What if new moms had to sign a waiver? - Mothering Forums
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#1 of 225 Old 06-05-2009, 04:00 PM - Thread Starter
 
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Here's an idea: what if every hospital maternity ward asked every new mother: "Do you want to breastfeed, or would you rather we feed your baby formula? The choice is up to you." Then if the mom said, "Feed my baby formula," the hospital would say, "Sure. Here are some free samples. You just have to sign this waiver first." The waiver would go something like this:

I am aware that by choosing to feed my baby formula instead of breastmilk, I am increasing his risk of dying of SIDS, lowering his IQ, increasing his risk of contracting diseases in infancy, increasing the severity of those diseases, increasing his risk of diseases in adulthood, increasing his risk of allergies...[We'll have to work on the exact wording here, since there are just so many risks to formula feeding, we have to pick and choose lest the waiver be too long.] I am also aware that by not breastfeeding, I am increasing my own risks of breast cancer, ovarian cancer, endometrial cancer, uterine cancer, osteoporosis, rheumatoid arthritis, and obesity.

If my baby or I becomes sick or dies as a result of this hospital feeding my baby formula, I will not sue this hospital.

Signed: Date:

Psychology studies have shown that people will make the right choice when it's the default, and making the wrong choice requires checking a box. If people realize that breastfeeding is the normal thing, and formula is dangerous enough to require a waiver, they might be more likely to make the right choice.
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#2 of 225 Old 06-05-2009, 04:06 PM
 
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What if the mother in question is undergoing chemotherapy or has CF or hypoplastic breasts or has lost her breasts to cancer? Would they still have to sign the waiver? What about adoptive mothers? Should they sign too?

Formula has a purpose. Plenty of us who have had to use it feel immense guilt about it and do not need to be reminded that it is the inferior choice. Plenty do feel it is the default choice and that is more than unfortunate.

For many of us, the consequence of not using formula is the starvation of our child.

Formula is a tool that should be used judiciously and really isn't in our society, but I really dislike the idea of every mother having to sign a waiver. I think we can be lactivists without being anti-formula.

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#3 of 225 Old 06-05-2009, 04:20 PM - Thread Starter
 
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As I said in the first paragraph, this waiver would only be presented after mothers had made their choice, which implies they have a choice to make. If they have no choice, obviously they wouldn't need to sign a waiver about their choice.

Although this does bring up another issue: why do such women have no choice? If someone needs a blood transfusion, there are banks of donated blood for them. Hospitals don't make them get by with some inferior artificial blood. Ideally, society should have human milk banks as an alternative to formula. Then mothers who can't breastfeed actually would have a choice.

I think this is a separate issue, which would be best served by a separate thread. This waiver would only apply to women who have a choice, so let's discuss that in this thread.
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#4 of 225 Old 06-05-2009, 04:41 PM
 
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Surely you're joking.

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#5 of 225 Old 06-05-2009, 04:47 PM
 
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At the hospital where DDIL had her baby, they give out something very much like that at prenatal check-ins. The mother is given a form on which she checks off her infant feeding preferences, on which is printed out a statement that babies who do not receive breast milk are more likely to get juvenile diabetes, certain childhood cancers, obesity, diarrhea, colds, ear infections, allergies, exzema, or bowel disease, and are more likely to be hospitalized in the first year; that mothers who BF are less likely to have PP bleeding problems, are more likely to lose their pregnancy weight sooner, and have a reduced risk of breast cancer, ovarian cancer, and osteoporosis. It also includes a comment on the immune properties of colostrum and breast milk. The statement concludes: "Sometimes formula is necessary, and can even be life-saving, but it is better to avoid it when possible." Every pregnant woman who comes in is asked to read this before filling out her feeding preference form.
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#6 of 225 Old 06-05-2009, 04:53 PM - Thread Starter
 
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Surely you're joking.
Um, which one of us, about what? Pumpkinhead seemed to think that maternity ward nurses would ask a mother who had lost both breasts to cancer if she wanted to breastfeed. I guess clueless nurses might, but I'm not one to engage in such gallows humor.

Some hospitals require a woman to sign a waiver before they'll let her try a VBAC. If one of their patients is choosing to engage in behavior known to be risky, why shouldn't they make her sign a waiver first?
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#7 of 225 Old 06-05-2009, 04:56 PM - Thread Starter
 
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At the hospital where DDIL had her baby, they give out something very much like that at prenatal check-ins.
Awesome! I wondered where this hospital is, and then I noticed you're from Canada. Could you send some missionaries down here to civilize us?
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#8 of 225 Old 06-05-2009, 04:58 PM
 
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Sorry to be unclear. My remark was directed to you, TheLoud.

