Teresa asks: Just a question about this - why the requirement that the baby
must take all
feedings by breast or bottle? We ran into this when my grandson was in the
NICU and he was being breastfed then "topped up" with EBM by gavage. We
wanted to try using a tube at the breast to give him the extra milk and felt
we could take him home feeding that way, but the pediatrician was insistent
that the baby had to have all feedings from either breast or bottle.

Teresa Pitman
Guelph, Ontario

Being able to take adequate feeding via supplementer at breast definitely
qualifies as feeding at the breast and there is no reason that a baby able to
do so should be kept in the hospital.  I was just simplifying the criteria
for disch.  Basically baby has to be able to take adequate feeding "by
mouth".  SNS, cup, etc. would qualify as long as the intake was adequate. In
more complex situations we even send babies home on tube feedings.  A little
flexibility is the key--if a baby can eat well with supplementer at the
breast, why keep him in the hospital?

Kathy Boggs, RN, IBCLC

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