Hi lactnuts I am thinking about developing a very short, 1/2 page bf "care Plan" to clip to the front of the nursery nurses' clipboard. This is to write out very distinctly the plan of care for the bf dyad, and the point is to eliminate the bf-sabotaging practices that still so frequently occur in our hosp. For example, recently an LGA baby w/ glucose 28 (confirmed by lab) was supplemented formula w/ a bottle. The same day, a baby who experienced very long, difficult labor induction due to maternal diabetes and macrosomia was born w/ tachypnea (10 lbs b.wt.). He was being fed by gavage but then the nurse gave a bottle as first nipple feed to see how he tolerated it (RR 60-70 at this point). Of course I could not believe this, and asked why the baby was taking a bottle; if he did not need to be gavaged, he could go to breast. Would all this make you want to resign? It does me. The care plan could say: Pt/family goals: exclusive bf Pertinent findings on assessment: colostrum easily expressed (or I like to chart ample colostrum). Care plan: Frequent unrestricted bf, rooming-in. If MD orders supplement due to low bld sugar, the supplement is to be given at the breast w/ supplementer tube or via finger feeding (parent to choose). No artifical nipples/bottles (we don't have pacifiers - thankfully!). Care plan initiated by: xxx, ibclc Do any of you use such a thing (care plan) and if so can you share w/ me or give ideas? Thanks. Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e.USA ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com *********************************************** 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