Women who plan to BF don't need the waiver. If your point is to change the mind of women who plan to FF, is a sledgehammer a better persuader than education and support? I don't think so, imho.

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#9 of 225 Old 06-05-2009, 04:59 PM
 
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i am actually surprised you don't already have to. not a waiver to allow FF but a waiver to allow someone besides you to feed your baby. the night nurses while i was in the hospital were really gung ho about having the babies sleep in the nursery. i kept saying no and they kept asking me and asking me over and over again. they said they would finger feed him. i finally gave in and then found out i couldn't sleep without him.

so i don't know why they were so enthusiastic about the babies being in the nursery but since they are i guess hospitals don't really see a problem with it. my cousin spent every night in the nursery while they were in the hospital. she bf for a week or two after that but thats it. it seems like it could be a liability though... who knows maybe its included in the other wavers.
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#10 of 225 Old 06-05-2009, 05:02 PM
 
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Sorry to be unclear. My remark was directed to you, TheLoud.

Women who plan to BF don't need the waiver. If your point is to change the mind of women who plan to FF, is a sledgehammer a better persuader than education and support? I don't think so, imho.
this is sort of what i thinking about when i said the night nurses really pressured me to let them take DS while i slept. for a mother who wants to breastfeed but doesn't know that bottles or w/e interfere or doesn't know about supply and such she may let the nurses take her baby at night and then have trouble bfing because of that.
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Originally Posted by TheLoud View Post
I am aware that by choosing to feed my baby formula instead of breastmilk, I am increasing his risk of dying of SIDS, lowering his IQ, increasing his risk of contracting diseases in infancy, increasing the severity of those diseases, increasing his risk of diseases in adulthood, increasing his risk of allergies...[We'll have to work on the exact wording here, since there are just so many risks to formula feeding, we have to pick and choose lest the waiver be too long.] I am also aware that by not breastfeeding, I am increasing my own risks of breast cancer, ovarian cancer, endometrial cancer, uterine cancer, osteoporosis, rheumatoid arthritis, and obesity.

If my baby or I becomes sick or dies as a result of this hospital feeding my baby formula, I will not sue this hospital.

Signed: Date:

Psychology studies have shown that people will make the right choice when it's the default, and making the wrong choice requires checking a box. If people realize that breastfeeding is the normal thing, and formula is dangerous enough to require a waiver, they might be more likely to make the right choice.
I don't think that many psychology studies have been done in labor and delivery wards.

The verbiage you suggest is strikingly similar to what I recall of the waiver I was required to sign before I had an epidural. Additionally, three weeks before my due date, my OB gave me an informed consent form in which it was explained that, as a result of being pregnant and giving birth, I might suffer and die. The exact forms that my suffering and death might take were laid out in some detail, with the probabilities of occurrence for each type of suffering and death helpfully provided. I signed both forms.

So first, I think that new moms giving birth in hospitals have seen enough scary forms in the recent past to cast their eyes over yet another one, roll those eyes, and sign. And second, I think this waiver is totally insulting to women who choose to, or need to, formula feed for whatever reason.

Hospitals are not all that good at distinguishing mothers who have a choice from mothers who don't. Indeed, the one may not be readily distinguishable from the other. If you have severe and intractable undersupply issues, you aren't going to know that on admission. If you had a double mastectomy in New York in your twenties, the records might not be in your file in Boston ten years later (and the L&D staff might not have time to review those records in detail and might not see it even if it was there, and if you have reconstructive implants, or are small-framed and they assume you're just flat... no, they can't tell just by looking). If you have a history of traumatic sexual abuse that means you cannot bear your breasts to be touched, you might not have mentioned it to anyone. So I think we have to assume that *every* mother, regardless of her ability and regardless of her actual feeding choices, would wind up asked to sign this waiver.

We do have human milk banks, to which there are a shortage of donors. Milk from banks is available by prescription only, generally at some cost to recipients (the last quote I heard was $3 an ounce, but that was years ago, I'm sure there's some financial assistance available for desperate cases), but there isn't nearly enough of it to be given to every single infant who is not breast fed.

By a strange coincidence, blood banks also face shortages all the time. THe day they invent a usable substitute for human blood, the Red Cross and every ER staff in existence will throw the world's biggest party. Because there is no such substitute, some people who would benefit from transfusions can't have them.
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#12 of 225 Old 06-05-2009, 05:20 PM - Thread Starter
 
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Women who plan to BF don't need the waiver.
They'd never even see the waiver. Is the first paragraph of my original post not showing up or something?

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If your point is to change the mind of women who plan to FF, is a sledgehammer a better persuader than education and support? I don't think so, imho.
I completely agree with you. Of course education and support would be much, much better than this, but do American hospitals provide such? No. Read 1littlebit's posts. Did those nurses have any clue about how to establish a healthy breastfeeding relationship? No. Will hospitals provide education and support any time soon? No. That would require a huge program to reeducate hospital personnel and change a lot of policies.

