Hi all,

I'm giving an hour inservice (for free, mind you) at a local hospital this
afternoon.  Yesterday the neonatal/pediatric clinical nurse specialist called
me to "just fill me in on a few things."  You know, sort of a "heads up."
 She had received my outline, and wanted to let me know that she disagreed
with just a few items.  To wit:

1.  Yes, they were doing cup feeding, but the "strict rule" was that no one
was to ever put more than 5 cc in the cup at a time, just in case the nurses'
arm was bumped and the baby got a big mouthful, choked & aspirated.  Sigh.
 Let us not make anything easy for the nurses.  Let's make it more difficult
so they will bottle feed the babies instead.  (This is the CNS that informed
one of my moms that nipple confusion did not exist.  There was no reason why
any preterm/full term baby given bottles couldn't/wouldn't go to the breast
if the mother was persistent enough.)

2.  For years I have recommended that if a mom is pumping, and just gets a
smidge of colostrum in the bottle/volufeed, that you add a tiny bit of
sterile water (or glucose water) to increase the volume and give it to the
baby.  Increasing the volume slightly keeps you from losing the colostrum
along the sides of the bottle, and teaches the mother that yes, her colostrum
IS valuable and the baby NEEDS every drop!  Well, apparently I am yet again
in grave error.  "We never give babies water for any reason" she said.  "It
screws up their electrolytes."
    While I was relieved to hear that they are no longer giving test feeds of
sterile water, I was a bit non-plussed to learn that 5 cc or so of water
every three hours would "screw up the electrolytes."  I've asked for the
documentation as I haven't heard that, and I suspect 95% of the hospitals in
America haven't heard that either.  So, I asked her what she recommended.
 Well, she'll put it in formula as she agrees the baby needs to get it.
 Wasn't she concerned about the potential for adverse reactions and allergies
to formula? I queried.  Now, netters, hold on to your hats, cuz I just
learned another new item!!  "Newborns don't HAVE allergies!!!"  After I
picked up my jaw and asked her to clarify what she meant, she said, "Newborns
don't have allergies to drugs & medications because they have to be
sensitized."  I said, "We aren't talking about medications, we are talking
about bovine protein and anaphylactic shock, including sensitization in
utero, or sensitization through giving one or two bottles of formula and a
response on the third or fourth go around."
   I got nowhere.  I asked her for her references, telling her this was new
information, and if this were the case, I'd need to change the information in
my classes "that I teach all over the country."  (I don't think that
impressed her either).  So, I've gathered up my references (thank you Ruth
Lawrence for several nice pages with documentation) that I could get together
hastily, and will give them to her today.

   I'm really looking forward to doing this inservice (NOT).  Why ask me to
do anything?  She obviously knows more than I do.....

Jan Barger, feeling very annoyed in Wheaton.