"I accept the physiological fact that a totally non-feeding baby may 
miss out on a bolus of colostrum, but I would want this balanced 
against the effects of introducing a mechanical 'thing' into this 
burgeoning relationship."

Ah, but our American births are so dysfunctional, and we have such a high rate of non- and poorly-breastfeeding babies...

Though I've never worked in a hospital, I've come to think that a delivery perhaps has 3 parts:  Delivery of the baby (important to the mother), delivery of the placenta (important to the midwife), and delivery of colostrum (important to the baby).  And a delivery shouldn't be considered complete until all three parts have been accomplished.

But when to intervene?  Well, if it's been an unmedicated birth and the baby isn't latching yet, we have every reason to believe that he will.  Interventions can wait.  If it's a medicated delivery and the baby latches, we have every reason to believe he will continue to do so.  Interventions can wait.  But if it's a medicated delivery *and* the baby doesn't latch during that first hour (and seems unlikely to), we've just been handed two strong pieces of evidence that problems are likely.  I'd say go get that early bolus of colostrum while it's there to be gotten, and thus maybe stave off the use of formula later in the day...  

If problems prevent the delivery of either baby or placenta by a certain point we intervene because we know there will be more problems if we don't.  What about putting that bolus of colostrum in the same category?  Does this make sense to those of you in hospitals?

Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com 

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