Robin, I put a paper 81/2x11 with infants tummy size and hung it up in
each room. Some staff and some Peds complained at first but got over it.
Parents like to be able to see for themselves and some even take it
home. I printed lots. Lois. Mathews R.N. IBCLC St. Mary's Medical Center

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Robin Roots, RN, IBCLC
Sent: Sunday, August 05, 2007 1:23 AM
To: [log in to unmask]
Subject: newborns stomach size and supplementation/long

Hi all,

I posted a brief "table" of what a newborns stomach capacity is at day 1
thru 
day 4 based on weight in grams.  I taped the paper to the formula supply

cupboard in the nursery in the hopes that the nurses don't drown the day
old 
infant with 60cc of formula.  

Unfortunately, I can't be their 24 hours / day and their are time when 
supplementation may be necessary.  Of course more way more overused and 
abused, and we have a fairly reasonable staff.  Anyway, my point is if
they 
have to use ABM at LEAST try 10cc so the babies don't go into that
drugged 
sleep and stop looking for mom.  We have our share of babies that have
low 
blood sugars and there is nothing I can do about this, or the jaundice
babies 
whom the physician says to push fluids to clear the jaundice, and I come
on 
to do rounds only to find these day old babies have had 60cc. geez.
Then the 
moms ask me why the baby won't wake to breastfeed.  Then they ask me why

do the nursery nurses give so much formula if it should only be a little
bit.. and 
then we get complaints from pts because they get too many mixed messages

and non-consistant information.
So like many of you other hospital LC's, I walk a tightrope.  Trying not
to 
discredit the nurse who I am following, but gently explaining how to
slowly 
decrease formula, and keep the baby skin to skin.  And yes the baby will
want 
to eat all the time because thats what babies do.  Especially, if their
bellies 
are distended due to all that ABM.  I don't say that but I want to.  At
this 
point I just try to help with all I have to the moms that REALLY want to

breastfeed.  These are the moms who usually succeed.  I don't have the
time 
or energy to try to talk someone into nursing, getting the baby latched
hurting 
my back only to come back the next day and have them tell me they
decided 
to bottle feed.  

Sorry I'm crabby today...   point is keep something around to remind
staff that 
babies tummies are small and they dont need tons of supplement.  Some of

the nurses really like it some don't care at all.  Thats life.  I also
have a 
algorythnm of when to call the LC.  It is very well written.  I can't
take credit 
for that one.

Sorry for the long rant...Worked till 2am and got my taste of what
happens on 
night shift.
robin

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