I will be presenting a short presentation on alternative methods of feeding to
some of the Registered Nurses and Licensed Practical Nurses at our local rural
hospital.  These alternative methods of feeding will be used when the newborns
refuse to latch onto the breast in the next 24 hours post delivery.

There are but a few moms who are not medicated when in labour.  Morphine or
Demerol (pethidine) and Gravol (dimenhydrinate) seem to be the medications of
choice administered when the moms are in labour.  Most moms receive intravenous
of 5 percent dextrose and water when at 6 cm dilatation.  Reasons given are that
if the moms or babes get in trouble the doctor has an open vein for prompt
intervention.   Of late many moms are augmented and or are induced.  The vacuum
extractor is often used.  All healthy infant are given to mom to cuddle right
after delivery.  Twenty-four hour rooming in is the practice.

My question to you post delivery nurses out there is: what guidelines do you use
for giving food to these "normal healthy babies"?  Do you wait 4, 6, hours if
their blood glucose and temperature are stable.  How many mls would you
recommend when and if you begin to supplement?  This last week when I have been
called to see two of these babies, they absolutely would not wake up even with
some enticement at the breast was used.  This particular sleeping infant finger
feed beautifully while sleeping.  The nursing staff had suggested for the mother
to wake the infant and to bring him to the breast every two hours, and to offer
between 15 to 20 ml of abm had he not latched and fed at the breast.  This
infant apparently has had an uneventful birthing experience although a long
second stage.  He cuddled with mom in the delivery room but did not latch.  At
24 hours post delivery he has made but a few attempts to latch. According to the
nursing staff he still has not made visible attempt swallowing.  He has had a
meconium movement and has urinated.  He is beginning to look somewhat jaundiced.

Upon finger examination, this infant seemed to have a weak suck.  I would have
liked to feel his tongue further under my finger.  He finally opened his eyes
for me at the end of my hour visitation with them.  He made a few attempts to
lick moms breast. I suggested to the mom to have many, frequent cuddles and
practice at he breast.  I told the staff that mom should start using the
electric pump regularly and to feed the colostrum to this infant instead of abm.
 I wonder if this abm is causing this infant to have longer sleeps.  The nursing
staff did not seem to have worried until the twentieth hour was reached.

I would appreciate any suggestion and would feel more confident in advising the
nursing staff re further similar cases.  It has been 18 years since I worked in
Obs. I usually see these infants 24 to 48 hours post-natal discharged.  We sure
had less intervention in my time.  To this day, I remain an Obs nurse at heart.
 You can E-mail me personally.

This is a most exciting time for me right now for I feel that our hospital may
be becoming more breastfeeding friendly.

Rosemarie Allain
St. Paul, Alberta, Canada