> 1.  Does your NICU use test weights?
> 2.  If not, what indices are used to determine the amount of supplement
> to
> premies learning how to take breast milk meals?
> 3.  If your unit has breastfeeding policies, please share them.
>
I work in a level 2+ NICU. This is an issue that for us does not seem to
have one-size-fits-all answers. It requires judgment and  assessment
skills on the part of the nurse. Unfortunately this may also mean that
different nurses are doing different things.

We do use test weights, though I have heard mothers exclaim, "He weights
less than before I nursed him!" It can be very reassuring to the mom if
the weight does go up.

We try to individualize this. We have a chart based on weight that tells
us how much a baby needs to get to gain weight. If a baby nurses very
well, maintains a good latch and sucks well for a good period of time,
swallowing is heard, milk is visible, he might not be supplemented at
all. On the other hand, if he latches, takes a few sucks and then falls
asleep, he will get the full supplement. We do not cup feed preemies,
per the NANN position statement on this, available at <www.nann.org>.

We have LC's on the maternity staff who come in to the NICU and help the
moms, and we're looking into getting some of our nurses certified.

We do get moms and babies skin to skin when baby's condition allows it.
One day over the weekend we had 3 parents asleep in recliners with their
babies, which was very nice to see.

Hope this is helpful.


Anne Stringer, RN
Munson Medical Center NICU
Traverse City, MI USA

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