The issue isn't the volume of colostrum available -- it's the number of
feedings in those early days. Several studies, cited in previous
Lactnet discussions, noted that babies feeding at least 9-10 times every
24 hours in those early days tended to have moderate bili counts. And,
for a variety of reasons, how commonly is *that* happening in most
hospital settings? The mothers don't feel full so they don't feel the
urgency, and they're self-conscious about practicing in public, Baby is
bundled up away from mom, being passed around to relatives, and probably
recovering from a birth with a chaser of medications, so they're not
asking. So if someone is just feeding a few times a day, waiting to get
home or for the "'real" milk to arrive, the colostrum intake doesn't
total up into a the steady doses that keep a baby pooping. Mother's
don't need to be asking "Do I have enough milk?" but "Do I have enough
feedings?"
Mother's need to know that the feedings aren't necessarily going to be
at certain hourly intervals. (Can't these babies read?!)
Cluster-feeding is a time-honored tradition, that got lost for a few
generations, when babies, wired for a *lot* of sucking to transition the
milk supply, found themselves flooded with milk from a bottle on Day 1..
Even getting the baby to the breast frequently won't suffice if he/she
is just sleeping, or is one of those "a little early" babies who can't
drive the train yet. So some of the vigilance about jaundice is
warranted, but it seems that almost every baby I see in private practice
has been supplemented for jaundice.
Margaret Wills, LLLL, IBCLC
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