Good morning friends!  (How odd to be typing to Lactnet during the day..)
I just got back from a hospital visit to a 35 week premie born by C-section
yesterday morning.  Mom had abrupto (sp?) placenta.  She only saw the baby
twice yesterday and tried to bf him both times but he's latch then fall
asleep.  He had some bradycardia and was lethargic.  He had been
finger-feeding yesterday, but would stop breathing.  There was concern that
he might have an infection or a heart problem.  Last night he was NPO and on
an IV as well his monitors. He was 5 lbs 10 oz at birth.
This morning the pediatrician had the IV removed and agreed to try him at the
breast.  I spoke to him before I went to the hospital and he said "Feed the
baby!"  But when I got to the nursery the nurse said her orders were that he
was to take 15 cc of formula, no more.  I went with the mom to the nursery.
 She has been pumping about every three hours with an electric pump and said
she gets about a teaspoon of colostrum at each session, but she's been
THROWING IT OUT because the nurses told her the baby couldn't have it, only
glucose or formula.
We got him on the breast this morning with formula in an SNS.  Now this is
the part that is hard to confess, because I think I screwed up.  I had
brought the SNS with me, but soon realized it doesn't have a 15cc measurement
on it.  I'm not a nurse, I don't work in the hospital and I don't know how
much 15cc is.  I estimated it was about half an ounce. The nurse had left me
in the nursery with the parents, so I couldn't ask her.
The good news is we got him on and after a slow start he got the hang of it
and nursed like a trooper!  He scarfed down all his formula.  The parents and
I were delighted.  He had the monitors on for the whole feeding and the nurse
came in and said the readings were good and left again.  Later the nurse came
back and said how much did he take?  I said he took almost the whole 1/2
ounce and she went ballistic.  I gather that's more than 15cc?  She said I
was going to stress the baby and it was going to throw off her blood sugar
readings because he didn't get exactly 15 cc.  I felt really badly.  I still
do.
I gave the mom some premie info ("BF Your Premature or Special Care Baby" by
Marsha Walker, "BF Your Premature Baby" by Gwen Gotsch LLL publication 26,
and the Ameda Egnell Pumping Pointers info sheet on premies) and made copies
for the pediatrician.  I dropped the info of at his office and he called me
in discuss how the feeding went.  I said it went well, but I was confused
about the limited intake when he had told me it was important to get fluid
into the baby.
Just then the nurse called the pediatrician to tell him I'd given the baby
too much formula.  He scowled throughout the phone call and told me the
baby's blood sugar was 35, thanked me (abruptly) for coming and turned to the
work on his desk.
Well I still feel terrible.  First off what is the rationale for limited the
baby's intake?  The pediatrician said he didn't want to "stress" the baby and
wanted to be sure he could tolerate oral feedings.  This is my first premie
baby.  Did I really put him at risk?  I also feel like I damaged my, as well
as other LC's, reputations by not giving him precisely 15cc.  It was
unprofessional of me.  Anyway, I'd appreciate information from your more
knowledgeable LCs about feeding a 35 week premie.
Thanks so much for your help!
Cynthia