What do hospitals do? They do surgery, provide drugs and formula, and try not to get sued. They are not in the education and support business. That's why a sledgehammer like this waiver would fit right into their existing policies and procedures.
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#13 of 225 Old 06-05-2009, 05:29 PM
 
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They'd never even see the waiver. Is the first paragraph of my original post not showing up or something?
It shows up fine. I, at least, think that most hospitals would ask all mothers to sign it anyway.

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I completely agree with you. Of course education and support would be much, much better than this, but do American hospitals provide such? No. Read 1littlebit's posts. Did those nurses have any clue about how to establish a healthy breastfeeding relationship? No. Will hospitals provide education and support any time soon? No. That would require a huge program to reeducate hospital personnel and change a lot of policies.

What do hospitals do? They do surgery, provide drugs and formula, and try not to get sued. They are not in the education and support business. That's why a sledgehammer like this waiver would fit right into their existing policies and procedures.
No, that's why a sledgehammer like this would have no effect on women's choices.

If the hospital gives you this waiver to sign about your feeding choice, but offers no education or support for the alternative feeding choice, well then, gosh, there you are with a waiver in your hand that says all kinds of awful things and no more idea of how to have a successful breastfeeding relationship than you had before you read it. And you just had a baby, so you're knackered, you've got hormones running through you that make puberty look like a walk in the park on a sunny day, and depending on how the birth went you may feel, physically, anything from just peachy to remarkably like dog vomit. You may or may not be on morphine. If there isn't a lactation consultant on staff and you don't already know where to find one, you are unlikely to feel up to doing this piece of research now. If you said, fine, I'll formula feed, you may now be extra grouchy, but you are no closer to breast feeding than you were before you saw the form.
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#14 of 225 Old 06-05-2009, 05:51 PM
 
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I'm all for educating health professionals, changes hospitals so they are baby-friendly, providing education and support, pumps and pillows, household help, whatever it takes.

I'm opposed to harassing women who've just given birth.
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Do you find that guilt trips and threats are a good way to change your kids' behavior? Or do you only recommend that for other adult women?

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#16 of 225 Old 06-05-2009, 06:21 PM
 
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Holy smokes - is this for real? I have to tell you, it is truly disheartening to see posts like this. Just like chfriend said...I'm opposed to harrassing women who have just given birth and Rivka5 has an excellent point too. Why do you feel the need to pick like that? Sure, we all want to see bf the norm but throwing stuff out there like your original post is not going to get the job done. No matter what, there are women who will FF. I had to supplement my 3rd child and it nearly killed me. It got to where I wouldn't even check this forum for fear of seeing crap like this. Why don't you concentrate on setting a good example? Try a little compassion. Breast feed in public whenever and wherever you can. Gently and intelligently answer questions. Praise breastfeeding women...anything but guilt trips. Whew.

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Why don't you concentrate on setting a good example? Try a little compassion. Breast feed in public whenever and wherever you can. Gently and intelligently answer questions. Praise breastfeeding women...anything but guilt trips. Whew.
This. And none of my 5 children have *ever* touched a bottle, let alone any formula, but frankly I think the idea of making a woman sign a waiver like that is ridiculous. What would the consequence be if the mom refused to sign it? Call CPS, let the baby go hungry, or what???
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#18 of 225 Old 06-05-2009, 06:32 PM
 
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I think we can be lactivists without being anti-formula.
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I'm opposed to harassing women who've just given birth.
Holy crap yes to both!! Esp the second! For those of you who gave birth in the hospital, think back to what you remember... I remember labour and birth and..... sleeping.... pooping for the first time PP..... going home. If DH wasn't there, I would probably still be in the hospital because they apparently came in, told me I was going home at 2, and I totally never heard them. DH had to fill me in on why he was bring in the carseat at 1:30

I would like to see an environment where formula isn't viewed as an 'option' as much as a medical supply. I think they should move it from the baby isle to the pharmacy. There are lots of people on insulin, but you can't just pick it up in the candy isle.

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#19 of 225 Old 06-05-2009, 06:40 PM
 
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What do hospitals do? They do surgery, provide drugs and formula, and try not to get sued.
Some do, yes. But ime, it was not true. I've had two hospital births, both unplanned, and both went very well and I felt the staff was very supportive. There was no formula pushing by the nurses. We did get the sample bag with the first one, but not the second. Both times the lactation consultant came to my room, presumably by request of the staff because I did not ask her to come. She was nothing but helpful.

