Can a nurse make the call to change a baby to soy formula?

Irishlass79 · Oct 3, 2011

There is nothing wrong with a nurse suggesting to change a formula however it depends on the issue. I wouldn't change the formula if the infant is being treated for a malabsorbtion issue or failure to thrive etc. Example: There is no order needed if a parent claims they don't have the money for the brand they are using, we just simply tell them a cheaper brand and help them with suggestions on how to change formulas.

merlee · Oct 3, 2011

A postpartum nurse usually only sees the baby for a day or two. Why would this happen so quickly?

Just curious.

Irishlass79 · Oct 3, 2011

Another example or a diet change would be when to wean the infant? Of course there are guidelines... a doctors order is not given to change the diet to solids and yet, nurses teach parents how to wean and much of the decision is based on the infants weight, eating habits, parents preference and beliefs.

Fiona59 · Oct 3, 2011

Is the OP mixing up post partum with Community Health Nurse?

It was at a monthly well baby checkup that they recommended we go to soy because he had what I thought was the worst case of cradle cap ever and turned out to be excema. Our doctor had told me it was cradle cap and not to worry, he was just a colicky baby, etc.

Community Nurse + soy formula = way less fussy baby.

Irishlass79 · Oct 3, 2011

I missed the whole postpardum nurse thing....looks like I need another cup of java.

DebblesRN, ASN, BSN, RN · Oct 3, 2011

I work in nursery, and we do change formula on occasion. If an infant is screaming a lot, spitting up large amounts of oatmeal consistency or "clabbered" appearing milk, and there is a family history of lactose intolerance, we change it.

Typically, you need an order in the hospital setting, our doctor's (with the exception of a few) don't care as long as baby is eating. The few that do care, we just document that mom REQUESTED soy due to history of lactose intolerance in the family, infant fussy and having diarrhea and/or large amounts of emesis.

Trust me, after working with babies for a while, you can sort out which ones are just fussers, and which ones have an issue with the formula.

I also counsel moms in the situation where baby is having the above symptoms and suggest that breastfeeding may be a better alternative altogether, especially since their baby's stomach is not happy with formula in the first place. :)

So--in answer to your question, TECHNICALLY, you need an MD order to switch formula, but where I work, the doctor's trust our judgement, and don't have a problem when we do.

Eagle2110, ASN, BSN, APRN · Oct 3, 2011

My daughter was born with an milk/soy intolerance. However, before it was discovered, it was always a pedi who recommended a new formula. Even if I spoke with a nurse first, she had to consult a doctor. I guess it was for the best that it went through a doctor because she evenually had to see a GI specialist, and where I live you can only see the GI specialist with a doctor's referral after all other formula options have been exhausted. Sorry for the rambling, but long story short, guess it just depends on where you live.

Mandychelle79, ASN, RN · Oct 3, 2011

When my daughter was in the NICU, the nurses changed her to soy, but they very well could have had an order for it. My son, started on Soy in the hospital, because of my daughters history. We switched to milk based, per fam doc recommendation, and when I went back to work and stopped bf all together, switched back to soy and had a different baby.

Isabelle49 · Oct 3, 2011

I don't think a nurse can prescribe a diet.

klone, MSN, RN · Oct 4, 2011

I don't think a nurse can prescribe a diet.

Correct. A diet order change in a newborn would have to come from the pediatrician (or the parents, but the pediatrician would still need to write an order for it if the parents aren't supplying and giving it themselves).

germanshep · Oct 4, 2011

We can change the formula at the request of the parent. The MD typically writes the order "Feed q 3 hours with 20-30ml of supplement" if the baby is losing weight/fussy/jaundice, etc. If parents ask my opinion, I typically recommend Good Start/Good Start Soy because of the glass bottle. All the mothers on WIC request Similac. We obviously follow an order if the MD writes for a particular brand.