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From:
Maureen Allen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 29 Sep 2002 23:07:43 -0400
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Nikki, If this baby were truly too sick to go to breast, he would not be receiving feeds at all. Feeding--and I mean any stuff that is transported by any means into the stomach to be digested--SHOULD NOT happen in a truly sick child.  A sick baby will not tolerate the food.  They will vomit, or as your friend noted, the food just sits--it will not digest.  The baby is expending all of his energy and reserves to get better--if he is not tolerating feeds, there is NO REASON to force the issue.  Of course, breastmilk or colostrum will be better tolerated, however, sick babies will not even digest breastmilk.  So, either these people were too ignorant to realize her baby was not ready to feed, or they do not care about breastfeeding and breastmilk.  Unless her baby is really sick, and I mean on an oscillator, ECMO, with chest tubes, and on pressors, there is absolutely no reason for that baby not to get held and see if maybe he will latch.  If he really feels unwell, he won't feed orally.  It is really as simple as that.  In our NICU, all full term infants should be offered the breast, even if tachypneic.  If the baby doesn't feel up to it, he is not force fed.  Many babies who are breathing faster than conventional wisdom would allow, will regulate their breathing and the rate will fall to a more comfortable, regular rhythm.  But if it doesn't happen, then the baby is not ready.  Bottle feeding makes tachypneic babies worse.  Breastfeeding doesn't, and sometimes makes them better.  If this baby is very sick, he can receive colostrum ASAP.  Babies (and adults) who are NPO should be given mouth care for comfort and to prevent cracking and dryness.  1. If milk prevents soreness and cracking on nipples, it certainly would makes babies' mouth and lips feel better.  2. It tastes good--and is positive reinforcement for oral feeding. 3. The baby starts to get the benefits of his mother's milk--WBC and antibodies will be absorbed through the mucous membranes of the mouth just like it is in the gut.  4. Mothers feel good when they see their milk is used for their babies, no matter how sick they are--their unique contribution to their baby.  
It is not unusual to get only drops of colostrum--I'd encourage her to hand express to more easily get a volume of colostrum.  Good luck, Maureen Allen RN, BSN, IBCLC, Brigham and Women's Hospital, Boston, MA

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