After scouring the archives of LACTNET, I am having dificulty finding
information about the appropriate length of early (Day 1) feeds to counter
my peers who believe a "true feed" must be at least ten minutes on each
breast.  My institution is also in the process of creating breastfeeding
policies (as currently there are NONE), and I would like to provide
research which will guide us away from routine blood sugar checks on a
baby who has a "perceived" breastfeeding problem.  Can anyone direct me to
research which supports demand feeding but also addresses appropriate
length of feed (ie.. quality of feed vs. length of feed)?  When confronted
with the "consensus" at my institution, I would like to be able to back my
position with evidence-based information as I have tired of performing
blood sugars on babies who are asymptomatic but have not satisfied those
around me that their feedings have been sufficient.  Case example:
Newborn at 0930, uncoordinated suck for about 2 hours, mom pumps colostrum
x 5 minutes, baby to breast with bait of colostrum and suckles 10 minutes
vigorously on one breast.  Br attempts 2 and 3 hours after 1st feed
unsuccessful.  At 4 hours after 1st feed, baby suckles 5 minutes.  At 6
hours after first feed, baby suckles another 5 minutes.  Because of lack
of supporting breastfeeding protocol, blood sugar was checked on
asymptomatic baby (big shock it was 65).  Then baby has second longer feed
of 10 minutes again about 8 hours after first.  Any guidance will be
greatly appreciated.  Angie, RN, CLE, Breastfeeding Advocate

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