I am a midwife with privileges at a BFI hospital. I am disappointed to see excessive amounts of formula being fed to term babies with and without risk factors for hypoglycemia. My most recent experience was a term baby with several risk factors and who demonstrated initial hypoglycemia, who was given 28 mL formula every two hours after delivery until blood sugar stabilized. The baby's mother was instructed not to put the baby to the breast, despite her desire to breastfeed and ability to independently latch the baby. The parents were instructed to keep the baby wrapped up rather than placed skin to skin and the mother was not supported to stimulate the breasts through hand expression or pumping at this time. This approach, which favours excessive amounts of formula over evidence-based interventions such as skin to skin or breastfeeding support in favour of long term infant feeding outcomes, does not account for neonatal physiology, CPS guidelines, or parent choice about infant feeding.

This is not the only experience I have had of nursing staff at this hospital practicing non-evidence based and non-breastfeeding friendly practice. The unit protocol for monitoring of hypoglycemia (which is applied to LGA, SGA, IGDM, and any babies who experienced significant resuscitation, ie. more than 20% of infants) maintains that parents are not to feed babies when they are demonstrating hunger cues, but to wait until after the nurse has taken the baby's blood sugar (every 2 hours). This is contrary to the CPS guidelines on hypoglycemia, which recommend that "frequent (on demand) breastfeeding should be encouraged for at-risk infants, and, if they are being formula-fed or supplemented, the volume of enteral intake should be adjusted based on an infant’s size, chronological age, and gestational age." I hope that BFI will investigate and revoke their status if they are not found to be upholding the expected standards.

The Provincial Authority for The Baby-Friendly Initiative

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