Jeni asks (for term well newborns in hospital), "How can I present how long
a feed is long enough?"

This is a tough question because how can anyone know how long is enough for
any particular infant? There would possibly be a difference between a 10 lb
baby of a primipara mother, who for some reason initiated bf at 2 hrs, and
between a 6 lb baby of a multipara mother who initiated bf in the delivery
suite. The key is to keep mothers and babies together and encourage
unrestricted bf. There are guidelines from Academy of BF Medicine I
believe, with sort of algorithms to assure staff that the baby is well and
does not need supplementation. I would certainly start there.
What I like to do is this:
1. keep mom/baby together, do STS so baby's caloric needs are minimal and
temp control is good. Drum this into the staff by leaving articles, sending
emails about STS and first day of life.
2. encourage unrestricted feeding for any cue. Try to avoid the ubiquitous
pacifier which moms often put in the mouth instead of bf.
3. If staff or parents or you are worried about any aspect of bf (hx of low
milk supply, insufficient glandular tissue, mom wants to give a bottle)
then have mother wake baby at least every 3 hrs to feed, and if baby
doesn't feed, express and spoonfeed colostrum. Of course this can be argued
to let the baby sleep/wake when he wants, but my experience is to be
proactive to lessen wt loss, jaundice, and hasten milk production.
4. assess mom's comfort with bf, latch, and milk transfer.
5. I do teach moms that especially after the first day, (but usually the
first day also) most babies will feed for 10 min or more, I do give moms
guidance becoz they really want to know what is a good feeding - 10 to 40
minutes, but a 5min feed or a 1 hr feed can also be normal. This is my
experience of over 30 yrs.
6. Monitor wet/dirty diapers - 1 each the first day.
7. In my experience, babies who feed frequently for only a few sucks have a
poor latch, usually. In my experience, babies who "use mom as a pacifier"
are trying to get a milk letdown.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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