I work in an Australian NICU (for about 14yrs now) and we now have
careplans/clinical pathways where the mother is asked what type of feeding
she wants breast/bottle,is the baby allowed a dummy,bottles yes or no.It is
then written in black and white for everyone caring for mother/baby to
follow.

recently we had a 35wker whose mum was quite adament that she wanted to
breastfeed her baby only,no dummy,no formula ,no bottles.Baby born at
night,mother was willing to come to ICN as often as needed to bf her son.

We did explain to both parents as Dad was also firmly fixed on bfing only.
That being only 2.4kgs and a35wker that the baby might tire at the breast
and need to feed via other means if necessary.This would be via a
naso-gastric tube with mum's expressed milk in preference to formula,however
we might have to use some formula with her EBM to make up the baby's feed
quota.

The parents stated that they would try bfing first and see how baby went and
then take it from there.Mum was willing to express.She had bf her 15mnth old
with no problems-forgot to ask for how long.But she certainly knew what to
do when she put her new son to the breast and didn't need much help.
baby breast fed well for first 2 feeds but the next time was too sleepy(peds
had wanted 3/24hrs feeds) and not ready to feed so left mum cuddling baby,to
try again when woke up abit more.

This baby only had one kidney and was passing huge amounts of urine from
birth,we were concerned for baby not wanting him to become dehydrated and
put his kidney at further risk.

We were quite happy to adhere to mum's feeding plan as long as the baby's
health wasn't put at risk.

This was explained at length to both parents by the nursing staff and the
neo registrar so the parents could make a decision that was suitable for
both them ,the baby and those caring for the dyad.

Went off duty and have been off for several days,will be checking to night
to see whether baby was able to fully bf or needed NGT feeds.


Anne Clements RN RM BNS
Brisbane QLD
Australia

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