Hi Susan,

I'm a  midwife trained in the US, doing mostly homebirths. I am now living
in Saipan (Commonwealth).  I have never had a HB (homebirth) baby not
breastfeed at birth. I have seen strikes a few days later but no bf trouble
in the first 24 hours.

With that in mind, in considering a plan for hospital born babies, I think
it's important to look at birth related factors that might inhibit
breastfeeding. Did mom have pain meds, epidural, c-sec? If so, it's not bf
that is the problem, it's a sluggish babe or mom. Was the birth difficult or
traumatic? forceps? induced? precipitous labor? are mom and babe connecting?
is baby alert?

Most babies (in my HB experience) breastfeed at birth, then go into a long
sound sleep for 6 or 7 hours, usually with mom and family all snuggled up
together.

So maybe babe needs to have that sleep before feeding again. I wonder if
this is permitted in most hospitals.

If babe and mom are rested and alert yet not connecting, then I'd suggest a
rebirthing bath.

Once drugs, traumatic birth, exhaustion, distraction and psychological
factors are ruled out, I'd leave it alone for 24 hours when I go to make the
first PP home visit.

If baby does not take to breast, then I"d call in the local LLLL to see if
she can think of something. This is assuming we have a healthy, term baby
who is peaceful and alert.


Lisa Boisvert-Mackenzie, Midwife
Saipan, Commonwealth of the Northern Mariana Islands

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