IN response to Ann's post:
IN our hospital, if babies lose more than 10% of birth weight, they are
not allowed to go home, and artificial milk is pushed as a solution.  I
use the spoon method just to prevent this.  I would much prefer just to
leave the baby alone to recover, but unfortunately, this may mean that
he loses too much weight.  Our babies are usually epidural birthed and
born with exaggerated weight from extra fluids.
I have now been put totally in charge of breastfeeding, including
complete protocol change and staff re-education.  I have to make it
clear that giving artificial milk is not the answer to every
breastfeeding problem.  I want to use Chloe Fisher's permission form for
"top ups" with fluids other than breast milk, which means that not only
does the mother have to sign after reading the "hazards" of giving
artificial milk, but also the nurse and the physician have to sign and
give a reason for ordering the top up.
I also explain to moms that the feeding frenzy on day 2 is not really
hunger per se, but the baby's need for breast comfort to help him feel
good in extrauterine life.  I explain that colostrum sooths their
immature gut and helps clean out all the excretions that he is trying to
get rid of, from both ends.  It is that day 2 feeding frenzy which is
one of the most difficult hurdles for new moms in the first few days.
Too often, other staff members lead moms to think that the baby is
starving, that her milk is not adequate, and by the time I get to work
in the morning, I am doing breastfeeding rehab instead of helping moms
get started.
Esther Grunis, IBCLC
.


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