Dear Friends:
    The recent post about when to supplement brings up an issue that I have
encountered in my private practice.
    Many mothers who come to me for lactation help are waking their healthy,
term babies on some sort of 2 or 3 hour schedule. In my experience, babies
that are aroused from deep sleep don't feed well. They latch poorly and are
not very responsive. Imagine someone waking you at 2 AM and shoving a
sandwich in your face!
    These mothers are doing it because some hospital staff has impressed upon
them that the baby MUST feed every 2 or 3 hours. MUST! Where does this
interval come from? My guess is that someone has calculated that if a baby
should feed 8-14 times in 24 hours, this averages out to once every 1 1/2-3
hours. So baby should feed every 1 1/2 to 3 hours. The problem with this is
that people don't eat that way. Most newborns will cluster feed, and eat a
whole bunch of times in 2 or 3 hours, then sleep for a longer interval. The
baby is programed to eat when it needs to eat; this is a fundamental survival
skill. Problems arise when outsiders tamper with this mechanism.
    Insisting on an arbitrary feeding intervals undermines confidence, which
is the major factor in establishing breastfeeding. Mothers get an idea that
the baby won't wake to ask to eat unless they do it. This puts more pressure
on the mother to make breastfeeding "work." Phooey.
    Keep baby close to mother, preferably in her bed for the first few weeks.
Maximize skin to skin contact. Even babies born under the influence of
epidurals will latch on if left with their mothers for TWO hours after
delivery (Sepkoski study).
    For even better results, don't beat the baby up during labor and
delivery. Restrict drugs used in labor (Righard and Alade study). Teach
mothers infant feeding cues. Babies want to eat, they want to leave. They
also need to sleep.
    As I said, this applies to the healthy term infant. Not premature or
neurologically compromised ones.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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