Okay, so we obviously still have work to do in educating many hcp's, but I think we have a better chance of doing *that*, than we do of getting them to agree to have their patients sign a waiver.
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#20 of 225 Old 06-05-2009, 06:43 PM
 
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I'm all for informed consent, and I think that all women should know the risks of formula feeding. IMO prenatal visits are the best time for health care providers to pass on this information.
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#21 of 225 Old 06-05-2009, 06:45 PM
 
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Eh, I don't think it's so bad. It's just a waiver, we would sign for other medical interventions. And the hospitals give such crap breastfeeding advice, even crappier support, and then wash their hands of the whole issue coz they pressured mama to put baby up to her breast at least once so they could tik\c off the 'breatfeeding initiated' box. Might warn mamas to not take nurses' 'a little formula won't hurt, just til your milk comes in' advice so damn trustingly.
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#22 of 225 Old 06-05-2009, 06:52 PM
 
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I'm all for informed consent, and I think that all women should know the risks of formula feeding. IMO prenatal visits are the best time for health care providers to pass on this information.
I was just wondering about this. Do they not generally do this? I've only had midwifery care, so I don't really know what goes in a typical OB visit, but isn't there any discussion of care for the child, breastfeeding, etc...

And ftr I am not at all opposed to the idea of handing out a sheet or booklet on infant feeding practices which details why breast milk is the best option and the risks of formula feeding.
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#23 of 225 Old 06-05-2009, 07:02 PM
 
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This is all along the same lines as the whole "what if formula was only available by prescription" argument.

Formula is not dangerous. "Not breastfeeding" is dangerous. If a woman is unable or unwilling to breastfeed, or needs to supplement, formula is the 2nd safest choice (after donated human milk.) If you restrict access to formula, you're not going to make more women breastfeed. It's more likely to result in more babies being fed innapropriate breastmilk substitutes, such as plain whole cow's milk.

I'd love to see human milk banks expanded. If they'd let women with babies over a year old donate, I think we'd have a whole lot more breastmilk available.

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#24 of 225 Old 06-05-2009, 07:03 PM
 
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I don't think it's such a bad idea either.
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#25 of 225 Old 06-05-2009, 07:18 PM
 
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I was just wondering about this. Do they not generally do this? I've only had midwifery care, so I don't really know what goes in a typical OB visit, but isn't there any discussion of care for the child, breastfeeding, etc...
In my experience (in Canada) it is often left to a 'so, how do you plan to feed your baby?' with no information other than 'breast is best'. In general I think family doctors are more likely to give more info than OBs, and midwives give the most information.

I had an awesome family doc in the last city I lived in who talked about brestfeeding with women during their annual exam. She said that it gave her a chance to talk about it naturally when she did the breast exam, and allowed her to get not yet pregnant women thinking about it at least.
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#26 of 225 Old 06-05-2009, 07:20 PM
 
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Total crap info in the mainstream medical sector - both a lack of info and misinformation. Hospitals are notoriously breastfeeding unfriendly, including the ones that have that 'breastfeeding friendly hospital' designation.
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#27 of 225 Old 06-05-2009, 07:25 PM
 
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In my experience (in Canada) it is often left to a 'so, how do you plan to feed your baby?' with no information other than 'breast is best'. In general I think family doctors are more likely to give more info than OBs, and midwives give the most information.
Hmm... maybe they should be giving out copies of The Womanly Art.
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#28 of 225 Old 06-05-2009, 07:39 PM
 
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I do know hospitals in New Zealand have an informed consent form for people to sign if their newborn is to recieve infant formula in the hospital. The informed consent does not discriminate against mothers who choose to feed their babies that way or mothers who as a previous poster said, have had double mastectomies. In either case, both groups of women, no matter who wishes it wasn't so, have babies who are at increased risk of the various negative health outcomes that occur in babies fed infant formula.

There certainly are risks and benefits to most things. Having an epidural is one a previous poster mentioned. While I do not want to side track this thread, if hospitals already require you to sign for this, then what is the difference here? Do people think that signing a form requiring the woman to at least think about the risks along with benefits of getting an epidural- however briefly- is akin to making women go through a guilt trip about having an epidural? No, it is not. And, if you really do need an epidural, it doesn't take away the risks of epidural. So why get all up in arms about this kind of form?
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#29 of 225 Old 06-05-2009, 07:51 PM
 
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Reminds me of the waiver I signed at my pediatricians when I declined to vax on schedule.

Except then I hadn't been up for 26 hours, wasn't in significant pain and didn't have bizarre new hormones coursing through my body. A time like that is not the appropriate time to "educate" someone.
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#30 of 225 Old 06-05-2009, 08:09 PM
 
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i suppose they could have you do it when you sign all the other papers. there are enough of them it might be squished in there somewhere already refusing to sign it would be a good way to prevent the hospital from trying to slip the baby some formula.
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