When I walked into the nursery this morning , one of the nurses said she has a "naughty" baby, i.e. one who has lost too much weight. According to his chart, he had lost almost 8% of his birth weight by day 2. I flipped the page to see what has been happening with the breastfeeding and guess what.....he is a bottle baby, and never got breast milk in his life, poor kid. I told the nurse that he is a bottler, and I would go call the mom to give him a supplement. She asked me what supplement and I said a breast, of course. She looked at me like I was totally nuts and said " But she is bottle feeding." So I answered that normally in our hospital, when a breastfed baby loses too much weight, "we" give him a supplementary bottle of ABM, so obviously if a bottlefed baby is losing too much weight we have to give him a breast. But she argued with me that the mother has chosen not to breastfeed and we have no right to force her to do so. So I argued that this is true, but when a breastfed baby loses too much weight, even thought the mother has chosen not to bottlefeed, we scare her into giving a supp bottle to avoid intravenous feeds, we frighten her that her baby will dehydrate, or worse, and sometimes we even say that her baby will have to remain in the hospital even long after the mom has gone home, and thus we are forcing her to give bottles even though she has chosen to breastfeed. I begged for her to explain the difference to me. She said that she just couldn't force the mom breastfeed. ( By this time what I was saying was starting to sink in, and I smiled as if I were joking, but I was dead serious.) "And now you understand why it is so difficult and illogical for me to tell a mom to give an artificial supplement, even if the baby is losing weight." ( They always beg me to convince the mom to give a bottle, because if I say it they listen to me. ) So I asked her to teach me what she does when a bottled baby loses weight. Her answer was logical: - ask the mom how the baby is feeding, if he is sleeping through feeds - watch how she feeds him to see if there is some problem with technique - sit with the mom and explain how to hold the baby while he feeds, see if he is sucking properly, etc. ( sound familiar?) -check him to see if he doesn't have some other physical problem -if all the above are ok, try another formula So I asked her why our hospital gives preferential treatment to bottlefed babies. She said that of course we don't. And I said if only we would follow those simple steps when a breastfed baby lost weight, before we crammed a bottle into his little mouth, we could make lots of moms and babies much happier. She said that I really opened her eyes with that "game" I played with her. We have to start using two separate thinking methods with breastfed and bottle fed babies. And not cross methods so easily. There have been cases where we have asked mothers who chose not to breastfed to reconsider because the baby can't digest anything else, but only after trying everything else first. We have to convince them to take the same stance with breastfeeders. I am gearing up for another in-service for our nurses. I think only lobotomy will really work. They want me to re-educate the entire bottle-friendly staff in only 6 hours. HAH!!!! Oops, sorry. I have to learn to write shorter messages. Esther Grunis, IBCLC Lis Maternity Hospital Tel Aviv, Israel mailto:[log in to unmask] PS, need a roommate at the ILCA conference in Scottsdale!! *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html