I find this to be a fairly common problem. While I suspect is some cases it relates to labor meds, I think in other cases some babies just aren't immediately interested in eating. After all, baby has just been through a very traumatic experience: being squeezed through an open that barely is large enough, then being bombarded with bright lights (even if they are dimmed for the birth, it's still more than baby has experienced before) and all kinds of sounds. I think if I had had a similar experience, I might want to "tune the world out" for a while while I get my bearings. I have seen some babies that take no interest for as long as 12-24 hours. Then if we haven't "messed them up" by trying to shove things (including breasts) into their mouths, they decide to eat and often make up for the missed feedings by going on a marathon nursing spree. I describe what's happening like this in taking with parents: "Baby hasn't figured out yet that the free ride is over and (s)he now has to "work" for food. Up until now, nourishment came through the belly button with no effort on baby's part. Baby didn't agree to this change in procedure. As soon as (s)he has adjusted to life on the outside, you can sometimes almost see the "light bulb" pop on and baby says "Oh, I get it. I'm supposed to do something about this hungry feeling." It might not be scientifically precise, but I find that it helps most parents relax and watch for baby's cues. I suggest they keep offering every 2-3 hours until baby figures it out, but not to get too upset if baby doesn't take them up on the offer. Of course it would be appropriate to assess the baby for any abnormal reasons for the lack of interest, but barring any indications that baby is having a problem, patience and persistance are the key. I find our nurses are for the most part getting more relaxed about this, but some still keep pushing for a specific time frame after which they have the go-ahead to intervene. I keep avoiding any specific times, emphasizing the importance of evaluating each individual baby. The more time that passes, the more likely I am to try some interventions such as trying to get a few drops of mom's colostrum to drip on baby's lips to see if we can spark an interest and in some cases trying a tube at breast to provide some "instant gratification". When a nurse is getting panicked that baby hasn't eaten, I encourage them to to an Accu-Check (non-lab blood sugar) being sure to warm the heel first (I've seen that make as much as a 10 point difference). The purpose isn't that I think baby has a blood sugar problem (unless I see other symptoms), but that in the vast majority of cases, the number is just fine and the nurse will relaz and give baby more time. One of my fellow LC's is from Australia and she reports that mom and baby can stay as long as necessary until feeding is established. Since we don't have that luxury (which should be a necessity), and "not breastfeeding well" isn't a good enough reason for the powers that be to give their blessing to a longer stay, we do want to try to get as many feedings as possible in in that 24-48 hours so if there are problems, we can work on them. The major point is - each baby is unique and we have to avoid expecting them all to fit our preconceived idea of how they should behave. Allowed to adjust at their own pace, nearly every baby (unless there is some physical or physiological problem) WILL decide to eat eventually. Winnie Mading IBCLC *********************************************** 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