As a hospital based LC, I do encourage moms to wake sleepy babies in the
first few days for several reasons.
If they have not started eating in the first 12-24 h then by day 3 when
they are due to be released, they will have lost "too much" weight and
then the problems start.

The docs start forcing artificial milk with threats of danger of
dehydration or worse.
Moms self-confidence starts to wane. No one thinks to suggest that they
pump and give pumped milk!

To avoid this scenario, I suggest to moms to wake babies and try to get
them eating. With early release these days, poor stimulation in the
first two days may result in belated milk supply and engorgement when
mom gets home, or worse yet that the mom may be forced to give
artificial milk when it really is not necessary.
I try to express a little colostrum in a spoon to let babies get a taste
and after about the third spoon, we usually get some rooting and a good
latch.  some babies make a terrible face when the spoon touches their
lips so I make sure to tell the mom the grimace is a criticism of the
plastic and not the taste of her milk.

If I were in a breastfeeding friendly hospital, I would leave them alone
until they start to show some interest, encourage lots of skin-to-skin,
and maybe suggest that the mom start pumping in order to get things
going.

In addition I warn the moms that babies who do not eat in the first days
will do a marathon feeding frenzy once they do start.

Just as a curiose, I had four moms today each with one nipple dimpled
and one not.  Needless to say all came into the class using silicone
shields, and all babies but one eventually managed with the problem
nipple without silicone of course!!
Also three short frenulums, two of which caused problems and one which
did not.  Frenotomy solved both of the problematic ones.
Sundays are like that!!

Esther Grunis, IBCLC, NN
Lis Maternity Hospital
Tel Aviv, Israel

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