Re: Hospital Policies on Breastfeeding / Feeding Pumped Milk Post-Surgery

[Guest guest]

I have had numerous occasions to counsel RN's and physicians on this topic and I

have never had anyone 'overrule' the existing policy our organization has which

supports breastfeeding, and use of mother's breastmilk as soon as she arouses

and physically feels well enough to initiate a feed or pump.

I also print these policies out when I get to the unit, including the storage

and collection (milk goes into the pt. refrigerator on the unit floor,not in a

bio-hazard bag, gloves are not necessary etc. etc.) because I anticipate the

staff is unfamiliar with this and I want them to have the policy and ask them to

pass it on in future report and leave it with the pt.'s chart for future staff.

I work in a large city hospital as a LC. Of course we primarily serve the birth

center but we are called all over the hospital to attend readmitted

breastfeeding mothers (ED, ICU, PACU, med-surg, etc.).

Fay I would attribute the situation you are describing to potentially 2 things,

lack of staff education, and poor policy development.

If there are IBCLC's on staff in the facility I would start there and contact

them about how to work together to best serve readmitted lactating mothers.

Depending on the size of the facility, it can be a challenge to educate all

staff, regardless of where they work, to contact lactation services when they

are serving a lactating mother (not to mention we are not on staff 24/7). That

shouldn't excuse the facility from performing this education, everyone is

required to know how to call an emergency code, wash their hands, etc. etc.,

being familiar with lactation resources can be added to that required

new-hire/annual education.Unfortunately rather than explain they (the staff)

don't know how to advise the patient on compatibility of meds or anesthesia and

breastfeeding, but they will find out (page the consultant, refer to the online

organization 'readmitted lactating mother BF policy', check on Lactmed, refer to

Hale's guide, or call the Infant Risk center), they instruct pump and discard. I

think this is all just part of the overall low value our culture has for

breastfeeding and how our culture has 'normalized' formula.

The other issue is that of policy development. My facility has a policy for

readmitted lactating mothers that includes notifying the IBCLC for a consult,

accessing an electric pump for the mother, and collection and storage of her

milk (we incorporated accessing Lactmed into one of our annual clinical staff

education days for ALL clinical employees).

Incorporating the USBC Core Competencies in Breastfeeding Care and Services into

the education of all health professionals during their training will help

further the knowledge, skills, and attitudes of professionals regardless of

where they work in the health setting so they are better equipped to address

these types of circumstances.

H. Kinne BA IBCLC RLC ICCE CD(DONA)

www.CascadePerinatalServices.com

>

> I was horrified today to find out that one of our two local hospitals here

> in Vancouver, WA, forbids breastfeeding for 24 hours post surgery, and

> insists that any pumped milk be dumped. I am trying to find out if the other

> hospital has the same policies. Maybe I have been living with my head buried

> in the sand for the past 7 years (during which I have been doing

> breastfeeding counseling), but somehow this little " hospital policy " managed

> to sneak by me!

[Guest guest]

Just a thought- can it be overruled by BABY's doc?

 

I have had numerous occasions to counsel RN's and physicians on this topic and I have never had anyone 'overrule' the existing policy our organization has which supports breastfeeding, and use of mother's breastmilk as soon as she arouses and physically feels well enough to initiate a feed or pump.

I also print these policies out when I get to the unit, including the storage and collection (milk goes into the pt. refrigerator on the unit floor,not in a bio-hazard bag, gloves are not necessary etc. etc.) because I anticipate the staff is unfamiliar with this and I want them to have the policy and ask them to pass it on in future report and leave it with the pt.'s chart for future staff.

I work in a large city hospital as a LC. Of course we primarily serve the birth center but we are called all over the hospital to attend readmitted breastfeeding mothers (ED, ICU, PACU, med-surg, etc.).

Fay I would attribute the situation you are describing to potentially 2 things, lack of staff education, and poor policy development.

If there are IBCLC's on staff in the facility I would start there and contact them about how to work together to best serve readmitted lactating mothers.

Depending on the size of the facility, it can be a challenge to educate all staff, regardless of where they work, to contact lactation services when they are serving a lactating mother (not to mention we are not on staff 24/7). That shouldn't excuse the facility from performing this education, everyone is required to know how to call an emergency code, wash their hands, etc. etc., being familiar with lactation resources can be added to that required new-hire/annual education.Unfortunately rather than explain they (the staff) don't know how to advise the patient on compatibility of meds or anesthesia and breastfeeding, but they will find out (page the consultant, refer to the online organization 'readmitted lactating mother BF policy', check on Lactmed, refer to Hale's guide, or call the Infant Risk center), they instruct pump and discard. I think this is all just part of the overall low value our culture has for breastfeeding and how our culture has 'normalized' formula.

The other issue is that of policy development. My facility has a policy for readmitted lactating mothers that includes notifying the IBCLC for a consult, accessing an electric pump for the mother, and collection and storage of her milk (we incorporated accessing Lactmed into one of our annual clinical staff education days for ALL clinical employees).

Incorporating the USBC Core Competencies in Breastfeeding Care and Services into the education of all health professionals during their training will help further the knowledge, skills, and attitudes of professionals regardless of where they work in the health setting so they are better equipped to address these types of circumstances.

