"This makes me wonder: are there any studies done on healthy newborns in a
non-medicated, non-hospital setting. I wonder if any of us really *knows* what
normal sleeping-feeding behaviour is of newborns in a *natural* setting,
(meaning non-medicated birth in a non-hospital/institional setting), whit mom
and baby not separated and both healthy. And what effect on short and long term
milksupply this sleeping-feeding behaviour has. Does anyone out there know?"

Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium

In our birthing center moms receive no medication and are instructed to feed baby on cue, they remain at the center for 4-12 hours before going home.  We see them at a home visit between 48 and 72 hours.  My belief  is that while we adults
have our cultural biases, babies have not yet been exposed to any particular culture and can therefore be trusted to abide by the biological norm. (Since we are determining what we believe to be feeding cues we are not completely free from
bias.)

I notice that most babies will show feeding cues at about 20 minutes of age and will continue to feed until they reach two hours of age, they then fall asleep.  Most will then show feeding cues and be fed every 1-3 hours round the clock
with one 3-5 hour sleep stretch each day until the milk comes in.  There are some babies who are reported to nurse "constantly" until the milk is in but on further questioning it is usually hourly feeds which last up to 40 minutes.

In the past four years I can remember 4 exceptions to this; one was a Down's baby, one showed no interest in feeding for eight hours when he coughed up an extraordinary amount of mucous and then promptly fed, the other two were babes who
tried valiantly but mom's breasts were so tight that they could not latch on for anything, one of these went on to feed well with lots of support, the other mother chose to bottle feed.

I have not seen a single case of obstructive engorgement.  Most moms are full and uncomfortable for 24 hours but I would not call this engorgement.  Maybe it is just a difference in definition.  I have rarely had moms complain of
engorgement.  When I was a WIC peer counselor 11 years ago it seemed that everyone got engorged!

I also would like to know what normal is, I think we are pretty close but so much of what our clients do is based on what we teach them that it really hard to be sure we aren't interfering with the process.

Can anyone in a home birthing practice compare this with what they are seeing in the first three days?

Continually Curious,
Janie Ginder RN IBCLC
Eugene, OR USA

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