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Journal of Human Lactation
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Standing Feeding Orders in a Well-Baby Nursery: "Water, Water Everywhere..."

Deena R. Zimmerman, MD, IBCLC

Dept. of Pediatrics, UMDNJ-RWJ Medical School, 312B MEB, 1 RWJ Place, New Brunswick, NJ 08903 USA.

William R. Bernstein, MD

UMDNJ-Robert Wood Johnson Medical School

The objective of this study was to examine standing physician orders affecting healthy breastfeeding newborns for items not in concert with the "Ten Steps to Successful Breast-feeding." All order sets of physicians or physician groups (n=22) at a mid-sized hospital in central New Jersey (USA) (approximately 1200 deliveries/year) were reviewed. Seventeen orders called for water to be offered routinely as the first feeding. Five order sets called for two or more such feeds. Twelve orders gave infants nothing by mouth (NPO) for more than 2 hours and six mandated 4-hour intervals between feedings. Practices that undermine successful breastfeeding are still ubiquitous. Physician orders, in addition to hospital policy, should be targeted for improvement.

Key Words: Baby Friendly Hospital Initiative • breastfeeding • water

Journal of Human Lactation, Vol. 12, No. 3, 189-192 (1996)
DOI: 10.1177/089033449601200314
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J. H. Knopf
Article on Physician Advice Too Vague
J Hum Lact, December 1, 1997; 13(4): 275 - 275.
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