Hi All, here's my $.02 worth:

1. The word "supplement" by definition implies the baby is already getting
"something" to eat, and the issue is "Is it enough?" If the baby has not
yet latched, the baby presumably hasn't yet eaten "ANYTHING". (Actually the
baby was swallowing up to 450 ml/day of amniotic fluid resulting in 0.9
gm/kg/day of protein.) The more important question to ask is "WHY hasn't
this otherwise normal baby latched and started breastfeeding well?" But I
digress.

2. Colostrum is a low-volume feed. Not-so-coincidentally, a newborn's
stomach capacity on day 1 averages 4-5 ml. IMHO, there's not much
justification for thinking that a newborn "needs" more than the amount of
colostrum a mother naturally makes (10-100 ml/day, average 30 ml/day in
small doses to coat the gut).

3. Colostrum is thick, almost gel-like. Again, what a coincidence! The baby
is trying to coordinate suck-swallow-breathe. If he's trying to protect his
airway, a thick glob is easier to manage than thin runny stuff. By the time
the breasts modify their milk composition to a thinner sweeter fluid
starting 30-40 hours postbirth, the baby presumably has learned how to both
breathe and handle oral feeds. The timing of Lactogenesis II (onset of
copius milk supply) is triggered by the separation of the placenta
regardless of the route of delivery.

4. For trivia buffs: The baby uses 60 separate muscles in the mouth,
pharynx, neck and shoulders to accomplish coordinated suck-swallow-breathe.
(I sat down with Netter's anatomy atlas one day and counted them!)
Suck-Swallow-Breathe uses 6 out of the 12 Cranial nerves. At birth the
newborn skull has 22 bones which articulate at 34 different sutures! Many
of the head bones that are single plates in adults are in several pieces in
the newborn. No wonder babies are a little disoriented after a rough birth!

5. So when does a newborn really NEED to have calories? I agree with Dr.
Jack and Nikki Lee: "Look at the baby." Nikki says "babies don't pretend to
be well." This is why newborn care isn't a one-size-fits all simple
protocol. Proper care of babies requires sensitive clinical judgment. It's
just as wrong to ignore a baby in trouble as it is to intervene
unnecessarily with a well baby snuggled happily on his mother's chest. I
haven't found any solid research on this - has anyone else? How about from
Australia or elsewhere?

A personal story: My firstborn was kept NPO for over 24 hours (and away
from me, in a central "nursery") which was the practice of the day in 1970.
His birth record stated that I had a saddle-block spinal, which I didn't
have. I also refused the standard dose of 100 mg. demerol (pethidine) which
was the starter dose of pain meds in those days. If the nurses expected
babies to be groggy from all that narcotic, I can almost understand why
they wouldn't want to try and feed them for a while. (This comment should
not be construed as condoning those practices!) Remember this was before
LeBoyer first published the concept that the baby had feelings and needed
to be respected during birth (Duh - what a concept) and before fetal
monitors documented the effects of narcotics on babies. Before then, the
baby was considered to be merely the unfeeling, passive passenger during
births. Now we know better! Or should.

Happy New Year,

Linda Smith, BSE, FACCE, IBCLC
Dayton Ohio USA where it might snow today and cover up the ugly dead grass.
Bright Future Lactation Resource Centre
http://www.bflrc.com