Back in the olden days (1970s) in Connecticut where I worked as a nursery
nurse, all breastfed babies went to their mothers to nurse every 4 hours whether
they needed it or not.  After 30 minutes, they were collected, wrapped tight
and put on display in the nursery window. We didn't even start this routine
until the babies were over 12 hours of age.  We advised nursing Moms to limit the
nursing to
1 min/breast/feeding  for the first day, 3 min the 2nd and 5 the third day.
This was to prevent sore nipples and "break them in".  We also gave pc (after
feeding) glucose feedings  after every breastfeed to prevent dehydration and
to "flush away" any bilirubin.  Our special care nursery was equipped with a
large number of bili lights to treat the common high levels of bilirubin due to
"lack of breastmilk"   I remember 8-10 healthy full term babies under lights
for normal physiologic jaundice some nights when I went to work.   Around the
mid 1980s the Docs started to believe that colostrum may actually lower the
incidence of elevated bilirubin because bilirubin needs protein to become
metabolized and excreted by the baby.  The glucose water was actually the worst thing
for the jaundice issue because it interfered with the baby receiving any
quantity of colostrum.  And we even allowed Moms to nurse ad lib.  Babies started
getting more milk and protein and moderate to severe jaundice was become less
common place.  There are of course, pathologic reasons for elevated bilirubin
which necessitates medical treatment to prevent bad outcomes.
I am rambling down memory lane, not especially good memories!
Christy Ann Flynn, RN

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