Good Morning! I work as an LC in a hospital setting. Our nursery is a
Level 2 and we care for many 34-38 weekers. I am in the process of writing
a policy for gavage feeding these little ones. Often, our mother's are not
producing as much milk as the infant needs for growth, so, sadly, we need
to use formula in addition to mother's milk. (Our doctors are not
accepting of donor milk, yet.) We try to maintain gavage and
breastfeedings without bottles when possible.
It seems that I was born with the knowledge that one should always gavage
feed the expressed mother's milk before the formula; especially, not mixing
them together. Now that I am writing this policy, I cannot seem to find a
reference or a study supporting this. I have found many of the Special
Care Baby nurses have been mixing them routinely and are reluctant to
change (as usual). Eventhough it makes perfect sense if one considers the
function of IGA and some of the other protective qualities of MOM, I need
some scientific evidence for this practice! Does anyone remember seeing
this anywhere, or have any ideas?
An additional question is: Some mothers only come in one or two times a
day, bringing their pumped milk with them and leaving after the next
feeding. Is it better to divide the mother's milk up so there is some that
can be given before each feeding, to coat the gut, or is it better to feed
the milk as fresh as possible, resulting in some later feedings having no
MOM? I would appreciate any thoughts on this concern.
Thank you, all, for any advise--I work alone and quite isolated, so Lactnet
has been a godsend for me to follow and use. Some days, it's like talking
to someone with the same passion--good therapy!
Thanks, again, Elayne Clubb RN, IBCLC.
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