Thanks, Chayn, and for everyone who discussed this earlier.  When I sent in
the comment, I meant it to be a question - "Is it EVER medically necessary
to give a baby anything but the breast in the first 48 hours, if the mother
is breastfeeding
?"  but it turned into my little rant and the question was never really
asked.

If you want to have all your enrage-glands turn on, read this incident:
http://www.msn.com/en-za/news/featured/newborn-forgotten-in-incubator/ar-AAe957R

However it highlights the fact that healthy full term babies are remarkably
resilient.  It reminded me of the Mexican City earthquake in 1985 where up
to 40 babies were pulled from the rubble of hospitals, one as late as 9
days after the quake.  There are countless stories like this about
earthquakes - mostly in warmer places where it was obviously possible for
the babies to stay warm enough to survive.

Last night the question became relevant again.  A pregnant woman in our
antenatal classes wanted information on expressing colostrum antenatally,
as she has Type 1 Diabetes and was told that as soon as the baby is born,
he will be supplemented to bring up his sugars.  The hospital will accept
expressed colostrum if the mother provides it.   My new question is: is
formula supplementation "just in case" evidence-based practice if the baby
is going to the breast well? The mother is determined to breastfeed, so why
not let that happen??  We all know that the baby will be followed very
closely, as he should be.  Her safety net of expressed colostrum is a
wonderful idea.

I have read Dr Newman's article and will share it with the mother.
http://www.nbci.ca/?option=com_content&id=71:hypoglycaemia-of-the-newborn-low-blood-sugar&Itemid=17


Getting back to the issue of overlarge volumes of "supplements": the more I
read around this issue, the more I've come to believe that in the first day
or two, the breast needs the suckling more than the baby needs food.  In a
marvellous choreography, the steady practising in the early days gives the
baby a rich boost of immune factors and lessons in coordination, while also
stimulating the breasts to do their thing to produce the volumes needed
later.

The baby has a strong need to suckle, yes, so the stimulus of the bottle
teat in his mouth will keep him suckling long after his little tummy is
full, which leads to all sorts of misinterpretations in mothers (and some
staff members).  Is this what causes the first damage that could lead to
colic and reflux later?

Are there other medical conditions where the breastfeeding baby *should* be
given a supplement before Day 3, preferably human milk?

Best wishes
Jacquie Nutt IBCLC

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