H. Kinne BA IBCLC RLC ICCE CD(DONA)

www.CascadePerinatalServices.com

>

> I was horrified today to find out that one of our two local hospitals here

> in Vancouver, WA, forbids breastfeeding for 24 hours post surgery, and

> insists that any pumped milk be dumped. I am trying to find out if the other

> hospital has the same policies. Maybe I have been living with my head buried

> in the sand for the past 7 years (during which I have been doing

> breastfeeding counseling), but somehow this little " hospital policy " managed

> to sneak by me!

-- Eden, BA, IBCLC, RLCLactation ConsultantAtlanta Breastfeeding Consultants, LLCwww.AtlantaBreastfeedingConsultants.com

(404)-590-MILK (6455)

[Guest guest]

I think that's an interesting question to ask.

She is probably admitted as a surgeon's patient. Not making excuses, I imagine

it's rare for people to take the initiative to contact a pediatrician

(especially on a weekend or evening) to discuss the case.

The just 'presume' formula is 'harmless' and it's no big deal.

It's an education thing...and it's a really unique situation also considering

the baby is not a patient either.

>

[Guest guest]

Now I know that many moms (and other people) automatically do as the doctor says, but if one goes in, fully informed, to the operation and knows when it will be safe to breastfeed wouldn't you just do it and not care what the doctor says? Or pump and save the milk, not dump it? How would the nurses or doctor know what you were doing when they are not in the room. Or even if they are can't you make your own decision and do what you want? I wouldn't not nurse my baby just because they said not to do so. Unfortunately, there was a time when I might blindly follow the doctors advice, also but knowing what I know now, they wouldn't stop me.

Cheryl

To: Sent: Friday, September 23, 2011 12:56 PMSubject: Re: Hospital Policies on Breastfeeding / Feeding Pumped Milk Post-Surgery

I think that's an interesting question to ask.She is probably admitted as a surgeon's patient. Not making excuses, I imagine it's rare for people to take the initiative to contact a pediatrician (especially on a weekend or evening) to discuss the case. The just 'presume' formula is 'harmless' and it's no big deal. It's an education thing...and it's a really unique situation also considering the baby is not a patient either.>

[Guest guest]

I completely agree! I really encourage anyone working prenatally with mothers to

reinforce that they should contact an IBCLC if they are ever being instructed to

disrupt or discontinue breastfeeding because it's our job to be in the know.

The challenge is two fold (maybe three, humor me here).....getting consumers

informed enough about the relevance of breastfeeding that they 'care' when it is

being disrupted, informing consumers that they should contact an IBCLC to get

accurate, informed information related to their circumstance if that's the case,

and then.....empowering mothers and their families to do it!

>

> Now I know that many moms (and other people) automatically do as the doctor

says, but if one goes in, fully informed, to the operation and knows when it

will be safe to breastfeed wouldn't you just do it and not care what the doctor

says?  Or pump and save the milk, not dump it? How would the nurses or doctor

know what you were doing when they are not in the room. Or even if they are

can't you make your own decision and do what you want?   I wouldn't not nurse

my baby just because they said not to do so. Unfortunately, there was a time

when I might blindly follow the doctors advice, also but knowing what I know

now, they wouldn't stop me.

>  

> Cheryl

>

>

[Guest guest]

Sigh - I tried to find the detailed reply that I sent to this msg, and it has

disappeared into thin air. So here goes again - plse forgive me if it actually

is a duplicate.

Thank you for the responses (both on and off list) to my concern - I felt very

supported!

I was incredibly relieved yesterday to discover that the info given by the staff

nurse on one of the non-Family-birth-Center wards (about the " hospital policy " )

was INCORRECT! Yay! It is NOT hospital policy - just ill-informed staff (as

K hypothesized). I'd hoped that was the case! I spoke with the head of

the FBC about the situation, and she said that she would pursue better educating

the hospital staff.

So now we are back to where I thought we were all along: educate the mom, so

that she can educate her doc and the anesthesiologist, if necessary. Wphew!

But this brings up a new question: an IBCLC, who spent an hour helping one of

the moms I mentioned, said that this service was not billable and that the

hospital would have to eat the cost. This isn't great for encouraging hospitals

to care for post-discharge breastfeeding moms well, if they need to be

readmitted for some reason.

K mentioned, " My facility has a policy for readmitted lactating mothers

that includes notifying the IBCLC for a consult, accessing an electric pump for

the mother, and collection and storage of her milk " . Considering that this is a

policy, I'd imagine that it is a regular occurrence. Is there actually some way

that they are billing for the costs involved? Is there any way to find out, so

that I can pass the info on to this local hospital?

Thanks!

Fay Bosman, IBCLC

www.nwmothernurture.com, Vancouver, WA

>

> Fay I would attribute the situation you are describing to potentially 2

things, lack of staff education, and poor policy development.

>

> The other issue is that of policy development. My facility has a policy for

readmitted lactating mothers that includes notifying the IBCLC for a consult,

accessing an electric pump for the mother, and collection and storage of her

milk (we incorporated accessing Lactmed into one of our annual clinical staff

education days for ALL clinical employees).

>

> H. Kinne BA IBCLC RLC ICCE CD(DONA)

> www.CascadePerinatalServices.com