My friend and colleague, Doris Sperer, who has been in this profession as
long as I have ( we both passed the exam in 1987) and not a day goes by that
we don't discuss cases, discuss burn-out,discuss changing profession when
every baby we see had super dysfunctional suck.  Doris is an avid lurker on
Lactnet !!

So 40 + weeks ago,  when her grandson was barely more than 4 cells, we were
already imagining being grandmother to a breastfed baby.

Thursday night, little Nadav was born, weighing in at 2490.  Her daughter
had decided to give birth in a non-breastfeeding friendly hsopital, much to
our discontent because you can have a private midwife.  This particular
hospital has such terrible breastfeeding management problems, that ot
p[rovides us lots of work in our private clinic.  Doris and I were ready to
dress in army fatigues and stand by Nadav's little plastic baby box, armed
with Uzi's, ready to attack anyone who dared come close to him with anything
even closely resembling artificial baby milk.  I guess they had good
intelligence information on us beforehand because they didn't even dare
offer him the usual "welcome to the world" cocktail.

But the poor little guy had a pretty difficult time being born.  His mom was
zapped with pitocin in order to help him out a little faster........and at
the end he was further assisted with what was described as a "mild" vacuum.
( If that was mild, then a serious vacuum must be decapitation!!)

He was not very hungry after the delivery.  He looked at his parents, and
his doting grandmother for a while and went to sleep.  So much for
breastfeeding in the delivery room!! About 14 hours later mother, father and
baby moved into the "hotel" which this hospital has for parents who want
rooming-in.  It makes the Hilton look like a 3 star accomodation, and costs
more that the presidential suite, however,  usually the staff are a little
too willing to give your baby "the other stuff" so that you can sleep at
night.  Of course there are some parents who actually use this hotel as a
way to get breastfeeding started, but  with such negative help, most don't
succeed.

By 14 hours, little Nadav still had not really shown any sign of wanting to
do the very act that  his grandmother and I have been working on and helping
thousands of other babies do for so many years, and Doris called me to
consult since I work in a hospital ( she sees the moms after they get out of
the hospital). He had had one feed, but since then, nada. He was gagging and
spitting up, and seemed generally nauseous.  Given his size, I was not happy
about this.

And here is what I had wanted to contribute to  the thread of what to do
when babies do not eat during the first days.  I usually get them started
with a little colostrum on a spoon and usually by the third spoon, they are
ready to go for the original packaging. If they don't then I suggest to
mothers to continue spoon feeding with a small plastic spoon. Usually about
5 spoons from both breasts every 2 hours is enough to avoid dramatic weight
loss, to encourage milk supply, and to keep the baby hydrated until he
recovers from whatever traumas he encountered in the delivery room. Osoa;;u
by the second day, they are ready to breastfeed, and if not, then it is more
reasonable to start pumping.
 Doris called me in a panic...she was unable to get any colostrum out of her
daughter.  I am not surprised after hearing about the birth: pitocin, IV
drip for at least 16 hours.  I envisioned all the LC nightmares in one.  It
was then that it dawned on me that maybe an LC should not help her own
daughter.  I will get colostrum out of her if you promise to help my
daughters when they have babies!!

When I arrived, Nadav was sleeping peacefully on his mother, skin to skin.
He was tiny, and if he really had not had a good feed, it was not good.  I
picked him up, and he screamed in pain.  It seemed as if even the slightest
move was excruciating.  Probably all that pitocin caused him to keep
smashing into the perineum, and he probably had baby whiplash, and an awful
headache.  He had this terrible worried look on his face. His oral mucosa
was dry and he had already lost 150 g from birth weight. Starting to look a
little yellowish already.

I was able to get some of that wonderful golden liquid out on to a spoon.  I
guess that when it is your own daughter, you are unable to squeeze as hard
as you might otherwise. Usually the first squeeze is more painful, and if it
is your daughter, and she winces, you stop.  After the second squeeze, it is
less unpleasant, and the milk starts to run more freely.  It was amazing.
After a few spoons the baby perked up, started looking around, cried, but
would not go to breast no matter what we did. Taught mom how to express
colostrum onto a spoon.

Doris and I left after midnight with strict instructions of spoonfeeding
colostrum at least 5 tiny spoons from each breast every 2 hours during the
night, and not even to attempt to breastfeed until the morning.  We had to
just let him take his time.

This morning, Ruthie's milk was flowing much easier, and Nadav started
feeding like the grandson of an IBCLC should be ( without the influence of
Murphy's Law), and both grannies ( the real and the surrogate) are happy.

I am interested to hear what others think about LC's helping their own
children when they become mothers.  I definitely think that it is best to
let one of your colleagues do it.  It is so difficult to detach and  not
pressure the mother and baby.

Sorry this was so long, but Doris gave me permission to tell this story.

Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel

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