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 *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html