<so, tell me Jean and others. What would you say the important factors
are in
being able to tell the baby is getting milk (ie confirming milk transfer
-
note "confirming") while you watch baby feed? And do you see any one
factor
being more important than another?>
I wish I had a sure-fire answer, Ruth.
First, we are talking very small volumes in the hospital in most cases.
So hearing at least an occasional swallow is nice. But it too, is sort of
subjective, even on the part of the HCP, for some babies are just noisy
swallowers, even if little is being transferred.
I guess I have to say that deliberately eliciting an MER, or seeing
evidence of a spontaneous one, is a great positive sign to me, as once
again, the MER is the most important force in the process of milk
transfer. And if the milk occasionally leaks out the side of the baby's
mouth, so much the better.
Next, might be palpating the sinuses after the baby lets go. If the
sinuses were firm to begin with, and are much softer afterward, that's a
positive sign.
Also, teaching the mother breast compression is a first step in helping
her awareness of whether there is any change in the firmness of the
breast, especially of the upper-outer quadrant, where over 50% of the
glandular tissue is located.
It's also good for teaching her to observe the character of her baby's
jaw actions (hopefully wide excursions) in response to a renewed flow of
milk.
I'm sure there will be others I haven't thought of. (When push comes to
shove in desparate cases, test weighing would seem to be that one factor
more important than any other in the eyes of the HCP who is deciding
whether supplements are necessary.)
Jean
****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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