I have a copy of Jack Newman's other version of the same book, year 2000, titled The Ultimate Breastfeeding Book of Answers. He mentions sugar water on pages 54 and 105.

Pg 54:
"Many hospitals used to routinely supplement all breastfed babies' feedings with water or sugar water, at least for the first few days. This is not now supposed to be routine for all babies, yet many babies receive these supplements for a variety of reasons - most of which are not valid - because many health professionals are not confident about breastfeeding working well."

The other two paragraphs in that section discuss how to supplement with devices and getting extra milk with a more effective latch.

Pg. 105: section titled Expressed Milk is the Best Supplement in Chapter 5, Not Enough Milk
(4th paragraph)
"So the first choice for a supplement is the mother's own milk (colostrum in the first few days - and colostrum, despite having a different name, is still milk - just the first type of milk.) If only a small quantity can be expressed in the first few days, it can be diluted in sugar water. In other words, colostrum diluted in sugar water will be the second choice at least for the first 24 to 48 hours. Diluted colostrum, even a few drops of it, still has antibodies, white cells, and protein to help the baby fight infection and get some of the appropriate protein and fat he needs."

So what if NO colostrum is available?
(6th paragraph)
"The third choice is plain sugar water which can be used for about 24 to 48 hours. The baby will remain well hydrated, and will get some calories, and, if the sugar water is used properly, will, we hope, be breastfeeding by 24 hours of age. Some worry about babies becoming jaundiced because of the sugar water, but I don't see this as an issue. The proper management of breastfeeding will prevent the development of excessive jaundice caused by inadequate intake of calories."

Then he explains other supplementation choices: banked milk before going to formula. This is a book for mothers and there is no list of research citations. Is this wording different from the book version you have? By quoting this, I am just trying to see the context of his statements.

I find myself mentally riding both sides of this fence. On the one hand, a drip or 2 of sugar water to get baby interested when mom can get only a drop or two of colostrum - which I have entertained but never tried - because on the other hand, how is that different from the nurses' using Sweet Ease on mom's nipple to hurry up a breastfeed in that precious 30 minutes' maximum time limit in Level III? I know, it's off-label. Sweet Ease is to be used as a pain reliever. That's enough on Sweet Ease.

Maybe we can ask Dr. Newman to discuss his views on supplementation when he comes to Arizona to speak next month.

Phyllis

---- Nikki Lee <[log in to unmask]> wrote:
> In a message dated 11/9/2006 11:26:53 PM Eastern Standard Time,
> [log in to unmask] writes:
> "The third choice is plain sugar water, which can be used for about 24 =
> to 48 hours."  p. 86, Dr. Jack Newman's Guide to Breastfeeding (2000).
> Dear  Colleagues:
>     Evidence comes from peer reviewed journals or from a meta-analysis like
> the Cochrane data base.
>     Someone writing it in their book, even if they are a physician, is not
> evidence.
>     1 liter of sugar water contains 200 calories. (5% of the solution is
> dextrose; 4 calories per gram)  A newborn won't be getting very  many ounces (or
> calories) in 24 hours, which we know increases bilirubin levels for several
> reasons. One is that starving people have higher bilirubin levlels; another is
> that sugar water will make the baby pee but not poop and it is pooping that
> eliminates the bilirubin. There is a lot of research about this.
>     warmly,
>
> Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
> Adjunct Faculty, Union Institute and University, Lactation Program
> Film Reviews Editor, Journal of Human Lactation
> www.breastfeedingalwaysbest.com
>


--
Phyllis Adamson, IBCLC, RLC
Glendale, AZ.
[log in to unmask]

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