I am requesting on behalf of the listmothers that any discussions of routine
care of newborns in the immediate post partum period keep as their focus the
way in which routines hamper or promote breastfeeding.  

Please note that Lactnet is not the place for us to debate whether
prophylaxis is needed in the first place, but we can discuss the merits of
the various prophylactic or therapeutic measures in place in various
hospitals or countries in the world.  

I find it interesting to hear what other places have as routine care.  It
may help us understand why establishing breastfeeding is more difficult in
some places than in others.  I still remember my astonishment at the use of
two separate nursing staffs to monitor mothers on the one hand and babies on
the other, for the first couple of hours after birth.  If mothers and babies
are kept together, not only can the monitoring be done by half the staff,
there will be fewer deviations from normal because mothers and babies need
each other during this time, from a purely physiological standpoint.  

For the record, prophylactic Vitamin K administration to newborns has
nothing to do with antibiotic eye drops.

Eye drops, especially the old fashioned silver nitrate ones, interfered with
early contact between mother and baby because the drops were so irritating
that babies often were unable or unwilling to open their eyes for the first
couple of days after birth.

Vitamin K administration, the purpose of which is to prevent hemorrhagic
disease of the newborn, can be done by injection while baby is skin to skin
with mother, or while baby is feeding.  Our guidelines say within 6 hours
after a normal, non-traumatic birth, but immediately if baby was born by
forceps or vacuum extractor or looks bruised.  It still need not interfere
with establishing breastfeeding if done sensitively.  Vitamin K can also be
given orally, as drops, in which case it is even more inobtrusive.

Rachel Myr
Kristiansand, Norway

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