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IrishIzCPNP, BSN, MSN, RN, APRN, NP 14,480 Views

Joined Jul 25, '06 - from 'Somewhere over the rainbow...'. IrishIzCPNP is a MSN, CPNP-PC, IBCLC, RLC. She has 'A whole bunch...' year(s) of experience and specializes in 'Pediatrics, High-Risk L&D, Antepartum, L'. Posts: 1,395 (35% Liked) Likes: 1,377

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  • Feb 17

    Quote from Spidey's mom
    Baby Friendly happened at our small rural hospital over 10 years ago but we were not given a script and we snuck pacifiers out to some moms and had formula too.

    I'm a huge proponent of breastfeeding but dislike the undo pressure I sometimes see put on new moms to not use formula and only breastfeed.

    My daughter-in-law had a baby two months ago and knew ahead of time she might have problems breastfeeding due to a previous breast-reduction surgery. But she wanted to try. After 4 days and an 11 ounce weight loss plus mommy-exhaustion, her mom and sister sent her upstairs to bed along with my son and took care of the baby by feeding that kid some formula!

    She's doing both now - breastfeeding first and then she does what she calls "topping off" with formula. The baby is fine.

    We don't have a staffed nursery at our hospital so babies have to stay with mom. Our little "nursery" is where the baby gets a bath and weighed and measured and the boys get circ'd. There is a rocking chair in there and when it is slow, I have been known to take the baby for vital signs and then rock the baby to sleep. Then I quietly slip the baby back into the room where the sleeping parents lay. We try to give them a break.
    And this is a great example of breastfeeding 11 ounce loss isn't a meaningful piece of information. The baby's initial weight needs to be know, the amount of fluids given to mom in labor needs to be considered before looking at weight loss.

    Also, "topping off" is a great way to ruin the breastfeeding relationship. If she wants to use formula...that's fine. If she wants to have continued to success with breastfeeding she needs to be careful with "topping off" because you can over-feed a baby and you can stretch their small stomachs. The baby should be able to get all the baby needs at the breast...if baby can't it is important to try and determine the issue whether it be a supply issue or an anatomical issue with either mom or baby.

    That fact that the kid is fine isn't a reason to not educate parents. This is all about ensuring parents are making an educated decision.

    The reality is that moms should be given more information at their OB appointments about breastfeeding and formula feeding...but sadly they aren't. So many moms come to the labor floor with a decision they made based off of information from a friend or a relative or something they found on google. These moms haven't been told the risks of formula. They also haven't been told ways to support their breastfeeding relationship if they decide to breastfeed. There is a lot of sabotage at the hospital level for breastfeeding moms and that is another key to the BFI...remove the barriers and the sabotage so that we can have more breastfeeding success.

    Formula is still there. Moms just get to make an educated decision...just like every other medical issue they will be faced with in their life or their child's life. We do need to make sure the information is presented as factual and not biased. We need to make sure that after mom is given the information and she has signed the consent form that we then support her with formula feeding and give her the tools to use the formula properly.

    The key is we are working towards educating these moms so they make an informed decision and also supporting and encouraging breastfeeding because we know the benefits.

  • Feb 17

    Quote from Nineteen84
    Fact based can sound hard and uncaring and result in parents feeling inadequate. If a parent is unsure about breast or bottle I'm more than happy to provide information on BOTH. If they have made up their mind I don't go in and tell them all the risks of bottle feeding.

    Also, I have found that many lactation studies are VERY biased. Think about where breastfeeding rates are higher (at least in the US)....upper middle class. Of course an upper middle class family is on the whole going to have fewer medical costs - it's very likely not the breastfeeding but preventative care, access to nutritious foods, etc. that's skewing these results.
    So we shouldn't educate when somebody has made up their mind? In what other field of medicine or nursing do we not educate a patient just because they have already made up their mind? That just isn't a good reason to not do our job of educating. We can't control their feelings but we can ensure they make an educating decision after we present factual information without bias.

    Seriously? So because you think that some of the studies are biased and that healthcare is cheaper for upper middle class that maybe breastfeeding doesn't have the benefits? Seriously? Plus, this isn't just about the benefits of breastmilk but also about the risks that are associated with formula feeding. We know these risks are valid.

  • Feb 4

    That isn't really a home birth gone wrong. That is a case of poor decision making. Safe home births are exactly and usually safer than in the hospital. If a mom makes a poor choice against medical advice it doesn't mean that choice is wrong for everyone.

  • Nov 25 '16

    I only want to do Peds so that's where I'm headed...primary care ped np. I'm probably going to to a post masters certificate in acute care down the road. I didn't consider FNP because I won't consider working with adults. Specializing too much can be an issue but i believe not specializing some can also be an issue.

  • Aug 31 '16

    Okay here we go...The program at Drexel is not easy. You will have moments of "wow this is hard" and "are you kidding me" and "do they have any clue what they are doing" and "wow she's an amazing instructor" and more. Be prepared for the full range of emotions.

    The first year has changed a little...they removed a class and then kind of put that into another. But overall the first year isn't bad.
    Patho...I had a GREAT instructor. I know others who had somebody who they were not fond of. That is the first class where it is in your best interest to LEARN everything. This isn't the patho you had before...LEARN!!!! You need to understand the material!!!

    Advanced Pharm...great instructor if you get Zarro. This is again a class where you will need to make sure you learn the material but Zarro is wonderful.

    Pharm for peds...this class was rough but the instructor is VERY approachable. You will see this instructor again in the last year. She is a very nice lady, very approachable, down to earth and just nice.

    The assessment class for peds also has some great instructors and really isn't a bad class. Learn the material...there are no tricks here. The final check out...know exactly what they tell you to know. There are no just have to know the process. The nerves are what get you...but the instructors aren't looking for fail you. The instructors are really just making sure you are following the process and not missing an assessment. These instructors are also super sweet and approachable. If you have an issue or are confused...let them know because they will help you.

    Now watch that elective in your first year!!! FYI...later on you may need to take more electives. You need 4.5 credits in order to qualify for financial aid. So your first 3 quarters in the 2nd year won't qualify for financial aid. So what do people do? Well some pay in cash or drop. Then the rest of us take an elective for those 3 other quarters. That ends up being 3 quarters of electives. There are a few certificate programs that are 4 you can end up taking all 4 classes between the elective you need and the 3 quarters of needing financial aid and get a certificate out of it. There is a certificate for complementary therapies and an autism one (I think this is 4 classes). So keep that issue in mind when picking your may change how you do things if you need to take the extra classes for financial aid.

    Preceptors....I will be honest that finding your own can be a nightmare. NIGHTMARE. They say everyone always gets a preceptor...that doesn't mean you aren't going to bust your butt finding somebody. I have easily spent 20 hours looking for a preceptor for just the first 2 quarters and with at the times I hear "no" I am kind of at a loss of who to turn to for the last 2 quarters. You will want to formulate a plan of need to expect to work to get preceptors. You need to know this can take a lot of "man hours" on your part. Be prepared...finding preceptors is not easy.

    Be prepared to spend a lot of time on are not going to breeze through this. I found my RN to be not so bad, my BSN to be mostly easy....this is none of the above LOL This is work. The quarters for prepared to spend 16 hours at your clinical site each week plus you will have class one night a week for 3 hours. They expect you to be there. If you are working full time and have a TON of will probably need to cut back. You are going to need to have some flexibility. Oh you also have mandatory class online for the peds pharm and the assessment class.

    Hope this helps!