my own ethical
dilemma
here. Working on my BScN, considering Public health but watching people be
so paternalistic with women and their looking like the "good" Nurse because
they give the message that formula is just as good. Will I be selling out?
Can I trust this system with other areas of Public Health if so much info
given out regarding infant feeding is bogus?

We go to the meetings to explore ways to increase Bfing duration/initiation.
Am I going crazy here or what if we openly informed the public about the
potential hazards here, as we do for immunizations, carseats etc. I just
dont
get it.
Janet Black, RN,CBC, BScn student
Mission, BC.

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