In a message dated 9/3/2006 10:26:14 PM Eastern Standard Time,  
[log in to unmask] writes:

I  recently had a 
pt deliver a 9+ pounder and everyone wanted to  feed  this baby 1-2 oz from 
the 
start-I was the only one talking about  limiting  the am't to closer what  
the 
baby would have gotten if  breast  feeding. I do have a chart on wt and 
formula  requirement.



HI Jane,
Part of the issue and therefore the need for teaching, is not the size of  
the newborn but what the physiological norm for all babies is.
It does not matter if the newborn in 5 pounds or 11 pounds.  In the  first 2 
days of life all babies are recovering from birth and allowed to their  own 
means would take about the same amount of colostrum in no matter what their  
birth weight.  The calculations of calories per kg cannot start until a  baby has 
recovered.  They just cannot handle the larger feeds in those  first 2 days.
I liken it to women in labor.  It does not matter if the woman is 100  pounds 
or 200 pounds, they would be limiting their intakes and if required an IV  
the amount of fluid would not differ because of mom's size.  
I have been trying for years to reeducate the staff on normal intakes for  
newborns and limiting the intake when they are fed formula.  I have also  been 
critical of the formula companies having very little instructions on the  
normal amounts for newborns or how they show bottle feeding.  Yes, I know  they 
just want more of their product used.
I do not have a handout on paced bottle feeding but am also interested if  
someone has come up with one.
Ann Perry, RN IBCLC
Boston, MA

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