Hi all,

I posted a brief "table" of what a newborns stomach capacity is at day 1 thru 
day 4 based on weight in grams.  I taped the paper to the formula supply 
cupboard in the nursery in the hopes that the nurses don't drown the day old 
infant with 60cc of formula.  

Unfortunately, I can't be their 24 hours / day and their are time when 
supplementation may be necessary.  Of course more way more overused and 
abused, and we have a fairly reasonable staff.  Anyway, my point is if they 
have to use ABM at LEAST try 10cc so the babies don't go into that drugged 
sleep and stop looking for mom.  We have our share of babies that have low 
blood sugars and there is nothing I can do about this, or the jaundice babies 
whom the physician says to push fluids to clear the jaundice, and I come on 
to do rounds only to find these day old babies have had 60cc. geez.  Then the 
moms ask me why the baby won't wake to breastfeed.  Then they ask me why 
do the nursery nurses give so much formula if it should only be a little bit.. and 
then we get complaints from pts because they get too many mixed messages 
and non-consistant information.
So like many of you other hospital LC's, I walk a tightrope.  Trying not to 
discredit the nurse who I am following, but gently explaining how to slowly 
decrease formula, and keep the baby skin to skin.  And yes the baby will want 
to eat all the time because thats what babies do.  Especially, if their bellies 
are distended due to all that ABM.  I don't say that but I want to.  At this 
point I just try to help with all I have to the moms that REALLY want to 
breastfeed.  These are the moms who usually succeed.  I don't have the time 
or energy to try to talk someone into nursing, getting the baby latched hurting 
my back only to come back the next day and have them tell me they decided 
to bottle feed.  

Sorry I'm crabby today...   point is keep something around to remind staff that 
babies tummies are small and they dont need tons of supplement.  Some of 
the nurses really like it some don't care at all.  Thats life.  I also have a 
algorythnm of when to call the LC.  It is very well written.  I can't take credit 
for that one.

Sorry for the long rant...Worked till 2am and got my taste of what happens on 
night shift.
robin

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