In a message dated 8/10/00 7:48:26 PM Eastern Daylight Time,
[log in to unmask] writes:
<< If the baby doesn't vigorously
nurse q3h, the staff seems to make it their personal challenge. They will
force the infant to the breast and in the long run cause a complete
aversion. >>
Barbara,
This is certainly not a problem unique to your facility. I have been working
for years & years on making changes to encourage & avoid interfering with BF.
Changes take a long, long time. We are seeing more of our babies breastfeed
immediately after delivery before going to the nursery for a couple of hours
(still working on that one). The nurses are getting more relaxed about
letting babies go for longer periods without nursing as long as the baby is
OK-- vital signs stable, no symptoms of low blood sugar. Our log states that
baby should BF at least 6 times in the first 24 hrs, but doesn't get into
"scheduled" feedings. Staff are learning about cluster feeding being normal,
even if it occurs in the wee hours of the morning when the mom thinks she
should be sleeping. I'm noticing babies going for 12-24 hrs without
supplementing.
Then Kathy says:
>>We have such medicated deliveries, and then sleepy babies. And if they =
won't nurse after the mandatory 4 hours in the transitional nursery =
(after birth), they will be given a bottle. Well, another bottle, they =
get the mandatory glucose water in a bottle to see if they can suck and =
swallow <<
This test feeding has been discussed on Lactnet & I thought most hospitals
have given up this practice. Esp. if the mom breastfeeds at birth, they have
had their "test". The condition that we are testing for is so rare and babies
who present with it have so much mucous that it doesn't get missed. Also,
colostrum is present at birth & is less irritating than water or glucose if
aspirated. I also keep in mind that when mom's had twilight sleep years ago,
we let babies recover for up to 24 hrs before feeding them.
One reference that may be helpful is listed below. I used it as the basis for
a log for moms to keep in the first week to know if baby is getting enough
milk.
1st 24 hrs--minimum 6-8 feeds, 1-2 voids & 1-2 mec stools.
2nd 24 hrs -- 8-10 feeds, 2-3 voids, 3 mec stools.
3rd day -- 8-12 feeds, 3-4 voids, 3 trasitional stools
4th day -- 8-12 feeds, 4-5 voids, 3+ yellow stools.
5th day -- 8-12 feeds, 6+ voids (large amt dilute urine), 3+ yellow stools.
I also mention cluster feeding and the signs of a good latch & adequate
feeding.
The complete reference for the publication on documenting the number of wet &
dirty diapers of a completely BF baby in the 1st week of life is a hard cover
book of about 300 pages.
Clinics in Perinatology, vol 26, no. 2, June 1999
Publisher: W. B. Saunders Co., Philadelphia
Clinical Aspects of Human Milk and Lactation
guest editors: Carol L. Wagner & Dilip M. Purohit
Marianne R. Neifert author of chapter entitled "Clinical Aspects of
Lactation: Promoting Breastfeeding Success"
Laura Hart,
Winter Park, FL
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